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Re: [IPk] Carb Book

> I am still having a few problems setting my basal. What works great for one
>night doesn't seem to work the next. I am not quite sure whether I should
>put up
>all my nightime basals as mostly I am waking up high which takes a bit of
>fiddling during the day to get right (14mmol in the morning). However
>I go to bed with 6 and wake up with 6 in which case if I raise the nightime
>basal I would probably go hypo.

Moira -

No answers, but a few thoughts...

What point in the night does it go high, when it does? Sorry, you'll have
to set the alarm clock :) Do you experience any dawn effect - a sudden rise
at 5am say? Is that what is causing the unpredictable highs? There's no
need to increase the basal for the whole night.

If you can sometimes go to bed at 6, and wake at 6, without food confusing
the situation, and samples overnight are on target, then clearly you're
doing something right. If it doesn't always turn out like that, keep a
diary, do some detective work and find out what sort of things throw you
off target. Usual suspects: are you having a mild night hypo and bouncing
back? Are you eating a large protein filled meal which turns to glucose
about 8 hours later? Is it alcohol/beer related? Do you sleep badly
sometimes? If I sleep badly, I get a high bg. And a high bg makes me sleep
badly. It's a vicious circle. To that end, Julia and I got an extra large
double bed and separate duvets. I now sleep soundly and usually have a good
waking bg. Is it women's things? Some women find their insulin requirements
change dramatically at the two key times of the month, and change their
basals accordingly. There's a discussion of this at www.insulin-pumpers.org.

Lastly, a pump doesn't guarantee you good bg's. It just gives you the best
chance of getting them, and a controlled way to respond to off-target bg's,
rather than just shrugging your shoulders ;-)

>Then there are weekends of course. I am usually
>more active running around doing stuff than during the week when I am slaving
>away over my bench in the lab.

Can you not use the temporary basal adjustment for this? Up or down 10%,
20%, whatever. The Minimed pumps can't do this. You can only set a new flat
temporary basal, and it beeps horribly on the hour, but the Disetronic
gives you more flexibility here. Use it.

>Washington is more of a challenge. Everytime I went to Wash. before my bgs
>mad and stayed high until I came home. I am curious to see what will
>happen with
>the pump. Maybe it is best just to set a flat basal when I go and then do any
>tweaking as I go along ? Suggestions from seasoned travellers welcome.

Sounds a reasonable strategy to me. Set an adequate flat basal, then test
every 3 hours and take a measured small correction bolus if it's high.

>There just seems so
>much to take into account every day that it sometimes seems quite daunting and
>frustrating as I can have one good day and then have a bad day for no obvious

I think you're a perfectionist, which is excellent :) The way I see it is
that what I now call a bad day, I used to call a good day, if you follow...
Celebrate the good days. Be phlegmatic about the bad ones.


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