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Re: [IPk] Re: ip-uk-digest V1 #92

>I'm new to this list, so, typically, i'll start with a question. I've been
>pumping for nearly 3 months and i still have not been able to get the right
>bolus:basal:cho rate for my breakfast . The rest of the day i am in
>reasonable control, but breakfast remains a problem. My present Bolus: CHO
>rate is
>1:20. However if i apply this ratio to my morning meal, within an hour my BG
>shoots up from about 5.5 mmol/l to about 16mmol/l  stays there for an hour
>and then goes  back down to its original value about 4 hrs later. If i take
>more insulin with breakfast then i go too low before lunchtime.  Does anybody
>have any advice on how to avoid this early morning excursion?

Robert -

Breakfast is typically an extremely difficult time to balance everything.
It's the same for me. I don't claim to have found any golden solutions. The
blood circulation is reduced at this time, and various waking-up hormones
increase your insulin resistance.

But it sounds to me like your insulin timing is at fault. If the bg returns
to normal later, you're probably getting the right amount of insulin, but
too late.

What insulin do you use? If you're on Regular/Actrapid/Humulin, you could
try Humalog which hits the system much faster. If you're already on
Humalog, try taking it earlier. I typically take my breakfast bolus as
quickly as possible after I wake up, to allow it to get into the system
sooner. Then I get up and wash and potter around before breakfast. I also
find coffee exacerbates the sharp rise.

Hope some of these thoughts help...


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