Re: [IPk] Sugar to Carb ratio? + ? dawn phen.
Pat,
When I sent the reply yesterday I had a sense that in a while, when we are
up and running, I might have a cringe factor for having wasted people's
time having asked daft questions. I am still suprised at the peace that
comes from feeling really heard on the lists. Feeling safe and supported
regardless of the questions makes it possible for me to breathe.
Thanks everyone
All the best
Mir
----- Original Message -----
From: "Pat Reynolds" <email @ redacted>
To: <email @ redacted>
Sent: 30 August 2004 07:45
Subject: Re: [IPk] Sugar to Carb ratio? + ? dawn phen.
> Hi Miriam,
>
> I think you will find it surprisingly easy when Grace starts pumping.
> You'll be given a carb-to-insulin ratio to start with (if you don't
> already have it worked out), which you will quickly see is either spot
> on, or needs adjusting a little.
>
> From then on, meals become a lot easier, in many ways: yes, you still
> have to consider carefully the long-term impacts of eating unhealthily
> (because for diabetics, the long-term impacts are worse than for non-
> diabetics), but this is just as you have to do for non-diabetic
> children. And as with non-diabetic children, occasional 'bad' foods
> such as chocolate, crisps, etc, are par for the course. No one will
> ever have to 'hide' eating from Grace again, as she will be eating
> alongside them (if other children are eating _very_ unhealthily, of
> course, you may want to encourage a community-wide change).
>
> To work out how much insulin to bolus, you just count up how many grams
> of carbohydrate there are to eat (or, often, how many have been eaten)
> and divide by the ratio number (they often start you off with 10, as
> it's easy to divide by, and it's a number that fits a lot of diabetics).
>
> On working out the basals needed: you can do this without skipping meals
> - indeed, some of us find that we have different basal needs when we
> skip meals! To do this: make sure that the meals while you are testing
> are the same. So always test overnight basals after exactly the same
> evening meal, and morning basals after the same breakfast.
>
> If you do see a peak a couple of hours after breakfast, you can check to
> see whether that's from a lack of basal insulin or from too little bolus
> with breakfast in one of two ways: you can either try moving breakfast
> by a couple of hours, and see if the peak moves too (rising time has to
> stay the same, though), or you can try increasing or decreasing
> breakfast (e.g. serving 1 or 3 rather than 2 weatabix, giving the right
> amount of bolus for that carb serving, but not changing the basal - if
> you find that there's less peak with a smaller breakfast, and more peak
> with a bigger breakfast, the problem lies with breakfast, if the peak
> stays the same, the problem lies with the basal).
>
> Don't worry if you can't work it out before you start. One of the
> problems with long-acting insulins is that they are incredibly variable
> in their action. So if some mornings Grace 'has' a dawn phenomenon, and
> on some she 'doesn't', this may just mean that on some mornings her long
> acting is peaking at different times, and it may take the few days to
> get it out of her system before you can start working on the basals
> properly.
>
> Smiling at the DSN sound like a great idea!
>
> Best wishes to you both,
>
> Pat
> dm 30+, 508 3+
> --
> Pat Reynolds
> email @ redacted
> "It might look a bit messy now,
> but just you come back in 500 years time"
> (T. Pratchett)
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