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[IPk] Re: fasting to fix basal rates etc

Hi Tori
Thanks! finally I made another connection - the black cohosh - I think
this whole thing of finding that I needed lowered basal rates during
the morning when I eat breakfast and not when I don't (i.e. weekends
etc when I sleep in and days that I have to do fasting blood tests)
started when I started taking a tablet containing black cohosh
(Feminol) with my breakfast (says on the packet one should take it with
food) about a year ago, it has then become more extreme when I added
the linseeds with my cereal four weeks ago. In addition, now that you
have started me thinking, I mostly take another tablet of different
isoflavones (also for menopause related reasons) in the evening, and it
seems to me that it is on those not so rare evenings when I forget to
take it that my overnight BG seemed to be 'mysteriously'  - now not so
mysteriously - raised.
I'm thinking about the theory you quote below about exogenous insulin
being more effective with food - it does seem to tie in with my
experience, though the other thing I find that when reducing highs or
dealing with high carb eating is that raising the basal rate as well as
giving a bolus is much much more effective in getting BG down than
simply bolusing the total identical amount of insulin. I have a
Distronic Htron-plus so don't have the option of an extended bolus, so
can't tell how that would fit into the grand scheme of things.

Regarding what Tony and someone else (sorry I can't remember who) about
diabetics being essentially in a DIY situation, that it is the diabetic
not the doctor who enjoys/suffers the consequences of their more/less
successful BG control, and knowledgeable experienced diabetics being
typically much more capable of managing their diabetes than most
doctors, I of course agree totally. I had just pointed out that unlike
almost anyone else on this list (as far as I can gather) I seem to have
found (after some trial and error) a doctor from whom I have learnt a
lot about diabetes who understands that diabetics have a life, and is
very knowledgeable, very intelligent and open-minded and really looks
carefully at my blood glucose logs and listens to my concerns - this
doesn't enable me not to think about and address issues myself - on the
contrary the dialogue prompts and encourages me (as this list does too
of course) to be more proactive in my own diabetes management, just as
much as anyone else. 

>Something occurs to me, as I also find that BGs vary whether or not I 
>(although they vary anyway, so it's a little hard to figure it out!). 
>highest insulin need (highest basal rate 1.1unit) is from 8:30am to 
> and if I eat breakfast (which I usually don't), my basal needs to 
>lowered in that timeframe.

>What occurs to me is (and I don't know the technical or medical 
>words/expressions, so this may be clumsy) that I have always been told

>exogenous (injected) insulin is always more effective when given WITH 
>I wonder what the mechanics of that are, and if it's true. It
>seems true in me - hence if I have a high BG, giving an enormous bolus

>works far better in me if I also eat something (even if it is
>carb helps more).

>Any thoughts?

>Tori (I was taking black cohosh tabs - Remifemin - for an early 
>peri-menopause until recently, another isoflavone, and found also that

>insulin sensitivity decreased when I stopped taking them .... But I 
>made the connection until you mentioned it here!)

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