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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. 
Nanette

>Something occurs to me, as I also find that BGs vary whether or not I 
fast 
>(although they vary anyway, so it's a little hard to figure it out!). 
My 
>highest insulin need (highest basal rate 1.1unit) is from 8:30am to 
11:30am 
> and if I eat breakfast (which I usually don't), my basal needs to 
be 
>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

that 
>exogenous (injected) insulin is always more effective when given WITH 
food. 
>I wonder what the mechanics of that are, and if it's true. It
certainly 
>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
non-carb, 
>but 
>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

my 
>insulin sensitivity decreased when I stopped taking them .... But I 
hadn't 
>made the connection until you mentioned it here!)



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