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Re: [IPk] Any Suggestions?

If you say that this is a "typical day", then something is wrong and you
need to contact your diabetes team and sort it out.

Why did you take 20g CHO at (02-03) and bolus 2 units? You could see that
your BG was going up.

The suggestion that you need to check your basal rates is a good one.
However, you should not adjust basals with checking with your diabetes team
first, until you have been on the pump for at least six months and things
have stabilised.

Start these tests when at least 5 hours has passed since your last bolus
insulin and 3 hours after your last carbohydrate intake. It is then that
only your basal rate will be affecting your blood sugars. Your blood sugar
at the start of testing should be between 5.5 mmol and 8.3 mmol. When your
blood sugar stays within 1.7 mmol from beginning to end of the test, you
probably have the right basal right.

Do not start to test if you are ill, after a hypo, after exercise, if you
are stressed or if you have eaten a meal with a high fat content.

Split your testing into 4 sections:

Between breakfast and lunch.
Between lunch and evening meal.
Between evening meal and bedtime.

Test the night basal before the day tests because activities that affect
blood sugars, like exercise and eating, are suspended during the night.
Check your blood sugar before going to sleep and again at 2am. Tests should
be repeated until the required results are obtained two or more times at the
same basal rate settings. When the correct night time basal has been
determined, a normal waking blood sugar will be easy to achieve. Don't
forget the 2am test!

It is then time for the day time testing.

For the period between breakfast and lunch, miss breakfast and check blood
sugar every two hours. Have lunch as normal.

For the period between lunch and dinner, have breakfast but miss out lunch,
again check blood sugar every two hours. Have evening meal as normal.

For the period between evening meal and bedtime, have lunch as normal but de
lay having evening meal by about 2 hours, again check blood sugar every two

Cautions in Testing Basal Rates:

Test your blood sugar any time you feel it may be going high or low.
If your blood sugar drops to lower than 4.0 mmol. Cancel the test for that
If your blood sugar goes above 11.0 mmol. Cancel the test for that day.

Contact me for a Fasting Record Sheet as used by the Royal Bournemouth
Hospital, (I need a postal address to send it, it will not e-mail). Then
please follow the directions for all daytime testing. Check and record blood
sugars where you see an *. Give the results to you diabetes team who will
assist you changing your basal rates.

Finally, if your hospital has the MiniMed Continuous Glucose Monitoring
System, request that you be put on it. It measures and records your blood
glucose level and produces a computer printout showing your levels every 5
minutes over a 72 hour period.


John Davis,
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