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Re: [IPk] Insulin resistance (I am missing something)



sounds similar to me Di
if I've had an odd high earlier and it has come down with a standard bolus:  
say a few units for BG of 20, this does not affect my basal needs as much as 
if  I have had loads more carbs than usual and bolused for them ( when I say 
basal  or bolus I now refer to injections). A BG of 20 for me would normally 
 mean I had missed insulin whether by forgetting an injection or in the pump
days
due to a  huge air bubble.
Also inactivity combined with loads of protein and fat  is a  lethal 
combination for me- high lipids in the blood cause insulin resistance  and a 
 proportion of protein gets converted to glucose. ( as over Christmas. I love
meat and
nuts and am not particularly bothered by sweet things  so realy go to town on 
the protein foods and tned to be innactive for several  days at a time rather 
than gymn or swimming 2 or 3 times per week. levemir had  to be increased by 
about 30 per cent and huge boluses were given but BGs still  spiralled out of 
control.I was glad to get Christmas and New Year over and out  of tempatations 
way and back to my normal routine- of course if I had some good  old fashioned 
self discipline...)I was not afraid to increase the levemir as I  knew the 
 reason for increased requirements would last several days and as I got back to
normal I could taper it down - also I think the effects of adjusting the  dose 
are more instanteous than that of lantus
 
I find the reasons for needing more basal with large protein and fat intake  
easier to comprehend than that for needing an increase due to increase carbs 
and  bolusing causing more insulin resistance. Certainly I have heard that 1/3 
to 1/2  of total daily insulin should be as basal (of course not in all 
cases)so if you  give loads more short acting things become out of proportion. 
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