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Basal rates (was Re: [IPk] low carbs/no carbs)



Cathy wrote:

 >>>In theory if your basal rates are set up correctly you should be able to go
without food all day if you wanted to!

 I know this is the theory, but it would be interesting to know how many of us
can actually achieve this in reality.? Even using CGM to fine-tune my basals, my
levels will still drift around even overnight when I have no IOB and have not
eaten for several hours. If I skip lunch and go all day without food, chances
are I will have to make a small correction or eat a few carbs otherwise my CGM
readings will drift out of target range.

 At the Diabetes Technology meeting in Manchester in November, somebody from the
Hovorka group in Cambridge presented data from their Artificial Pancreas
project. Subjects had their overnight basals managed via a closed-loop system
using a CGM readout to control basal insulin delivery using a pump controlled by
a laptop computer. Subjects achieved an amazing overnight stability in blood
glucose levels, pretty much non-D levels! There were two interesting points of
note: 1. How many small changes in basal levels the pump was having to make. 2:
How much these levels differed over successive nights for individual subjects.

 If you bear in mind that the conditions for the study were carefully controlled
- subjects eating early and going to bed with no bolus IOB - this shows that
basal requirements vary over quite a short time scale and that they can differ
substantially from day to day. Maybe this explains why "Think like a pancreas"
notwithstanding, it can be difficult to maintain really flat BG levels.

Joel
.
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