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Re: [IPk] Back to high morning Bg's

On Fri, 20 Jul 2001, you wrote:
> If you lowered your carb input, and so increased the amount of protein you 
> eat, would it make sense to change to a longer acting bolus insulin (ie 
> actrapid)?
> Or do you take your humalog later after eating, or do you use square wave 
> boluses (and the like) with your pump?

Hi Ingrid
If you *always* ate high protein/fat and low carb, it  would make sense, but
you might not want to for other reasons. It would also affect your basal
insulin. In principle this doesn't matter, since it's constant, but in practice
it means that if, say, you want to turn down your basal for exercise, you have
to do it much longer in advance for it to take effect. Same for setting basal
rates,  making any basal changes, or turning off the pump.  So it can be a
pain. Some people like Actrapid in their pumps precisely *because* of this
slowness. I love the fact that Humalog works so fast, and that you can bring
down a high quickly, or stop the pump quickly. And if I eat fast carbs, I don't
have to bolus 30 mins in advance, which I would with Actrapid.

  Personally I would always go for Humalog, because you can deal with
the meals by using a square wave bolus, or dual bolus, or by taking the humalog
later. i usually take the humalog directly after I've finished eating. I use
the square wave and dual boluses for high fat meals, but I don't eat them much.
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