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Re: [IPk] High sugars in early morning and after set change

Dear Colin,

I'd try and see what happens without the breakfast before altering the
basals.  It does seem a rather sharp rise - but I don't eat cereal
(blagh!!) so I don't know what my body does with the stuff.

If going without breakfast would make life not worth living, try eating
half as much, and seeing if you get a smaller rise - but doing proper
basal testing is well worth it (i.e. going without food for several
hours, so eventually you have the whole 24 hrs pattern).

Best wishes,

dm 30+, 508 1+, must type up her bg diary from her weekend in Boulder

In message <email @ redacted>
, email @ redacted writes
>I finally started on a pump two weeks ago, and am currently in the process
>of trying to get Basal rates stabilised.  I have noticed two things which
>both affect me during mornings.
>Firstly, my BMs shoot up when I get up/after breakfast (I haven't yet
>determined what happens if I don't eat breakfast).  One morning I tried
>testing regularly to see what happens and these were my results (My target
>BM at present is 10):
>06:30  13.6
>06:40  Breakfast (Bran flakes + semi-skimmed milk) 75g CHO, 5.0 unit Bolus
>07:00  16.3
>07:20  19.5
>07:45  16.1
>08:30  17.3
>09:30  15.2
>I wouldn't expect a meal like that to induce such a rapid rise in BM, but it
>is completely repeatable day after day.  Has anyone else had a similar
>Secondly after a set change (9mm/43" Quickset) my sugars always go a lot
>higher during that morning and will usually require a couple of correction
>Boluses to get back into normal range.  I am confident that I am doing the
>set change correctly, priming the set, and giving a 0.5 unit prime bolus to
>fill the cannula after insertion.  Again has anyone seen anything similar
>and have any constructive ideas?
>The good news is that I have been fully funded for both Pump and
>consumables.  This was all done for me by the Pump Clinic at Guy's, who
>contacted my health authority (Sth Essex) and arranged funding.  This was
>all done before I could see Dr. Pickup for the first time (Which happened
>back in January). I had initially been referred at about this time last
>year.  Since January, Guy's have tried tweaking a few things with MDI and
>using a Glucowatch and Minimed CGMS to look in detail at what goes on,
>before coming to conclusion that a pump would be appropriate.  This decision
>was then made in May, which meant a new financial year and therefore
>re-applying for funding.  Fortunately this came through fairly quickly and I
>started on Saline on 9 July, and on Insulin on 15 July.
>       Colin - MM 508 2 weeks.

Pat Reynolds
email @ redacted
   "It might look a bit messy now, but just you come back in 500 years time" 
   (T. Pratchett)
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