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Re: [IPk] Late blood sugar rises and now, What to pumpers do?

Hi Jackie
Could you try for a few days not using any of the GF products with wheat 
starch but no gluten and see if that makes a difference? 

I wouldn't suggest going back to Actrapid, but maybe just trying the Novorapid 
after the meal instead of before.

On pumps it's really a matter of trial and error.
Jacket potatoes or very slow-acting carbs (like lentils) mean I need a square 
wave bolus. What I do is this: say I would normally take 3 units of insulin 
with my meal. Instead I would try taking the same 3 units, but over a period 
of 3 hours instead of all at once (the Minimed pump has a facility to let you 
do this). If I did this and found that I was going high an hour after the 
meal, then I'd maybe try taking the 3 units over 2 hours instead. And keep 
experimenting till I got it right. For a jacket potato I now know I need to 
take the insulin over about 2 hours, and I need less insulin than I would 
normally take for that amount of carbs (I don't know why!). As with anything 
to do with diabetes, it's never entirely predictable, because you have so 
many other variables like exercise, alcohol, phases of the moon, etc. etc.
So you just have to do the best you can. I always favour the trial and error / 
test and adjust approach, because my control is quite unpredictable, but some 
people are much more scientific about things. Elizabeth and I are almost 
totally opposite in our scientific vs trial and error approach to things, but 
neither method is really better - different things just work for different 

On Thursday 17 Jul 2003 6:54 pm, you wrote:
>  Thanks Di. I am trying different things. It may just be that the last few
> days meals have been either,
>  higher fat, or protein than usual. I do get a bit concerned that Sasha is
> going low soon after the meals
>  because that is what was happening when she was diagnosed with coeliac.
> She would go low, then very high
>  again later. I am wondering if some of the GF products that contain wheat
> starch with the Gluten
>  removed is affecting her. Damaging the gut. In the UK we use the Codex
> grade wheat starch with the
>  gluten removed, but actually there are always molecules of gluten left
> behind and in the US, Canada and
>  some other countries, they will not allow wheat starch to be listed as GF,
> but as low gluten. Some
>  people cant tolerate the GF wheat starch, but some can with no ill
> effects, but as the twins have never
>  had many noticeable symptoms it's difficult to tell. The trouble is that
> the gluten free wheat starch
>  breads etc are much more like "real" bread and taste better and keep
> longer. The twins are not keen on
>  some of the things made with strange flours, like potato and rice flours.
> Nor am I!!!!!!
>  I did think about using Actrapid for the evening meals but I didn't really
> want to go back to that again.
>  So what to people who pump do to deal with peaks that come later, hours
> after a meal. I know you can
>  increase the basal rate but how do you know just how much to give. Is it
> always quite predictable how
>  much and when the BG will increase? Or do people just test oftener and
> bolus the amount after the rise?
> Jackie
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