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Re: [IPk] Re: High bgs 2 hours after meal

Crikey.  I'm getting my pump next Wednesday and I think my head just  
exploded reading that!!

Kind regards,

On 3 Jul 2008, at 12:20, <email @ redacted> wrote:
> Hi Laura,
> It's hard to be sure, but it sounds as if you are
> absorbing the carbohydrates you eat faster than the
> insulin is working - so your blood glucose levels
> shoots up, and only later the insulin you took for
> the meal is bringing down your blood glucose. Some
> possible things that might help are (i) take the
> bolus a bit earlier before you start eating (I find
> less of a post meal high if I take my breakfast
> bolus about 15-20 minutes before eating), (ii) try
> changing to a different insulin which might act
> faster in you (various people have found differences
> between Humalog, Novorapid and Apidra, but not the
> same in all people), (iii) try using a superbolus -
> the basic idea of the superbolus is this: for
> example in your case, it looks as if you are
> bolusing the right amount of insulin for the carbs
> you eat, but it is acting too late - the superbolus
> is a way of getting more insulin acting sooner -
> currently in the 2-3 hours from the time you take
> your pre-meal bolus, you get the bolus (say 5 units
> insulin) which is injected at the beginning, and the
> basal (say 0.8 units/hour) spread gradually over the
> time, so over 3 hours, you have a total of 5 + 0.8 +
> 0.8 + 0.8 = 7.4 units of insulin, and it seems as if
> over the whole 3 hours, you are getting the correct
> amount, but you need more of it to act sooner - one
> way to do this is to take not only 5 units as bolus,
> but say 6.5 units as bolus, and reduce the basal
> accordingly over the next 3 hours to 0.3 units/hour
> - so over the whole 3 hours you get the same total
> amount of insulin, but you get more of it early on,
> so the effect should happen faster, and no, it is
> not a crime not to inject exactly the correct amount
> for the carbs you eat and to switch between basal
> and bolus (insulin in your body doesn't have little
> labels saying basal or bolus, and your body doesn't
> know the difference and will just use it as needed
> when it becomes available). I started doing this on
> the suggestion of my diabetes consultant, and it
> works very well for me, particularly for meals with
> a lot of carbs and little fat or protein - not
> advised for a meal of a lot of protein and fat. For
> a more official and formal and detailed explanation
> (and if you want to see that this isn't just my
> stupid idea) see
> http://www.diabetesnet.com/diabetes_technology/super_bolus.php.
> Good luck
> Nanette
>> Hello, i've only been on an insulin pump for 2
> weeks now but i've always had
>> this problem, even on injections. After i have a
> meal, my blood shoots up
>> sometimes right up to the 20's and particularly in
> the afternoon it's still
>> high at 2 hours after the meal, usually around 16.
> It always comes back down
>> by tea time though. I'm really not sure what i can
> do to help this but it's
>> really frustrating cos i'm trying very hard to keep
> my levels at a decent
>> level to improve my hbA1c and these aren't gonna
> help.
>> Thankyou
>> Laura
> .
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