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



Hi Ivan

Thank you for that.? 

 This is all very interesting and has given me a number of things to think
about!?

 Does anyone else mix their insulin like this in the UK? ?I haven't heard of it
before.? It sounds like it could be a very good option to sort some of the
things out.??I'll discuss it at clinic next time I go.

Many thanks,

Anna




-----Original Message-----
From: email @ redacted
To: email @ redacted; email @ redacted
Sent: Thu, 3 Jul 2008 10:02 pm
Subject: Re: [IPk] Re: High bgs 2 hours after meal



Hello Anna,

Just one comment about your low basal rate and high insulin sensitivity:
Unlike with long lasting insulin injected traditional way, basal rate
supplied by the pump is non-continuous. Basal rate is basically high set
of small equally distributed "boluses". My paradigm 722 uses shots of 0.05
IU of insulin and I suppose it is similar with other pumps. So in your
case basal rate of 0.30 IU/hour is turned into 6 shots of 0.05 IU every 10
minutes (you should hear a click coming from your pump anytime this
happens). My analysis shows that these shots are sometimes too high making
fluctuation of interstitial glucose level with peaks +/- 1 mmol/l with
frequency of couple of minutes. This results into poor overall diabetes
control with measurable highs and lows and higher need of insulin.
To reduce this fluctuation, you may think about mixing your insulin with
injection solution (I am sorry this might not be the proper name in
English) in rate 1:1 or even higher. This is normally done in case of
small children. It requires a bit of calculation as your basal rate and
boluses must be set twice higher, but it is not that big price for the
results it brings. My overall insulin consumption dropped by 40% after I
started mixing it in rate 1:1. And I also realized that less strong
insulin is milder to the insertion site.
I am just in the middle of experiments and analyses, I expect to provide
better explanation with some graphs and advice on my page in around one
month time.

Best regards    Ivan

>
> Thank you Jackie.?
>
>  This is really useful. Yes, I do find that when I have better control
> with
> consistently lower blood sugars I am more sensitive to insulin. The
> thought of
> getting all levels under 7 mmol for a day would be a miracle though,
> something I
> have never yet achieved.  I'm already very sensitive to insulin with a
> correction sensitivity of 6 mmol/L per unit insulin, and find that my
> blood
> sugars historically swing from high to low. I am on a low dose of insulin
> with
> one basal rate of 0.30 units/hour and a total daily dose of less than 20
> units.
> It doesn't take much to go hypo and most days I have at least one.
> However,
> following all three breakfasts since on the pump (started Monday) I have
> had
> these high blood sugars (as on MDI) which, Like Laura, return to the
> normal
> range before the next meal.  I have gone low before the next meal at
> times, when
> no active insulin is left, so maybe the basal needs reducing as well.
>
>  Thank goodness I am now on the pump and have the opportunity of sorting
> all
> this out.
>
>  Many thanks for your comments, if you can think of anything, else I will
> be
> very grateful.
>
> Anna
.
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