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Re: [IPk] musing on diet [long]

Dear Pat,

I wanted to thank you very much - you have stated very clearly, things
that I really sort of knew - the realization has been creeping up over
the recent months, but not in such a clear way.

It is clear that my insulin sensitivity (or resistance, to look at the
other side of the coin - endocrinologist said that anyone who uses such
small amounts of insulin should talk in terms of sensitivity not
resistance) is very sensitive to blood glucose levels. And I now tend
to believe that this is a major factor causing the difficulties I have
experienced in 5 and a half years of diabetes in achieving reasonable
control, since both basal requirements and bolus for food essentially
require a non-linear sliding scale according to blood glucose at the
time, in my case. 

I'm sticking to the diet for the time being because of the multiple
objectives, but hope that this has really been a learning experience
that will be useful also if I eventually return to eating a higher
calorie diet. 

As you say, thankfully I have the percentage changes in basal rates of
the Disetronic - I use this feature to raise or lower rates temporarily
almost every day.

But I'm also curious - are there any other people out there whose
insulin requirements are so sensitive to blood glucose levels, is this
common or rare??


>I really don't have much idea why you are getting so much better 
>from a diet with fewer calories and a slight shift from carbs to 
>and a change in fat source ....  But it does seem to be the amount
>that's eaten, not the source of the calories which is a factor,

>The only thing I can think of is that you have significant insulin
>resistance increase with higher bgs.  Most of us have some increased
>resistance (i.e. it takes more insulin to lower from 14 to 10 than it
>does to lower from 10 to 6, and a lot more insulin to lower from 24 to

>If after eating you get a peak (say from a normal stable six or seven 
>to 10), and at 10 you need twice as much basal as you do for the next
>three hours and so on ... Snacking (lots of peaks) would have a
>particularly bad effect.

>At least with a disetronic you can up your basal with a percentage to
>cope with high bgs!


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