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Re: [IPk] musing on diet [long] and low carb intake

In a message dated 6/12/2003 9:07:11 AM GMT Daylight Time, 
email @ redacted writes:

> 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??
Hi Nanette,

To respond to your second question first: no hard data I'm afraid, but I 
 suspect that this phenomenon is more common in those who have had such
with control that the pump is a necessity.  I do of course accept that having 
varying basal rates which don't conform to injectable insulin action is a key 
reason for a pump, but that in itself can influence amount of insulin needed 
for meals etc (e.g. if your basal rate is 0.5 units at around breakfast time 
 but 1.5 units at lunch time, you'll almost certainly need more insulin at lunch
than you did at breakfast to cover the same amount of carb).

Yes, I've found the same problem with insulin and bg level.  I have an 
 exponential curve effect - with low bg I'm very, very sensitive to insulin (0.1
can drop bg by several mmol), at bg say 5 - 9 then 0.1 unit gives 1 mmol 
 drop, 9 - 13 then 0.2 unit for same drop, over 14 there seems to be a very
exponential rise so bgs late teens/20s, I can't predict - can take several 
 units for a few mmol drop!, and obviously I don't want to go hypo so I have to
it bit by bit and it can take all day to sort out...I was thinking about 
 graphing out the latter so I could have a good idea of how much to give, but I
I won't have to :-).  (So why don't I change the set when that happens?  
After checking everything first of course, if there aren't any ketones present 
 then the set and site are working and I just don't have enough space on my abdo
only place I can use - to waste a site.  But that's another topic :-) )

Sorry, this is "me, me, me" but at least you know someone else has similar 

Tori, I take your point about low carb intakes.  I believe that there's an 
article coming up about that in "Balance" (Diabetes UK's magazine) and I'll be 
interested to see if type 1s are included in it (I'm not holding my breath on 
pumpers :-) ).  However, it is possible to have a relatively low carb intake 
 and still replenish your glycogen stores, as long as some starchy or fruit
are taken (don't rely on tiny amounts in veg etc adding up over the day, a 
topical example to avoid is the popular Atkins slimming regime).  Also if lots 
of exercise is being taken, extra carbs are required (do _not_ follow the 
 example set in this year's London Marathon by athlete Zola Budd - sorry, I
remember her married name -  !!!).  A lowish carb regime suits me very well on 
work days but I wouldn't dream of hiking, sailing etc without plenty of carbs 
on board first.

(IDDM 30 yrs+, MiniMed 508 2.5 yrs)
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