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Re: [IPk] Hypo control

Hi June
Ah, I forgot you had gastroparesis too. I bet that contributes to the 
hypo problem. It sounds as if because of the gastroparesis, you're now 
taking the insulin too much too late and it is mismatched against your 
food, or that the food is out of your stomach before the end of the 
insulin action. Or perhaps you are eating foods with a quicker action 
for your evening meal.
I'd start with cutting your evening meal bolus and/or reducing the basal 
a lot earlier, and then dealing with the post-meal high if it happens, 
once you've got rid of these awful hypos. It might help also if you were 
to try skipping your evening meal and seeing what happens to your BG.
*word of warning* - if I don't eat in the evening (or eat very little) I 
have to reduce my overnight basal by quite a lot.


June Searle wrote:
> Hi  Diana
> What you say is exactly what I said to the DSN - it is just as if there 
> is a pool of insulin which works in the night.  Up to Christmas 
> everything was OK.  After that I was worried with sight problems and 
> this seemed to affect control and it got very difficult.  I was very 
> depressed and felt I couldn't cope properly.  My requirements seemed to 
> go up and up.  I then tried changing the site from tummy to legs 
> thinking absorption was the problem and the site change made more 
> variables but seemed to settle down until 3 weeks ago when the problems 
> were at about 2.00 am.  This 5.00 am trick was a new one for me.
> I am beginning to think it is not the basals at all but the bolus after 
> all. As I have gastro paresis I do not put the insulin in too quickly or 
> I might go hypo in the meal.  If I don't inject sufficient I do not come 
> down a couple of hours after the injection.  How low do you go 2 hours 
> after a meal?  I think you are correct about cutting the bolus for my 
> evening meal and this will mean putting up with a higher bg for a while 
> so there is something for the insulin to work on.  It sounds simple.  
> Got to do something.  I was sitting here long the computer last night 
> and felt perfectly OK.  I didn't want to face bed.  I made a move at 
> 2.00 am and did a test.  It was 1.9!  I felt OK!  Still, once corrected 
> I got through the rest of the night and had perfect control this morning 
> again.
> I'm afraid I do very much less exercise than you due to pain and 
> breathlessness.  Trouble is, according to the chart showing ages of 
> pumpers, I must be one of the oldest.
> Thanks for listening.
> June
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