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Re: [IPk] Adjusting basal rates



> Hi Melissa

Last night my blood at 7pm was 6.4, then 9pm was 11.3 then at 11pm was
12.1 so I corrected by 1u which I think normally brings my blood down by
4-5. I am wondering now if I still had bolus on board from my bolus at
7pm. But then that would mean not doing anything when going to bed unless
my blood was very high. Or maybe I should have had my bolus before my meal
- usually I have it at the same time. I only had 4u at 7pm with my meal of
36g which doesn't seem a lot to start with.

Many thanks
Gillian

Hi Gillian
>
> If you were on MDI it might be appropriate not to bolus for <10 g
> carbs because it could be impossible to measure the right amount of
> insulin without overdoing it and giving yourself a hypo. However with
> the Animas 2020 pump you can measure a bolus as small as 0.05 units.
> Unless you are hypo or just about to exercise it is probably safest to
> bolus whenever something with carbs in it passes your lips!
>
> I don't mean to question your DSN but I would be curious how many
> years she has worked with pumps on a regular basis and what percentage
> of her patients are using pumps. It sounds like she is either
> uncomfortable with the technology or very old-school in how she
> expects patients to use it. If she has been dealing with pumps for a
> long time and is just set in her ways, you may benefit from a referral
> to someone else next year (while you are still getting to grips with
> having a pump, a bit more structure may be beneficial - but if these
> 'rules' she is telling you are meant to be permanent policies you may
> need to move on).
>
> My insulin:carb ratio is 1 unit to 10 g carbs. My correction factor is
> 1 unit to 2 mmol/L. Taking it backwards, 10 g carbs ought to raise my
> bg by 2 mmol/L. So if I didn't bolus for 10 g carbs when my bg was
> already 7, I shoud expect it to go up to 9 mmol/L. I correct my bg
> whenever it is above 7 though. With the tiny increments of insulin
> that we can give by pump compared to syringes or pens it could be
> considered a waste of the technology to bolus only as though we are
> using a pen.
>
> Did you do extra activity in the afternoon yesterday? Sometimes
> exertion can cause a hypo several hours later during sleep.
>
> Take care
>
> Melissa
>
> Melissa
> Type 1 15+ years; MiniMed pumper 7.5 years; Animas pumper 4.5+ years
>
> On Thu, Jun 26, 2008 at 8:59 AM,  <email @ redacted> wrote:
>>>Hi
>> I was doing what my DSN said to do which is if your blood is 5, 6 or 7
>> and
>> you have something with less that 10g carb then don't bolus for it but I
>> guess maybe that isn't right for me. After having a bad hypo at 4 this
>> morning I now have something else to think about!
>>
>> Thanks for your replies.
> .
.
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