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Re: [IPk] Adjusting basal rates



Hi Gillian

Keep in mind that insulin sensitivity can be greater at night than
during the day - you might need less insulin for your carbs at supper
compared to what you need for breakfast and lunch.

I am not sure what you mean when you say, "But then that would mean
not doing anything when going to bed unless my blood was very high."
You are aware that your pump can deliver a bolus smaller than 1.0
unit, yes?

Melissa
Animas 2020 user 1 year, pumper 12 years total

On Thu, Jun 26, 2008 at 9:32 AM,  <email @ redacted> wrote:
>> 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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