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Re: [IPk] Adjusting basal rates

> Hi Melissa

Do you think I should have corrected by less than 1u. I was just thinking
1u would bring it down to about 7.


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:
>>>> 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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