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Re: [IPk] erratic bg



Marcia,

My guess is that you should increase your post-supper basal rate immediately.
If you are indeed a couch potato after dinner, it's likely that your body
needs more insulin to keep your normal CHO:insulin ratio working.  You may
also be underestimating your supper CHO even though you're good at it for
breakfast and lunch.  Do you eat about the same menu for breakfast and lunch
each day?  You may know how much insulin to take for those meals because your
insulin requirement is consistent, not because you're actually guessing right
on the CHO (I say that because CHO counting took me longer to learn than I
thought it did!  I underestimated CHO almost constantly for a couple of
years).

Another possibility: you didn't mention whether you're on Regular or Humalog.
If you're on Regular and you eat a rather late supper, your insulin may not
have had time to work by the time you do your post-prandial test.  A third
possibility: there's something in certain meals that sets you off.  For me,
pasta, bananas, pizza crust, and cheesecake mean taking several extra units of
insulin.  A friend of mine can't deal well with cornstarch.  Perhaps you have
a trigger food or ingredient that shows up on your dinner plate but not at
breakfast or lunch.  Lastly, you didn't mention if you have a glass of wine or
a beer or a glass of milk (or any/none of those) with your meal.  Remember
that wine will probably make you go down on an empty stomach but up on a full
one; regular (not "light") beer has 12-15g CHO per 1/2 pt.; and milk has 12g
CHO/cup.  I have many times forgotten to add insulin for my drink.  Doing that
and underestimating my CHO intake by about 30g is enough to give me a very
nasty bedtime bg.

Good luck!

Melissa Ford
IDDM 7 years; MiniMed pumper 5 years
----- Original Message -----
My biggest problem since using a pump is my bg often goes high during the
evening even though my pre-evening meal bg is at a good level, 6 or 7.  I
think I count the carbohydrates and work out what bolus to take quite
sensibly
but my bg still goes sky high (18 - 20) by 10pm and I am having to do
corrections in order to bring it down.

Does anyone else have this problem and, if so, how do they get around it.  Do
you think it's because I am a couch-potato most evenings?  I am not a big
eater and have average sized meals and never eat a dessert of any kind.  What
am I doing wrong?   Help, please!

Marcia Neil
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