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Re: [IPk] Care?

Dear Paul and Emily,

The doctor may be right: changing from velosulin to humalog, which is
much shorter acting, may help her to get balanced more quickly (but
surely that means H. is the one for her, long term, too ... I don't know
why he'd want to change her back ... ours not to reason why!).

I wonder if the highs are at least partially rebounds or overtreatments?
I am dutifully treating hypos with 15g of detrose, but am wondering if
this is too much ... often I go from 3 to over 10.  This is with no
other food.

Hypos always upset the metabolism, so my old rule was 'after a hypo,
drop the basal' - I guess this might be the rule for the pump, too.
That is, reduce rates a little for 12 - 24 hours.  There is also my old
rule 'first, get rid of the hypos, then bring down the highs'.  That one
does not go down too well with the current team, who want to see lower
results - but I want to see a flat line - and I don't care whether it's
at 7 or 12 - then bring the line down.  Good in theory, but I'm finding
with the increased sensitivity of the pump that I can tell the
difference between days in which I exercise and don't, and have
difficulty working out how to deal proactively with the increased
insulin efficiency.  

The thing which cheers me up on days like this weekend, when the average
has crept back up, is 'think how bad it would be without the pump'.  

I think, by the way, Paul, that you are being very supportive - there
should be a support group just for partners of people on pumps - it must
be very hard on you, too.

Best wishes,

dm30+, 508 1m+, 9 basal rates (ranging from 0.1 to 0.7 p/h).
Pat Reynolds
email @ redacted
   "It might look a bit messy now, but just you come back in 500 years time" 
   (T. Pratchett)
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