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Re: [IPk] Re: Bad Day Today



I'm glad both Barbara and Andrew have discussed the pros and cons of
bolusing before or after a meal. Within days, it was apparent that Charlie
might not eat what he intended  - it was often a case of his eyes being
bigger than his stomach!! Bolusing after a meal seems very sensible and
we've certainly been dong it - but we haven't asked for a professional
opinion.

Barbara D
----- Original Message -----
From: <email @ redacted>
To: <email @ redacted>; <email @ redacted>
Cc: <email @ redacted>
Sent: Friday, November 08, 2002 10:34 PM
Subject: [IPk] Re: Bad Day Today


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> Hello Andrew and thanks for the in-depth reply.  You wrote:-
>
> I wouldnbt expect Humalog (I assume thatbs what youbre using) to be
gone
> in
> only 3/4 hour.
>
> Danielle has been prescribed Novorapid and our nurse told us that it
should
> have done its job by 3/4 hour so I assumed that there would be no insulin
on
> board after this time and if her bg was still high, I should correct with
> another bolus.
>
> Another thought b what did Danielle actually eat that you calculated the
4
> units for?  Was it something that digested slowly and therefore peaked
after
> the insulin was most active?
>
> Well it was a funny night because she had ballet and tap at 4.45 till 6.15
pm
> so I gave her ham sandwiches (2 slices) and gave a bolus of 2 units for
that
> and when she came home she had a baked potato with beans which I estimated
at
> 50 g CHO and gave her 2.5 units.  Her bg rose to 19.6 so I gave her a
> correction bolus of 4 units at 8 pm.  As I am writing this I am thinking
that
> I have definitely gone wrong and I feel so guilty.
>
> are you bolusing before or after Danielle eats?
>
> I am bolusing about 3/4 of the way through the meal because I don't want
her
> to go too high.
>
> Ibm also a bit surprised that the nurse didnbt suggest that you change
the
> infusion set when Danielle went up to 28.9
>
> She did suggest that but in the meantime Danielle had responded to the
> correction bolus afterwards and came down to 18.5 so we set a temporary
basal
> rate to 0.5 units per hour for the next 4 hours (she is normally on 0.3)
and
> she came down to 8.2 an hour later.
>
> We have just tested her blood and she is 13 but I am not going to do a
> correction because of last night.  I will see if the rate of 0.2 through
the
> night on basal is enough to bring her to a decent level in the morning.
> Danielle always goes low at night so that is why the night time basal rate
is
> starting at 0.2.
>
> Thanks again
>
> Babs x
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