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Re: [IPk] ip-uk-digest V5 #1326

Hi Nanette
 I take comfort in the fact that achieving "perfection" is not a realistic
approach to diabetes management!


 > On 1 Nov 2020, at 11:11, Nanette Freedman
<email @ redacted> wrote:
> o;?Hi John,
> You can use 0% temp basal - as you say, and as I have also learnt by
> unfortunate trial and error, temp basal is much safer than suspend.
> My excellent endo has also pointed out to me that as one gets only (I'm 71)
> low BG is something to be wary of more than high - I hate high's even
> though thankfully I don't suffer breathlessness. I do worry about what will
> be as I get older - my husband is enormously caring but far less involved
> than you are - to be fair this may be in part because I've preferred to be
> independent.
> You write about 'getting time factors right' - my approach to diabetes is
> that I am so obviously affected by most if not all the 42 factors that BG
> control cannot be an exact science for me (and this fascinates me - as a
> Medical Physicist, I've been working at the interface between the exact
> science of physics and the variability of human biology most of my working
> life) - so I do not think in terms of getting factors right - absorption of
> the same foods may be different at different times, writing emails or
> talking on the phone can send BG sliding or even shooting up or down, right
> is what works for me today at this hour, not some absolute 'correct'
> factor. The pump and  Libre are lifesavers. And thankfully my consultant
> understands all this and is not judgemental though he does come up with
> helpful suggestions.
> Best of luck
> Nanette
>> On Sun, 1 Nov 2020 at 12:52, John Gareth Hicks <
>> email @ redacted> wrote:
>> Hi Nanette
>> No, hadn't seen the 42 factors article, thanks a lot for pointing me at it.
>> A quick flick through and I can identify with several factors, have
>> printed it
>> out to go through in detail with Jean.
>> You may have gathered she isn't "computer friendly", just as well that I
>> spend
>> half my waking hours on one or the other (2 ipads and an imac).
>> Yes, that's the advantage of Dual Wave as long as we get the time factors
>> right, we don't always.
>> After confessing to using 'Suspend basal' to our consultant we now have
>> two
>> Temp Basal's set up. one at 200% and the other at 10%, the options are
>> limitless.
>> I did once forget to cancel Suspend Basal for 3 hours and we certainly
>> paid for
>> that lapse !
>> Reminds me of a recent occasion in lockdown when I started one of our two
>> vehicles to charge the battery, intending to go back out and switch off the
>> engine after 20 minutes, remembered 4 hours later !
>> Didn't do much for the local environmment that day.
>> I should mention that I am an octogenarian, Jean catching up fast, I can
>> tell
>> you that these age related memory issues are real !
>> John
>>> On 1 Nov 2020, at 07:24, Nanette Freedman
>> <email @ redacted> wrote:
>>> Hi John,
>>> In case you haven't seen this, it might be of interest:
>>> https://diatribe.org/42factors
>>> 42 factors that can raise or lower BG
>>> I was wondering when you write that you find dual waves of insulin
>> helpful,
>>> I assume this is because you stop the longer "dual" part of the bolus if
>> it
>>> is clear that the food that it was intended to cover was not eaten. By
>> the
>>> way, another trick that I find can help further in this sort of situation
>>> is to set the basal rate to zero temporarily.
>>> Best regards
>>> Nanette
>>> On Fri, 30 Oct 2020 at 16:55, John Gareth Hicks <
>>> email @ redacted> wrote:
>>>> Hi Rosie
>>>> Unfortunately Jean now associates breathlessness with a high bg so
>> starts
>>>> to
>>>> panic when the libre shows 8 bg, say, with an upward pointing arrow.
>>>> She is a bit lax with the timing of boluses, doesn't always pre bolus so
>>>> some
>>>> foods race away ahead of the insulin.
>>>> I find dual waves are a plus since she frequently can't finish the meal
>>>> she's
>>>> based the bolus on.
>>>> Thanks for the input
>>>> John
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