[Previous Months][Date Index][Thread Index][Join - Register][Login]
[Message Prev][Message Next][Thread Prev][Thread Next]

Re: [IPk] changing basals

> I have found, like Di that my basal requirements change frequently. I
> often
> rely on temporary decreases to 70 0r 80%
>   and also, increaeses to 120 or 130%. I,m not sure why this is as my
> day to
> day activities do not change drastically. i assume it's hormonal
> although it
> doesn't follow a predictable pattern. Even with these adjustments i
> think
> I'm being too conservative as i still managed to have around 5 hypos
> this
> week( 3 of which were below 3 mmols). Also, during the days when i
> require
> more insulin I don't manage to avoid hypers ( BG in teens) and
> premeal BG is
> often 8 to 10 which in the year before i went on the pump I would
> have been
> delighted with but now realise I'm not feeling at my best (
> presumabley
> because I'm spiking considerably higher than this after food)
> Also I've recently had some hypos 1 to 2 hours after food during
> which I
> really plummet ( because of humalog bolus). Sometimes this is because
> I over
> bolus but it certainly wasn't due to this
> yesterday.
> do others find that their insulin carb ratios change along with basal
> changes ( ie if basal rate has decreased do you find you need less
> insulin
> per given amount of CHO)
> I find hypos after food particularly annoying and distressing as
> obviously
> this is one time where ou really don't expect it
Yes, yes, all of the above apply to me too, and I too am probably too
conservative about changing basals (so my endocrinologist says) - at
the back of my mind is always the thought that if I change my basals
today to accomodate the pleasant run of nice normal blood sugar
measurements I have been having for the last 3 days (wow, 3 days in a
row where the same things are happening!!), then for sure by tomorrow I
will get into one of those high blood sugar phases and need to set them
back, or to even higher than previously.  So I too prefer to use the
feature for setting temporarily higher or lower basal rates.
The lack of stability is incredibly frustrating - a no-win situation. 
It could be hormones (menopause perhaps doing erratic things, but I
dont think it is only that), but there is no rhyme or reason to it.  It
has been like this throughout my now almost 3 years since diagnosis of
DM.  The chief advantage of the pump (2 years pumping now) for me is
that hypo's are almost all briefer and less deep, because they are not
prolonged by longer acting insulins, and hypers can be corrected fast,
conveniently and with small and accurate doses, minimizing the risk
that correcting a hyper will drive me hypo.
With all this stuff, my HbA1c has come down somewhat on the pump, but
nowhere near I would like it - still just under 8.
As for those hypos an hour or two after eating, I have had those too,
just occasionally.  They generally seem to occur in two situations: 1)
if the meal contained a large amount of protein and/or fat which may
delay absorption of the carbohydrate substantially - one way to attempt
to avoid this is to use a square wave bolus if your pump does that, or
otherwise divide the bolus into two parts, and take the second part
only towards the end of the meal, or 2) if I exercise immediately after
a meal - this has happened to me when I walked home from town to walk
off a large restaurant meal - seems to me that the magnitude of the
exercise effect is sometimes but not always greater if the exercise is
immediately after eating - my conjecture is that this is either because
the enhanced sensitivity to insulin has a particularly dramatic effect
at this time, or maybe that the exercise may also delay digestion and
absorption of carbs.
Incidentally, I had a flu vaccine this morning - can I expect any
reaction in terms of higher blood sugar during the next day or two?

Do You Yahoo!?
Yahoo! Messenger - Talk while you surf!  It's FREE.
for HELP or to subscribe/unsubscribe, contact: HELP@insulin-pumpers.org
help SUPPORT Insulin Pumpers http://www.insulin-pumpers.org/donate.shtml