Insulin Activity Surprises

Kelsey Bonilla Living With It I am a California Girl (in the best sense of the term!) I was born... Send Message Subscribe: Kelsey Bonilla

Tuesday, October 28, 2008
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As most of us know, many diabetics experience increased insulin needs during the early morning hours. Dawn phenomenon is common, and needing more insulin to cover breakfast is also pretty typical. I know that I need far more insulin before 1:00 or 2:00 p.m. than I do for the rest of the day. Latel...

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Untitled Comment
Scott Johnson
Tuesday, October 28, 2008 at 11:50 AM

Yep, has happened to me too. I think there are a lot of variables that can play games with these hard and fast numbers programmed into our brains and devices. I've heard, for example, that the actual size of the bolus can modify the duration of action (a very large bolus will "hang around" a lot longer than a smaller one).

I think we settle for these pretty simple numbers for a couple of reasons. 1) There would be WAY too much to deal with if it got much more complicated than it already is, and 2) Diabetes doesn't like to always follow those mathematical rules.

re: Untitled Comment
Kelsey Bonilla
Tuesday, October 28, 2008 at 12:22 PM

Hi Scott!

Yes, large boluses definitely behave differently than you'd expect. I guess that's why eating low carb works so well for diabetics, because then you avoid ever having to deliver a huge insulin bolus.

That's interesting about the duration being modified by the size of the bolus... I'm going to keep a closer eye on that. Thanks for the tip!

Temporary Basal Rate
lcakes
Tuesday, October 28, 2008 at 01:24 PM

Have you ever tried raising your basal rate higher for a couple of hours? Sometimes it seems to help bring down a high faster than just a correction bolus.

Laura

re: Temporary Basal Rate
Kelsey Bonilla
Tuesday, October 28, 2008 at 01:41 PM

Hi Laura,

Yes, temporary basal rates are wonderful! I don't find that they help me bring down a high "faster" but they certainly work efficiently at lowering blood sugars that are raising steadily. Also, an increased basal rate can help lower blood sugar without causing a low, as can often occur with aggressive correction boluses.

It sounds like you might be suggesting a correction bolus and a higher basal rate... that's probably the best of both worlds! It's good to remember that we can combine techniques to achieve our desired results.

Thanks!!

Kelly
Anonymous
Wednesday, October 29, 2008 at 08:48 AM

Sometimes it is just unexplainable. I have my pump set to 5hrs (this is what John Walsh now recommends). I think the temp rate is the best whenever it is running high (rather than overbolusing).

Sometimes it is just a good idea to change your site as the insulin may have pooled (for lack of a better word).

All in all, we will have days that we will run high; and as long as it is not too high, bolus lightly and use a temp rate of 5% for a couple of hrs - see what happens.

MaryAnn