Posted by Velinda on October 28, 2002 at 09:30:34:
In Reply to: bsl readings - what on earth should they be posted by Ed Timings on October 27, 2002 at 14:24:04:
To recap: you are giving daily long-acting (basal) insulin as well as fast-acting (bolus) insulin prior to meals. Blood glucose readings at 30, 60-, and 90-post meal are 18 and under (we have the same scales in Canada) -- yet, hours later the blood sugars are normal range (approx. 5 to 7, right?) before the next meal. Here's what I would do:
1. Check with your son's Dr. and print out and bring the Dr. any advice you receive on this (or other) boards. I don't believe I had much (if any) of a honeymoon period, and therefore, can't comment intelligently on what effects your son’s struggling islets have on b.g.
2. If I was getting readings like these, I would consider that my basal rate (long acting) insulin was too high and that
3. My fast-acting insulin was insufficient.
Fast-acting insulins begin acting within about 20 mins., and are significantly cleared from the system by 2.5 hours (or as long as 4.5 if it is an “older”—regular— insulin). Therefore, if the pre-meal readings are within range, it must be the long-acting brining them down. However, the unknown entity is that some of your son's islets are still functioning.
The pattern of “normalizing” before meals, despite going very high post-meals, is a classic example of too high a basal rate and too low a mealtime bolus. Have you monitored what happens to your son’s b.g.’s if he delays a meal? By delaying a meal 2 or 3 hours, and testing approx. every 40 mins., you can determine if the basal is close to correct. Should your son experience low b.g., when delaying a meal – it can be another indication that basal rate is too high.
You need to speak with your Endo., but, I would begin by testing basal (as above) and counting carbs/bolusing the fast-acting according to carb counts. You will need to watch post-meal b.g. levels very carefully and anticipate that, initially, lows may follow.
Finally, if your son’s HGA1C’s are good (around or under 7), he may be just fine. It is important to remember that life is for living and that diabetics risk becoming virtual slaves to their blood sugar monitoring and insulin regimes…yet, one must enjoy life and food! I hope others here can comment and assist you.