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Tackling the Unexpected

By Karen Graffeo

Guest Blogger

Posted:  10/23/2012 3:00 PM


In my last post I talked about using my pump’s Dual Wave Bolus feature to tackle foods that are rough on my blood sugar. But the Dual Wave isn’t the only feature on my pump that helps with my blood sugar management. I also make use of the Temp Basal function to try to cut down on highs and lows.

When I was on multiple daily injections I sometimes found the inflexibility of my long-acting insulin tough.  My endo had recommended reducing my 24-hour dose a bit if I knew I’d be having an unusually active day. But in life things are often spontaneous. A day of hiking can be ruined by an unexpected storm. A quiet day can quickly become anything but. Now that I’m pumping I appreciate having more flexibility for unplanned activities. By setting a Temp Basal rate, I can turn my basal up or down by a certain percentage in half hour increments for as little as thirty minutes or for as long as 24 hours.  Why might I do this?

I might set a higher temp basal when:

• I’m sick and it’s causing my blood sugar to soar.
• Hormonal changes are making my blood sugar high.
• I’m at a party and grazing on snacks throughout the evening.
• I’ve eaten a meal that makes me spike long after my Dual Wave finishes (Mexican food does this to me every time).
• I just have a very high sugar that won’t budge down.

There are also times setting a lower Temp Basal helps me avoid hypoglycemic episodes, such as

• When I’m doing aerobic exercise.
• When hormonal changes are making my blood sugar low.  (Yup, depending on the time of month, hormones may spike me or make me drop.)
• When it’s time for bed and I’m not quite low enough to need a snack, but I can see my blood sugar is trending down.
• When I’m going out shopping. Trips to the grocery store or to Target tend to bring on lows every time.

Of course, as with my Dual Wave Boluses, the Temp Basal settings took several discussions with my doctor and some trial and error. And there are times when I still end up too high or too low. But usually they help me stay closer to the range I’m aiming for, and that lets me enjoy my day even more!

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Bethanne Straser

Posted on Wed Oct 24 17:10:26 GMT 2012

People might think I'm crazy, but I love being diabetic. It has given me a close relationship with my body. I know my hormonal cycle down to the meal... :D Basals up for sickness, for hormonal swings, for stress.

Today, I've been sick for 11 days with a cold. A cold, a nasty virus that has no rememdy but time. Without that temp basal, I'd have spent the last week with sugars well over 180, continually correcting with each bolus. Not any more. With the CGMS, fingersticks, and the temporary basal options, now I only feel sick for one reason, not two.

Great article, Karen. Thanks for sharing.

Linda Morango

Posted on Wed Oct 24 21:59:36 GMT 2012

Your comment about shopping trips sometimes causing lows is much appreciated! I told my endo about this happening and she insisted that "normal" activities should not cause lows unless My basal was wrong. So reading your comment wil help me to make adjustments when shopping. I guess to her, normal shopping may mean picking up a few items, not shopping once weekly for a family, pushing a fully loaded carriage, loading a truck, unloading, flights of steps, not to mention putting all the stuff away. Thank you!

Dennis Knibb

Posted on Fri Oct 26 01:22:59 GMT 2012

The major reason that I pushed to get on an insulin pump was to get away from having to fight lows all day or having to add correction to every bolus because of hard to lower high blood sugars from something as simple as a virus, or an infection. Thanks for the blog posting.

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