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Bolus?

jlarsson said:
Most people put on weight after diagnosis to more or less gain back what they lost I think, I certainly did. I can't speak for anyone else when it comes to gaining more than was lost though as I have always had freakishly high metabolism. Is the difference in your metabolism due to diet or some other condition, or for all I know some lady parts thing that I would know nothing about?
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I think the lady parts thing is a real giggle maker!! There's been no change in diet, I was never a carb fan before T1 and I eat probably even less than before because of cutting out fruit big style. All conditions are the same that's what's leading me to question bolus and I suppose basal too. @jlarsson
 
Mel dCP said:
That’s what I was trying to say. Obviously the dose I was recommended to take was wrong, as I had to eat large amounts of carbohydrate to avoid hypos. No drop in weight or activity in that time, although I am slowly losing weight now that I’ve cut my carbohydrate intake and matched my dose to my new requirements.
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Crazy how many health professionals do this to people like they did to you. People trust them with their lives and for their guidance. So many deal with unsatisfying lives because what happens is they can never get there diabetes under control and think this is the way it will always be based on what their health care team tell them.
 
Brendon.Dean said:
Crazy how many health professionals do this to people like they did to you. People trust them with their lives and for their guidance. So many deal with unsatisfying lives because what happens is they can never get there diabetes under control and think this is the way it will always be based on what their health care team tell them.
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I should have known better, I’m a trained scientist. But I trusted them with my health. I’ve taken charge a bit more, the confidence of getting older!
 
I may be in the minority but I tend to almost always question advice given to me, I want reasons for why the advice is better. Not "because that's what's the industry says" but the actual logic behind the advice. This tendency annoys a lot of people, but sod them.
 
jlarsson said:
I may be in the minority but I tend to almost always question advice given to me, I want reasons for why the advice is better. Not "because that's what's the industry says" but the actual logic behind the advice. This tendency annoys a lot of people, but sod them.
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My dad’s best friend was our family GP when I was growing up. So I had an implicit trust in the medical profession that’s taken me a long time to get over. And now I realise they’re just as human as the rest of us, with their own beliefs, foibles and failures. Still, I got there in the end.
 
Mel dCP said:
My dad’s best friend was our family GP when I was growing up. So I had an implicit trust in the medical profession that’s taken me a long time to get over. And now I realise they’re just as human as the rest of us, with their own beliefs, foibles and failures. Still, I got there in the end.
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Yeah, and this applies to everything and not just the medical profession, people will have different approaches to just about everything. I know f all about silversmithing but I expect there are people who prefer one tool over another, one temperature over another and so on, all with their own reasoning that may be better in their own preferred context but may be wrong in another. Replace that with diet versus medication and you have the diabetes debate, replace it with offence versus defence and you have the sports debate, replace that will trickle down versus spread the wealth structure of your choice and you have the economy debate, and so on.
As we both know with our experiences with the Libre, looking at what actually happens after we eat and inject certain things and amounts and learning from it is far more important than just blindly following advice from a doctor or nurse that doesn't have anywhere near enough information about you to give you accurate advice. What I think is often forgotten when people complain over GP advice is that they don't actually have a ton of information about you, just because they have some numbers of your blood sugar or the number of carbs you consumed at a specific time doesn't mean they know the circumstances of those instances, whether you were ill during those spikes or if that meal was low in carbs but rich in proteins or whatever.

Sorry for the rant. ;)
 
mountaintom said:
Shouldn’t it be slightly higher than target to count for any exercise that might be done? You don’t want to be at 5mmol from basal alone without exercise.
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The target isn't a universal number. Everyone has there own personal target blood sugar which they would like to maintain for example mine is between 6 mmo/L to 6.5 mmol/L whereas someone else might be on the higher or lower side.
 
Brendon.Dean said:
The target isn't a universal number. Everyone has there own personal target blood sugar which they would like to maintain for example mine is between 6 mmo/L to 6.5 mmol/L whereas someone else might be on the higher or lower side.
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Your fasting basal is 6/6.5...what happens if you do some exercise without eating?
 
mountaintom said:
Your fasting basal is 6/6.5...what happens if you do some exercise without eating?
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That target would be the same for me. I personally have my cgm targets over night different but really before and after exercise, why would we want it to be any different?
 
mountaintom said:
If my fasting bg was 6.5 and I ran about for a bit I’d have a hypo.
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But it depends oon a lot of factors with lots of people... is that run about for a bit everyday, just weekends etc? Even runabouts can be catered for, but, if it isnt a normal day to day activity then basal testing wouldnt be a necessity. Basal testing is important as well to say whether you would need a snack before activitys or during or after or if on a pump, if a reducdd basal is needed and at what time.

It is still around basal testing, and whether exercise can be managed with or without foods or reducing basal rates etc..
 
donnellysdogs said:
But it depends oon a lot of factors with lots of people... is that run about for a bit everyday, just weekends etc? Even runabouts can be catered for, but, if it isnt a normal day to day activity then basal testing wouldnt be a necessity. Basal testing is important as well to say whether you would need a snack before activitys or during or after or if on a pump, if a reducdd basal is needed and at what time.

It is still around basal testing, and whether exercise can be managed with or without foods or reducing basal rates etc..
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It’s all about the bass(al) :D
 
mountaintom said:
Your fasting basal is 6/6.5...what happens if you do some exercise without eating?
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@mountaintom

I always exercise in the morning while i'm fasting to prevent my post meal high blood sugar from being insulin resistant. If it was evening time weights or exercise I would reduce the amount of insulin given for the carbs I eat.

Also if you wake up with 6.5 mmol/L and didn't eat and went about your day and go hypo, your basal dosage is incorrect.
 
Brendon.Dean said:
@mountaintom

I always exercise in the morning while i'm fasting to prevent my post meal high blood sugar from being insulin resistant. If it was evening time weights or exercise I would reduce the amount of insulin given for the carbs I eat.

Also if you wake up with 6.5 mmol/L and didn't eat and went about your day and go hypo, your basal dosage is incorrect.
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So are you saying that exercise does not affect the effectiveness of basal insulin? i.e. I could tune my basal so that upon waking, and not eating, I am within my target range? And doing exercise while fasting will not lower my BG?
 
mountaintom said:
So are you saying that exercise does not affect the effectiveness of basal insulin? i.e. I could tune my basal so that upon waking, and not eating, I am within my target range? And doing exercise while fasting will not lower my BG?
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@mountaintom
Exercise increases insulin sensitivity, so you have two options, change your basal insulin dosage or change your fast acting insulin dosage to change your blood glucose. I do not touch basal insulin in this scenario unless my body starts to drop in blood glucose, in which case I stop basal insulin.

The variable though, is everyone's body is different so what I do may not work for you; you have to test out what works for you.

Are you on a pump or on long acting and fast acting?
 
Brendon.Dean said:
@mountaintom
Exercise increases insulin sensitivity, so you have two options, change your basal insulin dosage or change your fast acting insulin dosage to change your blood glucose. I do not touch basal insulin in this scenario unless my body starts to drop in blood glucose, in which case I stop basal insulin.

The variable though, is everyone's body is different so what I do may not work for you; you have to test out what works for you.

Are you on a pump or on long acting and fast acting?
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Long and fast.
 
mountaintom said:
Your fasting basal is 6/6.5...what happens if you do some exercise without eating?
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There is no reason why the target has to be the same 24/7.
For me, I would have a different target if I was to do some exercise.
Some people may want a higher target when they go to bed compared to when they are awake.
 
helensaramay said:
There is no reason why the target has to be the same 24/7.
For me, I would have a different target if I was to do some exercise.
Some people may want a higher target when they go to bed compared to when they are awake.
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I’m afraid a lot of what I do is unplanned so I can’t live like that. If I changed my basal one night to account for something I planned on doing the next day then I’d probably end up not doing it.
 
mountaintom said:
I’m afraid a lot of what I do is unplanned so I can’t live like that. If I changed my basal one night to account for something I planned on doing the next day then I’d probably end up not doing it.
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This thread is about Bolus not Basal.
So, my comment was about adjusting your bolus immediately before exercise to reach your required higher target... or topping up with a few carbs if you were a bit low. This includes, maybe, drinking dilute squash during exercise to maintain your levels.

However, I have found having a pump gives me even more control for exercise: I only have to plan 60 - 90 minutes ahead, drop my basal and maintain the same target.

My point is, there are ways to be able to exercise at short notice with diabetes: you don't have to plan weeks ahead.
 
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