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<blockquote data-quote="Scott-C" data-source="post: 2003525" data-attributes="member: 374531"><p>Hi, [USER=326741]@NikC[/USER] , I agree with the above comments re considering split doses for pasta etc., but another thing to consider is whether your basal slow acting insulin dose is right. Google "basal testing". </p><p></p><p>Basal is meant to hold you steady between meals after the carbs from your last meal have been absorbed and the last bolus shot has worn out. It deals with the steady trickle of glucose from the liver which keeps us going between meals. </p><p></p><p>I sometimes just have a long lie in on a Saturday, watch a couple of movies and see whether I hold steady.</p><p></p><p>If basal isn't set right, it's a house built on sand. You'll either be having to bolus to bring down persistent rises if basal is set too low, or snack a lot if set too high.</p><p></p><p>I'd also recommend seeing if you can get yourself on freestyle libre, a sort of cgm, continuous glucose monitor, so you can see a continuous real time graph of how levels are moving. The prescribing rules are loosening up a bit from April 19.</p><p></p><p>It gives a much deeper insight into what's going on. </p><p></p><p>The "old" rules were along the lines of "don't test between meals unless you feel hypo and save corrections till meals."</p><p></p><p>The "new" rules with cgm, are that if you see a post-pasta unexpected rise appearing on your cgm graph, pin it with an extra unit or two at 7 to 8, long before it gets anywhere near 12.</p><p></p><p>Stephen Ponder's book Sugar Surfing (om kindle) is a good introduction to this sort of stuff. </p><p></p><p>He takes the view that because there are so many unpredictable variables in T1/LADA, while we can and should have a go at bolusing correctly for each meal, we should also accept that there is a fair chance of getting it "wrong", so shouldn't be shy of adding in a corrective dose between meals if the cgm trace is telling us we underbolused.</p><p></p><p>HCPs are terrified of the idea of us "insulin-stacking" through injecting between meals, but used sensibly with devices like libre which keep track of active insulin on board it is a perfectly sensible and safe way of steering bg into line in complex pasta situations. Ponder's book even has a chapter devoted to stacking for burritos!</p></blockquote><p></p>
[QUOTE="Scott-C, post: 2003525, member: 374531"] Hi, [USER=326741]@NikC[/USER] , I agree with the above comments re considering split doses for pasta etc., but another thing to consider is whether your basal slow acting insulin dose is right. Google "basal testing". Basal is meant to hold you steady between meals after the carbs from your last meal have been absorbed and the last bolus shot has worn out. It deals with the steady trickle of glucose from the liver which keeps us going between meals. I sometimes just have a long lie in on a Saturday, watch a couple of movies and see whether I hold steady. If basal isn't set right, it's a house built on sand. You'll either be having to bolus to bring down persistent rises if basal is set too low, or snack a lot if set too high. I'd also recommend seeing if you can get yourself on freestyle libre, a sort of cgm, continuous glucose monitor, so you can see a continuous real time graph of how levels are moving. The prescribing rules are loosening up a bit from April 19. It gives a much deeper insight into what's going on. The "old" rules were along the lines of "don't test between meals unless you feel hypo and save corrections till meals." The "new" rules with cgm, are that if you see a post-pasta unexpected rise appearing on your cgm graph, pin it with an extra unit or two at 7 to 8, long before it gets anywhere near 12. Stephen Ponder's book Sugar Surfing (om kindle) is a good introduction to this sort of stuff. He takes the view that because there are so many unpredictable variables in T1/LADA, while we can and should have a go at bolusing correctly for each meal, we should also accept that there is a fair chance of getting it "wrong", so shouldn't be shy of adding in a corrective dose between meals if the cgm trace is telling us we underbolused. HCPs are terrified of the idea of us "insulin-stacking" through injecting between meals, but used sensibly with devices like libre which keep track of active insulin on board it is a perfectly sensible and safe way of steering bg into line in complex pasta situations. Ponder's book even has a chapter devoted to stacking for burritos! [/QUOTE]
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