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Technical question about basal insulin

Discussion in 'Parents of Children with Type 1' started by quiltinmom, Mar 23, 2011.

  1. quiltinmom

    quiltinmom Approved members

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    What happens if your basal insulin stays a little too high for an extended period? By extended period, I mean a weeks or months, not just hours or days.

    The body has an amazing ability to adapt. The liver is always pumping out glucose, right? So we cover it with basal insulin. If basal is too high for a period of time, does the liver adust to increase glucose output, to compensate? Then this might lead to increase in the need for insulin, because BGs would start to rise. If this continued to happen, would it be enough to cause the person to gain weight? (or they'll just have lots of lows and gain weight from eating the extra food.) Would the body's ability to avoid lows be impaired, because the liver's stores would be less?

    If so, then if we lower basal a little, might it adjust back again, eventually?

    I read once that it's better to have basal be a teensy bit high, and correct with food. I'm wondering if there are any effects of having the basal a little on the higher side (besides the obvious: lows).

    Does anyone understand how that works?

    Thanks!!
     
  2. Ashti

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    We've always given DD a bit more basal than she needs, to help cover her grazing through the day and evening. There is no change that I can see to her basal needs from doing this. They are what they are.

    But regarding what you say about the body's adaptability, we have seen basal insulin needs go down when she hasn't eaten much for a number of days due to illness or other factors. They come back up when she starts eating regularly again.
     
  3. Sarah Maddie's Mom

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    Hmmmm :confused: I don't know for sure, but I'm thinking weight gain. But I can't explain why :p but still, I think that.:rolleyes:
     
  4. sarahspins

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    I run my basal a little on the low side... I think it's a much safer model than relying on food to stop/prevent lows....
     
  5. Darryl

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    Because there is no self-regulation with D, the liver does continue to produce glucose but somewhat randomly, not in normal response to the BG level. So having too high of a basal rate, whether for hours or months, results in the need to eat more carbs. This could cause weight gain if basal is significantly higher than needed.

    As mentioned above, many of us do set basal a little to the high side because of the risk factors of high blood sugar, and also because recovering from a mild low is easy whereas once BG gets much above 140 the body becomes insulin resistant and much more insulin than normal may be needed to bring BG down
     
  6. Heather(CA)

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    I don't know for sure, but I doubt it's the bodies response to basals, more likely something else, like you waited so long the weather affected it:confused:
     
  7. sarahspins

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    I should have elaborated, I rely on temp basals (usually +20%) a lot to make up for running mine lower... so my basal needs are actually being met just fine, I just don't have my pump set to give me 100% of the basal automatically. It's probably somewhere around 85-90% right now.

    I find that taking a more active role in what my basal delivery is every day actually helps me stay on top of things better. I took the lowest rate my prior basal pattern used, and I have that single rate set as my current basal profile.

    If I know I will need a higher rate for a little while (like that time of the month) I will switch to a different profile with a slightly higher rate, and run temps on top of that. The same goes for if I suddenly find myself needing less (usually when I am sick and not eating much).. I will set the rate on that other profile lower, and switch over for a while.
     
  8. SarahKelly

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    For our son we found, like Darryl stated, that his insulin needs increased more when he was having highs. For us due to his young age and the nature of the toddler grazer the answer was to increase his basals otherwise his bolus' never caught up with his food intake. So, he gets about 60% of his TDD as basal. This has actually brought his average TDD down from 8 units to 6 units. I know teensy amount of change but for a little guy that's significant and more so it has meant that he's staying in a healthy range for his age more often than not, lows and highs are easier to treat and he seems to feel better with this set up.
     
  9. mmgirls

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    If you are wondering about weight gain and increased basal needs then I would be thinkin witht the age of your child that purberty is around the corner.

    Otherwise if weigh is coming on TOO quickly and lows are a common thing, then yes running a too high basal and feeding the lows can increase weigh in an unwanted way. My dd getts "starving" when bg is low, below 65, and will eat additional carbs than needed just because of the starving feeling.

    during the summer I usually leave basal alone even thow they should come down because fer basal need is lower, but I will feed the excess basal with carby drinks and snacks and I will raise her I:C ratio. I would rather have her drifting down and give a few carbs than be running around with a big bolus about to peak, KWIM.

    I hope some more educated people can give you the physilogical answer that you are looking for, but my non technical gut feeling is that a high basal does not = weight gain for everyone, depends on the lows and the treatment of those lows and if additional carbs are consumed duing that time.
     

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