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Tricky insulin landing on target BG
From: j-dumas@see-sig2fix.com (Jim Dumas)
think I've discussed this analogy on usenet to date.
I look at my target BG (90 mg/dl) as a mountain trail on the crest (apex)
of a steep glucose mountain. The task is to lightly touch-down on the
trail, and stay on the trail that follows a cliff face on the left.
Below the cliff is hypoglycemia that takes little insulin to push you
into when at the target BG. So the tail of an insulin dose must end
quickly to prevent this HG abyss. This is very difficult to achieve with
the older Regular insulin with typically 8 hour tail. The newer 5 hour
tail, fast-acting designer insulins make this easier.
On the right side is a more gradual downward slope with increasing BG as
you go down (pulled by metabolic gravity). Landing on this right side is
not as drastic. But BG is high when the insulin dose finishes above the
target BG. If I increased my basal insulin, I could force this BG to be
a new target. But insulin is in the growth hormone family, so smaller is
better to prevent cancerous growths. So I have to take a small bumper
dose of insulin to get up the slope to the target BG trail.
If I don't correct this right side landing, metabolic gravity (liver
glucose output) will pull me lower on the slope and increase my BG. So
this is a slowly degrading location on the glucose mountain. My BG will
gradually rise. But I have time to work on the problem.
Note that the glucose mountain is not symmetric. I could fall into
hypoglycemia on the left side cliff very quickly. On the right side,
there is a slow increase in BG if not corrected. The target BG
equilibrium point is controlled by basal insulin and is tricky to land
on. As you get close to this target BG, insulin becomes more potent, as
metabolic gravity (liver glucose uptake) suggests on the left.
The problem is to achieve a soft landing on the ridge trail where you can
stay in equilibrium for hours. But it is a dangerous place to be with an
insulin dose working for meals (not basal). The point to remember is
it's tricky to stay on this target BG trail. But not impossible.
The left side is too much and the right side is not enough insulin.
--
Jim
Still kick'n! Low tech T1 4/86, no complications.
Email addy mangled: change see-sig2fix to mindspring to correct.
