[nashscan]

I started pump therapy yesterday. Before that, I was taking 12 units of lantus at night, and an I:C ratio of about 1 unit per 8-12 carbs, depending on how active I was. It kept me from spiking much at all after meals, and my blood sugars were kept within 30 points from bedtime to sunrise.

My new CDE now has me taking .65 units/hour, which comes out to 15.6 units/day basal. She's got my carb ratio of 1 unit/11 to 13 carbs. I'm spiking up well into the 200's after meals, and my increased basal is very slowly bringing down these high post meal sugars over a period of hours.

I've e-mailed her about this, and she replied if the blood sugars stay high like this over the next few days, she wants to increase my basals. I really really don't think that's the answer. I feel I need to be more aggressive with my bolus, and ease back on my basals. I e-mailed her again and she said

"the way pump therapy works, the basal rate controls blood sugar
overnight and to some extent, between meals. The meal boluses control
blood sugar for the first 2-3 hours after eating a meal. People often
need significantly more or less insulin over night compared to daytime
hours."

Well, yeah. Mmhmm. What do I do? I REALLY REALLY don't think more basal insulin is the answer!