Hi David, I did read your blog. I get the impression that your belief is that you do not need basal insulin but rather short acting bolus insulin such as Novalog to cover mealtime carbs. Your assumption may be correct but I want you consider that your first response insulin may be impaired because you pancreas is unable to build up insulin stores because it is constantly playing catch up. In this case basal insulin may be needed to help replenish those stores. First response insulin is for the most part insulin stored by the pancreas for quick release when carbs are ingested, if insulin production is to low to rebuild those reserves then first response is impaired. I believe first and second stage insulin response is covered in Bernstein's book and just such a scenario is mentioned. It seems to me that by the time your pancreas catches up it has nothing left to cover the sudden onslaught of mealtime carbs.
I love the fact that you are putting so much effort into analyzing this. I just want to give you another solution to ponder.
Gary S
