So, my T2 endocrine system still puts out a weak insulin response. Basically, through basal experimentation I've found that I can turn on up to 1U/hr basal without any effect on my BG, as well as turn it off with the same result.
This tells me my basal requirement is about 1U/hr. My pancreas can handle it (hence no rise without exogenous), an with more than 1U/hr exogenous my BG falls, at a rate roughly proportional to the basal rate.
SO! Given all this, how to calculate boluses? No problem if I'm basaling with my pump. I used to, but turned that off with the goal of getting my Omnipod to make it the full three days on 200U of insulin.
However, this means I'm making user of endogenous insulin production, so things like complex boluses are a bit more interesting to calculate. Basically, I've got to account for the basal as well during any extended bolus.
Here's what I'm doing in a sort of simplified TAG: For a high-protein, low carb meal, I'm doing the usual TAG adjustments: immediate bolus for the carbs, and an extended bolus over 3 hours for the protein, calculated as 50% of the weight in equivalent carbs. Then, I'm adding 3U to the total, delivered over the 3 hour extended, to account for the basal.
If I don't do that, because no basal is being automatically added to the infusion on account of my basal basically being off, the normal basal delivery by my pancreas doesnt happen so long as there is plenty of circulating insulin.
That's my theory, anyway. I seem to be having better results this way.
So, two points to this thread: Thoughts? And 2, maybe it will help someone else fine-tune their management.