What can I do better?

17 01 2008

My last A1c was a 5.9%, but I fear it isn’t going to be that good next time. My 30 day average keeps scooching up, bit by bit. First it was 124, then 126, then 127, now up to 129. I know I’ve had a few strings of highs which can be partly attributed to fighting off illness and that “special” time of the month. Ugh. However, I’m sure there’s more I can do across the board. But what?

1. Tweak basal rates?

I know my numbers improved a lot when I did a small shift from .75 per hour to .8 per hour (during the day). Should I try another small shift to .85?  At the very least, I would like to do an overnight basal test to make sure that’s set correctly because I haven’t checked that in awhile.

2. Tweak insulin/carb ratio?

I’ve already adjusted my morning i/c ratio to 9.5 (compared to 10 for the rest of the day) and it does seem to reduce that post-prandial a bit.

3.  Tweak correction factor?

I already feel discouraged when I have a high that Won’t Come Down, but now I wonder if it’s because I don’t have my correction factor set properly.   I’ve already adjusted it to 55 (down from 60), but maybe that needs more looking into.

4.  Try bolusing 20 minutes before eating?

This CANNOT be done in the morning because I just don’t have enough time.  But, I think I can swing it during the rest of the day.  I almost always bring my lunch in to work and I eat at a regular time, so this might be the meal to start with.

Overall, I feel like I’m doing okay.  Basal is around 53% of TDD,  correction is around 5% of TDD, average blood sugar is below 130.  But I know I can do better.  Any other ideas?

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3 responses

17 01 2008
jeff

hey amalas, thank you for the tip on pizza. here is a trick that i use(actually my endo guides me through this) to tighten up the numbers game. the trick is in getting your bolus and basal to get as close to equal as possible. whenever i have concerns about tightening up my numbers, we always look at where a certain basal rate can be changed and it seems to help. im not sure how you go about making basal changes, most of the time i do mine through carelink and with my endo. of course im still workin on getting my A1c down though……

how are things in MO?

jeff

17 01 2008
Sara

Actually you want your basal to be 60/40 or 70/30 of your total according to Pumping Insulin. Have you read it? It really helped me figure out my rates pretty well.
Are you only running one rate during the day? In a 24 hour period I am actually running 6 rates. Maybe some more variation in basals during the day will help you get what you want.
My A1c is 5.8 at last check and I was pretty happy – I’d be happy with 5.9 too! Sounds to me like you are doing pretty great!!

17 01 2008
Amalas

I used to have more rates during the day, but I found them to be too complicated and not all that helpful.

I do have Pumping Insulin, but have not read it lately. Maybe I will have to take a look again.

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