Another trick up my sleeve

7 10 2009

I’ve been using the super correct method to get my blood sugars down.  I have updated my technique to make it work a little better.

1.  I did end up doing the super part as “fill cannula”, which does annoy me that it doesn’t get tracked anywhere.  However, I imagine newer pumps will have this feature built in.

2.  I do the fill cannula in 2 steps, per Bernard, so that the last number listed is the correct “fill cannula” amount.  This prevents any weird things happening when I change my infusion site.

However, the newest trick added to the arsenal is using a temp rate to combat a low without having to eat Starburst.  =D

This mostly works because I have a Dexcom and can see these things coming.  If I am just above target, but going down too fast or have too much IOB, I will set a 10-15% temp rate for half an hour.  This small drop in insulin is enough to get me to my target and stay there, instead of dropping below and having to eat something to bring it up.

Just one more thing to add to my arsenal.  Take that, diabetes!


Fed up

4 06 2008

So, I’ve been having a problem with my dinner numbers for a loooong time now.  I brought it up at my last diabetes appointment (not with my endo, but with a diabetes educator) and she had absolutely zero clue as to what to do.  So, time to ask the blogosphere!  Here’s the deal:

  • for most of the day my basal rate is at .55 units/hour
  • 6:30 pm Blood sugar’s fine (90-110), bolus (1:10 I:C ratio) and eat dinner (varies).
  • 7:00 pm LOW LOW LOW, usually around 65-70.  I try VERY hard not to overtreat; usually just have 1 or 2 Starburst and that’s it.
  • 7:30 pm basal rate gets kicked up to .75 units/hour
  • 8:30 pm Typical 2-hour after dinner test yields a moderate blood sugar (140ish) with just about the right amount of insulin on board.
  • 9:30 – 10:00 pm  HIGH HIGH HIGH, easily at 170+ with practically no insulin on board.  Correct heavily and go to sleep, hoping I don’t overtreat and go low overnight.
  • 10:00 basal rate goes down to .60 units/hour for overnight

So, fellow PWDs, what’s going on?  At first I thought it was a combo problem with eating a high-fat meal (i.e. need less insulin up front and more extended insulin to combat fat), but I find this pattern no matter what food I eat.

I’ve thought of decreasing my I:C ratio to maybe 1:11 or 1:12, but I still worry about going high later.  Also, I wouldn’t think that a I:C ratio problem would show up as quickly as 1/2 hour after eating.

I’ve also wondered if the resulting high is a reaction of my body because of the low.  I do try very hard not to overtreat, but maybe my body is still freaking out anyway.

I suppose I could do a combo-style bolus at dinner, but that probably means there’s an underlying basal problem.  However, my last dinner basal test with similar rates (not quite exactly the ones I’m using now, but very very close) yielded steady numbers.  I can probably try a dinner basal test again, which will be much easier with Charlie, but other than that, I’m out of ideas.  Thoughts?

Control. Maybe a little too much…

3 04 2008

Well, I’ve gotten my 30 day average down to 120.  Hurray!  Other averages I check (21, 14, 7, and 3) all look great too!  I am fully looking forward to around a 5.6 or 5.7 at my next endo appt on April 15th.

Side note: Yes, I’m seeing a real endo.  I finally made an appointment with the best Type 1 endo in the area.  I just hope he’s good.

However, this lower average comes with a cost.  More frequent lows.  About one every other day.  Lame.

GiR threw a fit during my last low and said that I should do more basal testing.  Well, yeah, perhaps.  I’m just trying to get better control, and with better control comes more lows.  I’m also exercising more (more about that in a separate post), which is bringing my insulin requirements down.  I’m still figuring everything out.  For now, I’ve set my target blood sugar back to 95.  Hopefully that will help slightly.

I do miss the times when I wasn’t scarfing down Starburst every 15 minutes.  However, I certainly don’t miss those 200s.  They can kiss my ass.


20 02 2008

As you may know, I’ve been trying to pre-bolus at lunch to get my lunch post-prandials down. Today, like any other, I did just that.

11:38 or so: Test blood sugar. 89. Great! Bolus for 44g carbs for frozen dinner thing and a yogurt. Plan to wait around 15 minutes before fixing lunch.

11:48: Post about finishing a fantastic knit sweater.

11:51: Begin working on post about cupcakes and wombs.

12:05: Post about a tasty goleem.

12:08: Begin freaking out because it’s been 1/2 hour since I’ve bolused and I haven’t eaten yet.

12:12: Scarf down both lunch and Starbursts in an attempt to bring self back up from a stupidity-induced low.


What went wrong?

19 02 2008

I’ve been trying to get my blood sugar down just a hair, closer to a 115-120 average, instead of 125-130.  I tried some different things.

  1. I lowered my “target” blood sugar to 95 instead of 100.  This has worked out pretty well so far.
  2. I “pre-bolused” (bolus ~20 min before eating) for lunch, since my lunch times are very, very predictable and my lunch post-prandials were a touch high.  This works most of the time, when I remember to do it.
  3. I increased my evening basal from .80 to .85 (since my bedtime blood sugars were often a touch high).  This produced semi-decent results, so I moved on to step 3.
  4. I increased all of daytime basal to .85.  This resulted in disastrous lows before meals.  I got super cranky and it was general unpleasant.  So, scratch that plan.  Back to .80.
  5. I changed my insulin/carb ratio from 1:10 to 1:9.5.  (Side note, my morning I:C ratio is already 9.5, so I just changed the rest of the day.)  This shouldn’t make a huge different, right?  RIGHT?!?!?  Not so!  I spent almost all of yesterday low.  I was fine right before lunch, but after that, my highest was 115.  Twice in the 40s.  I consumed no less than 50g carb of Starburst, ice cream, and yogurt-covered raisins to keep my blood sugar from bottoming out.  So, scratch that plan.

What the heck went wrong?  I had no idea that such small changes would result in drastic lows.  Now I feel very discouraged that I’m going to be stuck with an average of 127, which is not really good enough.  Especially if I want to have kids some day.  Do I just have to deal with numbers in the 40s in order to get my average down to 115?

Ask and ye shall receive

19 01 2008

Well, I had been wondering how to get my A1c down, and lo and behold, I’ve been running low for the past 2 days.  I feel like I’ve eaten nothing but Starburst.  lol  GiR finally got me to set a 90% temp rate, so hopefully things will smooth out.


5 12 2007

GiR and I still out on weekly dates, and this week we went to Romano’s Macaroni Grill.  It’s a little fancy, but it’s a fun place.  They have paper tablecloths and crayons so you can draw pictures and play hangman.  =)  Most importantly, they have complete nutritional information for everything on their menu.  No direct link – click on “Menu, Locations, & To Go” then scroll down to the bottom for “Nutritional Information” and “Allergen Information”.

My favorite thing to get is the Parmesan-Crusted Chicken Salad.  Very tasty.  60g carbs total, but I figure it has croutons and the chicken is breaded fairly heavily.  I decide to bolus ahead of time because that’s supposed to result in better post-prandials.  Well, the food comes and the chicken does not seem as breaded as I remember it.  I chalked it up to my bad memory and I ate it anyway.  I did have an extra bite or two of the bread (about 22 grams for 1/4 of a loaf) but it probably wasn’t going to be enough.

Well, it wasn’t.  About 1 hr 15 minutes later, back safely at home, I tell GiR “honey, I don’t feel very good.”  A quick test revealed a number in the 50s.  Ugh.  Okay, get a slice of bread and a couple Starburst.  20 minutes later still in the 50s.  Double crap.  More bread more Starburst.  20 min after that I’m finally up to 98.  I top out around 160 later, so not too much harm done.

I just have to wonder what happened.  Did they change the recipe without changing the nutrition info?  Did they run out of the breaded chicken and substitute with non-breaded chicken?  Can you really call it parmesan-crusted chicken if there’s no breading?  Did our casual mention of diabetes to our waitress lead her to suggest a substitute to the chef?  (my guess is no on that part)

*sigh*  Even with seemingly fantastic carb information, things can still go haywire.