While I have to say my numbers are looking much better since I started bolusing for mealtimes, when I do need a correction this regimen doesn’t let me compute a correction factor–I just use 1 unit of Humolog and check again in an hour to make sure I don’t go low. Also, I walk nearly every day after lunch and even when I adjust my lunch bolus accordingly, I often have to check my BG mid-late afternoon to make sure I haven’t dropped below 90. I often have to eat a snack then and also at bedtime (e.g., I was 82 last night at bedtime). As of yesterday, I am only using 6 units of Lantus. So I guess I am wondering if this means my insulin resistance has improved and if anyone else has had similar experriences? Thanks!
If your doctor is not guiding you in determining your Correction Factor and Insulin to Carb ratio and then calculating meal and correction boluses based on those values, GET ANOTHER DOCTOR. NOW.
The old sliding scale, and perturbation protocols are way outdated, and will never achieve good control. Achieving an a1c under 8% will be a matter of luck.
I'm in pretty much the same boat using a steady basal and then bolusing the big stuff (I low carb quite heavily so don't always bolus). I don't have a clear handle on my ratio and I realise this has type 1's holding their heads, but the 1.5 thing means that my pancreas does muck up the numbers.
So at the moment I guess and test - but have managed to pull my HBA1C back to 6.2% (from 8%) in the last couple of months despite the haphazard approach.
I've just ordered an Abbott Libre so hopefully in the coming weeks I'll be able to see what exactly the bolus jabs are doing and how fast they're working. I'll probably be horrified.
oh - and I take Metformin too
Do let us know about your experience with the Abbott Libre!
i hope we don’t have to wait too long to get this in the U.S.
Thanks for your response and concern. I just talked about the correction factor issue with my CDE and she acknowledged that there isn’t a good way to deal with this since I take Metformin (due to the insulin resistance). The other afernoon I was a bit over 200 2 hours after lunch so I had a glass of dry rose instead of a correction shot…then kept an eye on my BG for the rest of the afternoon. Not recommended as a regular practice but sure worked!
Libre has arrived today and is now hanging, limpet like, to my left arm.
Feeling a little bit odd about it at the moment - like a weirdo with an incurable disease AND a large extra strong mint stuck to his arm.
You make it look good!
Hey, Swimmer–What’s your initial impression?
Ok, I've now been using this thing for about 4 days and there are quite a few things that are different.
The first thing that I noticed is that having the device on your arm makes me think about the condition more. I have long harboured a belief that us diabetics have a tendency to depressive thoughts and my first reaction this week was the polar opposite of the feeling of control I was expecting. Instead it made me consider the severity of the condition and that's not a great feeling.
There is no doubt that testing is far far easier than finger prick tests. This means I test very frequently now. I have always tried to add control by diet, though I am on a basel/bolus regime, so I eat - test after 1 and 2 hours and hope to be back at the starting point after 2 hours. A successful result is being back at a 'safe'level in 2 hours.
What's different about the libre is that readings are taken almost continuously - even if I only collect the reading after 2 hours. So I can see that a piece of toast will quickly bring me in to double figures (sorry we use mmol numbers). I can see the peak in all it's glory where before I would feel it but be happy to return to a good level after 1 or 2 hours.
Today I went in to London for the day and we ate at several places during the day. I had my novorapid pen in my pocket and I could make multiple small adjustments at or after meals, rather than having to calculate the correct dose and then find out 1 or 2 hours later to see if I calculated well. I realise I could do this with multiple finger pricks but in reality I wouldn't have. Also I can easily scan in public, on a bus, walking down the street without anyone being aware of what I'm doing. This freedom allows me to continously adjust my levels with small inputs of Novorapid. This also means that I can overlap meals which is a pain to do counting carbs and jabbing.
The final difference is that the test my libre gives me tells me the direction of travel. So a reading of 8 mmol is accompanied with an arrow that shows stable, rising/rising quickly or falling/falling quickly. There is also a graph displayed and you can therefore tell if you're peaking as you go high or bottoming out. This helps determine if an input of food or insulin is needed. You can't do that with a finger prick test.
It's early days. So far the device has been reliable - it reads a little higher than my blood meter but actually the numbers are irrelevant, as it's how the numbers move that's important.
I thought I would be proud to have it on my arm but I'm not so sure and will probably put the next one further up my arm so that it's covered by my t-shirt.
Hiya, @Swimmer! How’s it going with the Libre? Still satisfied? Discovered any new pros or cons? Thanks!