My last A1c was 5.8, but I got there because 70% of my blood sugar readings were “in target,” 15% were high (over 130) and 15% were low (under 80). My internist and endo are disagreeing about how to handle the frequent lows. My endo says eat a snack, 10-15 carbs between meals and don’t cover it with insulin. My regular doc says he thinks I need to lower my basal rate and increase my bolus (carb ratio). He admits he has no experience with insulin pumps but he always did a great job handling my diabetes before the pump.
I’ve been losing weight since I got on my pump in September and each time I hit a magic number of pounds lost (I’m not sure what number is), I have problems and need to lower my basal, per my endo. Each time I’ve made that change, she has only had me decrease my basal, not change my carb ratio and I haven’t had a problem.
I’ve lowered my basal rate and changed my carb ratio from 1:8 to 1:7 and for the first time in lowering it over these months, my sugars are spiking much higer after I eat. I’m not taking about 2 hours post-prandial, I’m talking about an hour or an hour and 1/2 half after I eat, and they usually come down. Before my sugar usually didn’t go over 140 or 150 at the most before coming down. Now it rises to 180-190 before coming down.
Does everyone have this problem? Do I just need to change my carb ratio again to like 1:6 to take care of the spike? Having my basal up a little has always worked as a scaffold and stopped my sugars from rising so much. Some how my doc seems to think I can just play with it and I’ll figure it out.
It’s been a particularly bad weekend with two lows in the 40’s and then it’s rebounded at the next meal and wouldn’t not come back down for several hours. So I’m not using this weekend to do basal testing or make any decisions. Both lows were within an hour before the next scheduled meal. One was when I was driving and one was in the middle of the grocery store yesterday where I felt like I was going low, my legs went out from under me quickly, I fell and they called EMS. Very embarassing and scary. This never happened before and I don’t think I’ve ever been in the 40’s before. Now I need to find a new grocery store to shop at, lol.
I’ll be calling my endo tomorrow, but I feel like I need practical advice from people who are actually dealing with this. Thanks.