i know this is kind of a basic question, but I am wondering what others use for guidelines with their blood sugars. I started on a pump in may and since then my target has been set at 90-130, but i’m thinking about lowering it to 120. I am also finding that I need a lot less insulin lately, partly from changing my eating habits due to more work, and partly from more exercise, so i end up going low a lot. Typically before bed i will be somewhere between 75 and 90, and if below 90, i’ll eat one or two glucose tablets. a few hours later i’m still below 90 and then will wake up below 70 usually, unless i have 20 or 24 grams of carbohydrate in the middle of the night.
should i be lowering my overnight basal rates? how low is too low to be consistently. i have to admit, i was excited to see the huge drop in a1c after just 2 months, and so i am hoping for an even lower number next time, but am worried that i might be too low too often. what is normal, or ok?
and, the question that probably differs for everyone-- at what # will you not exercise below? i walk every morning for 1 hr at 10 min. mile pace, and when i wake up at 65, i’ll eat enough carbs to raise my bs to a number within range, but then i am always worrying that it will drop too much again while i exercise.
since starting the pump i am testing more than ever, and am worried that i am being “too” vigilant with catching any highs and correcting, if that makes sense.
what are some of the numbers that you all use as guidelines?
My goal is to stay between 71 and 130 all the time. The only reason I came up with this weird range is that my CGM’s software shows glucose distribution in intervals of 30 (71-100, 101-130). This makes it convenient to measure % of time spent outside of 71-130.
Sounds like you need to do some overnight basal testing so that you can avoid waking to eat middle of night–unless you like doing that!
With pump finetuning you truly can get your glucose to stay (relatively) steady while you sleep–without the need to wake and eat (exceptions that may require middle-of-the-night waking, testing, and possibly treating: exercising unexpectedly or more than usual in the evening, consuming alcohol, bolusing/eating less than 4 hours before going to bed, illness, and general unexplained diabetes quirks :-).
Through much trial and error, I’ve found I need several basal rates overnight, especially a big uptick starting at 4 a.m. to cover a strong dawn phenom. It seems odd that small incremental changes (one tenth of a unit less during 1-2 a.m. and four tenths extra during 4-5 a.m., for example) make that much of a difference; I didn’t believe it until I did lots of basal rate testing.
I will moderately exercise after treating a low to above 100 as long as I know there’s not excess insulin in my system–that’s because my definition of moderate exercise drops me about 40-60 points. I tend to exercise before a meal, which means there should be no bolus still circulating. Exercising within 4 hours after a meal doesn’t work great for me because if I’ve miscounted my carbs, the bolus insulin can be too much in combo with the exercise. And to be sure, I always test before and after anything longer than a 15-minute walk.
Have you experimented with setting a temporary basal rate while you exercise? For moderate exercise of less than 45 minutes, I set the basal rate for the four hours after I finish. But for more vigorous exercise or of longer duration, I’ll set a temporary rate during the activity.
IMO, catching and treating highs–without overtreating–helps a person reach target A1Cs as long as basal and bolus rates are finetuned and carb counting is accurate. If you know your correction factors, you should be able to gently “land” a high without crash landing.
One big problem is being impatient. Depending on size of high, it may take several hours for it to come down. Taking too many units to get it down quickly may lead to later lows. Good luck! Let us know how it goes.
