Lots of band aid suggestions here. The pump only does what your settings tell it to do. . For me, as I have done for the last 28 yrs pumping and CIQ since if was released, priority is to do basal testing ASAP if this is not a sudden change. I do basal checks monthly, despite nearly 3 decades on the pump and 51+ T1D yrs. The you can check your correction factors and Carb ratios.
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All of us (and I mean ALL) have felt the burnout you describe because diabetes is relentless – you have to be ON always… which is a giant pain in the ■■■. I go through periods where I am always tweaking my pump settings because no one knows what is working for me better than me. And figuring out all that is made a lot easier by learning from others and lurking on sites like Tu Diabetes (my absolute favorite). Stay strong. Come back. We are here to cheer you on and up.
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Okay since your BG’s are steady when you haven’t eaten then your insulin to carb ratio is too low, you are eating more carbs than you think and under bolusing or you are not waiting long enough after you bolus to eat. These are all super easy fixes but the latter 2 require some self discipline and reestablishing of good habits.
If you are under bolusing then you need to start weighing your carbs to accurately dose for them at least for a few weeks so retrain yourself. to determine your prebolus time you need to take your dose of insulin and then wait until your CGM has a slight downward trend before eating.
Also, since you have only had diabetes for about 5 years your body may still be losing beta cell function which in turn will require changes to your doses until it stabilizes again.
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I’ve been using the Omnipod for many years. MDI was a problem for me because I couldn’t lower my basal when I exercised, which I can with a pump.
John
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Erbsnspices, I have had diabetes for 63 yrs, but have never used a pump, so I have thought about your post, but haven’t written anything.
I was dx when I was 8 yrs old and personally I think it would be harder to be dx in my 20’s like you were. My diabetes just became part of my life, but you were just kind of slapped in the face with it. It is a difficult condition to live with and who wants to get a disease which makes you have to change your life so much. It is difficult, but the disease has still allowed me to live a very good life.
If you like using a pump, I am sure you will learn to use it well. It may take awhile, but with help you will do fine with it or maybe you will decide to go back to using pens. Personally I like the simplicity of pens and I do extremely well with them.
I hope that you will give your self a break, and quit comparing yourself to others. That is really a losing game, because you will always come up short in some areas. There is always someone who out does us no matter what. Try to be happy with yourself because you are good enough and indeed special.
Welcome to the group! Many of us are very well acquainted with depression, so please don’t be afraid to reach out.
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You are doing well. Don’t let anyone, including yourself, tell you otherwise.
My guess is that this is more psychological than physiological. When my blood sugar is high in the afternoon, I just want to eat. I eat nuts and pieces of cheese. It’s probably an attempt at self-soothing. It doesn’t actually make me feel better and it’s kind of dumb, but having a high blood sugar can just be discouraging and being discouraged sucks. I’m guessing you feel down on yourself because your BG is high and thus sluggish.
This is a good point. When I was diagnosed, they told me I would have a 3-6 month “honeymoon” where my body would still produce insulin making BG control easier. My “honeymoon” lasted over a year and with good blood sugar control like you’ve been having, yours may have lasted even longer. When that little support goes away, it can make things harder and it’s a blow to the ego if you tie your self worth to your BG control which of course you shouldn’t. (But which is really really hard not to do.)
You can eat a fair amount of junk and sweets. Should you go on a low carb diet? Yes, probably. But you don’t have to. You can still maintain pretty good control while not being an exemplary eater.
You may have already figured this out, but a lot of the frequent posters on this site are older (as am I). They spend a lot of time and effort getting incredibly good control. That’s great, but, as a younger person, you may have other priorities – like spontaneously eating out with friends and enjoying what people around you are enjoying. That doesn’t mean you have to lose control of your diabetes. You can strike a balance.
Would it be better if we were all vegans eating low carb diets? No doubt.
But it can also be good to find a balance. It’s irresponsible to your future self to let all control go and eat junk all the time and lose control of you diabetes. It’s unforgiving to your present self to make all of your food and life choices based on what’s best for your diabetes.
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That is definitely stacking.
If your blood sugar is persistently high and you’re not doing anything much and you’re not planning to go to bed soon, a little stacking might be a pretty good idea.
However, if you’re about to go out or go to sleep, it can get you in trouble.
Have some glucose on hand, and, I guess, everything in moderation. If you don’t do anything because you’re afraid of stacking and your blood sugar stays high for hours, that’s no fun. But, if you rage bolus because you hate that high blood sugar you can have a steep drop later when all that stacked insulin hits at once.
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It’s a fine balance. . . The pump keeps track via IOB calculations, so that although it is technically stacking, if you space it out you can (usually) avoid the subsequent crash.
If the alternative is five units bolus to deal with a climbing sugar, you have done all your stacking at once.
I’d rather give one unit and see what it does to level things out before chasing with another. And usually 20 minutes will give me an indication.
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You can absolutely have treats. The key to it is knowing how much to bolus for with super fast hitting sweets like candy or soda and when to bolus. With ice cream or pizza you may need some insulin up front and some extended to account for the fat slowing down your digestion. Everything is on the menu with type 1 diabetes (in moderation) because you have insulin to handle the extra sugar. Even type 2’s can work in treats if they want them, it just takes planning. Keep in mind that weight gain is more of a problem with diabetes if you overindulge.
I eat potato chips several times a week but I only eat an ounce. I combine it with some pistachios for the extra crunchy/salty craving and voila! no spike and I get my chips. @Marilyn6 has a recipe for garbanzo bean chocolate cookies that you may enjoy.
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I do stack insulin shots “when needed”, usually as a corrective dose so don’t be afraid to safely medicate in order to correct high readings. I would suggest going back to Insulin pens until you and your endo can correct your pump settings. Don’t compare yourself with friends or anyone who can eat care free, my only advise would be to go low carbs or stick to measurable options of carb choices that you are comfortable dosing.
Hope things start moving in the right direction for you soon!
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Just want to add, that if you like fruit and vegetables look at Mastering Diabetes. After following a very low carb way of eating for 11 yrs and getting heart stents because of all of the fat, I switched to the Mastering Diabetes.com vegan diet which is grains, fruits, nuts and all kinds of vegetables. This diet is reversing the plaque in my arteries. My A1c is 4.8, my TIR is excellent. The woe is excellent for diabetes and is a healthy woe for our whole body. I eat around 250 healthy carbs daily and take a total of 19-21 units of insulin. If you do decide to try going very low carb, be sure to watch your LDL results. I ignored mine, and I paid heavily for it.
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I can understand getting burned out . I’ve only been on a pump for a month and the prep work that I’ve been doing without much support from my endocrinologist group if I didn’t have a very quiet routine, could easily burn somebody out.
Before “upgrading” to Control-IQ, I’ve been working hard with Bsal IQ mostly turned off to determine my basal profile, and for each meal type, the right bolus response. That’s not as easy as the docs and books make out when you have gastroparesis as a complicating factor. Control IQ may make it harder to time an extended bolus.
I have discovered that there are some misconceptions about insulin therapy with a pump and I had most of them . The biggest one is that the critical variables are insulin and carbs. (The second is that there are infusion set and CGM sensor failures. If a car can’t handle a road, it’s not a bad car - it’s been put in the wrong place. Steel cannulas don’t fail -they can deliver insulin in sites that aren’t permeable for insulin.)
It took me 3 weeks to figure out that’s that my body is the biggest variable. From day to day it changes. I eat the same breakfast and lunch every day. Every day the response to insulin is different. The unchanged CGM and infusion sites that work perfect one day, don’t work exactly the same the next day. A “plumbing pipe” stuck in one part of my body works ok, in other places it won’t. Pull it out and the insulin flows freely. “Medical science” wasn’t able to tell me which places would work.
The second biggest controllable variable is stress - over how well I’m controlling my BG. When things go well, they go great - like a run of days 100% in range. I relax. When things go less well, it looks like driving through the Rocky Mountains. I hate “driving” through unfamiliar mountains. I get tense, my sleep suffers, I worry. All those things effect my BG. My morning rise will be twice as much when I don’t get a good night sleep.
When I was on MDI, I never worried about it. I just used sliding scale at every meal to correct. My A1Cs were good enough for the endo., if not for me. That changed when I started using a CGM and could see what was happening. It got worse when I started using a T:slim and was concerned about staying “in range”.
For me it came to ahead when I was sick for 3 days and was too tired to worry about the tech. I always use a BGM when I know I’m sick. All I cared about was not going low, which I’ve always been able to detect without any tech. I ignored what the pump display showed, used a BGM for values and accepted the pump’s calculated boluses.
Looking at the t: connect graph later, it looked horrible but the statistics weren’t significantly worse for those three days than they had been when I’ve been trying my best to have “perfect” blood sugar.
I looked back over the weeks when I’d had the hardest time controlling lows and saw a pattern. Except for when there was an obvious CGM issue, those periods were always in 3 day clusters. They started off ok and got worse. There was only one thing in my routine that matched-site changes.
So, I started a new way to test after a site change. A BGM test two hours later doesn’t mean much when insulin has a 4 hour working period.
I change sites when I’m stable between meals, Instead I purposely bolus and look at the response. If my BG doesn’t drop within 30 minutes, the site isn’t great. If it doesn’t drop in a hour, it’s poor. If not in 2 hours it’s bad. Poor sites I test with a measured glucose, correct and time the correction.
Since starting to do this, the stress of not knowing what was happening has declined. I get annoyed by bad sites but I know what is happening and what to do to fix the problem. More often than not, patience waiting out a slow site and a small correction later is enough, a site change to a known better one fixes the rest - since I stopped trying for perfection.
Unless BG is getting dangerously high or low, I think that patience and tolerance is probably the most effective strategy. I can tolerate good control most of the time except when I need to be extra careful like around surgery. I’m willing to be patient for a few years with slightly less good blood glucose control than I could get with intense management oversight - as long as I have confidence that the next generation algorithm (not models) of closed-loop insulin infusion systems will available within 5 years and be a lot smarter.
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Personally, I think that using BIQ or CIQ as a first-time pumper isn’t a great idea. Switching from MDI - with long and short acting insulins is different from a pump. Pumping uses fast-acting insulin for both jobs. One of the benefits of pumping is that you can set up different basal rates throughout the day, based on your own body. Same thing with correction and meal boluses - you can tailor delivery to your body.
I would start off turning off CIQ, then with your MD or CDE, using your MDI doses as a foundation, set up your pump. Having the CGM will provide excellent useful data showing things, like your basal needs overnight (easy cuz there are no meals). You can see what times the basal hourly rate needs to be increased or decreased. Once the dialing in of settings is good, then activating the CIQ would most likely be more successful.
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Thanks for your input. I will have to discuss these different insulin options with my doctor.
Thanks for your response!
It’s great to hear that you were running marathons. As I said in my original post, I feel worried sometimes thinking about what I can’t do because of diabetes. I want to get into the mindset of respecting my condition without letting it control what I can/can’t do. It sounds like part of that is accepting it’s always a work in progress.
I’m sorry to hear about your dupuytrens. I hope that is something than be managed for you. It sounds like you have great glucose control, so I’m sure that helps. 
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First: thanks for your reply! I am a mess! 
To answer your questions:
I am 28, and I was diagnosed when I was 23, so around 5 years. My oldest brother has it. He was diagnosed when he was around 11, and he is in his 40s now, so he has had it a lot longer. I think some of my emotional issues with this may stem from watching the issues that he had as I was growing up. There was a time that I would get off the bus from school and be walking back our road so anxious because I was anticipating an ambulance to be there. He had very extreme lows for a period of time. Now he has the benefit of CGM and better technology overall and is fairly stable with it, but for the longest time, that wasn’t the case. I think it scared me as a kid, and it scares me now as an adult. I even think that maybe there’s a part of me that would prefer to have high blood sugars so I never have to experience lows.
I used to live in a very small town, and I moved a few months ago to a big small town/almost small city.
I do not have any major complications at this point that I’m aware of.
I think I need to majorly review everything with the pump controls and become more comfortable adjusting. I worry I’m going to give myself too much insulin accidentally by adjusting things. Yes, I frustrate myself (lol).
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Thanks Jane. I’m glad you got everything adjusted.
I’m going to work on my communication with my doctor. I think I’ve found another doctor I can connect with more regularly.
Thank you for putting it so succinctly. I wasn’t necessarily just letting it do it’s thing without any input from me, but I honestly don’t think I understand the tool fully. I am going to review all of the settings.
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Thanks for your help!
Thank you so much!