Chasing sugars what works for you?

Hi all, I have been chasing my sugars again today. When I am having pain seems no amount of insulin will bring it down. So worried about my A1C this time. I am wondering how the dexcom has helped you keep it between your targets and when you have corrected. I am seeing my Endo next week and need to discuss this with her.

For me it wasn't about chasing sugars, but rather understanding them in order to find a balance of lifestyle on a day-to-day basis. I'll go ahead and say it: A good diabetic is a boring diabetic. There, now that's out in the open we can talk more about it. Truth is, the more regimented you are, the less you'll need to chase your levels around to make them behave. Yes, it's boring at times but it's the best method bar none. Good luck with your chase.

P.S. no, i'm far from perfect :)

I agree Scott, I test myself at least every 2hours. Most of the time I do well but when my meds are not working enough my sugare go high and stay hi. My a1c are usually in the 6% just started with the dexcom which has given me insight to higher mornings that it actually starts at 4am as my body is waking up. So that will need adjusting. It is the days I am in pain that hits me hard.

Pain must be a tough condition that complicates BG control. I'm sorry I don't have any experience to offer you on that factor.

It seems like I'm always trying to fix some BG problem. Lately I've been have very persistent low BGs between 11:00 p.m. and midnight, about an hour after I fall asleep. I always try to treat hypos conservatively so that I don't overdo it and start on the roller coaster. But the last few nights I've had to take 5-6 glucose tabs and even a 1/4 cup of apple sauce. The lows (50-60) took over an hour to turn around.

And then I get the inevitable bounce to 200+ that lasts most of the night and then also causes my morning BGs to jump too high since I have dawn phenomena along with the reactive hyper from earlier in the night.

What I've concluded is that my 9:00 p.m. to midnight basal rates are too high. I lowered them today by 0.2 units/hour, an aggressive move. I usually only adjust in increments of 0.1 units/hour. But the low was so hard driving, I felt I needed more.

Well, the fix is in and I'll need to monitor tonight to see how it goes. It's played havoc with my sleep so I'm hoping I'm on the right track.

More often than not I find that basal rates are at the root of the problem. My basal needs don't stay the same so I'm constantly tweaking. My insulin to carb ratio and insulin sensitivity factor seem to be more stable. Sometimes I make adjustments to my basal rates and then return them to where they started a week or two later. If something's not working, make some change, monitor it and adjust again if you're not happy.

When things are going well for me, I can get good numbers for a few weeks a time. Even then I usually make minor BG corrections each day, like pulling a 135 back down to 85 or 90.

The Dexcom has been invaluable to me for managing BGs. I upload it almost every day to my computer. This is how I can see where the trace crosses a threshold into bad territory and I can then change my basal two hours before that time. I also pay close attention to my weekly BG average, standard deviation, and % time in target. I'm a numbers nerd!

Bottom line, my basal rates are the key to my BG management.

I'm not perfect, either. If diabetes has taught me anything, it's humility.

I would be really worried if I was going low at night, as for my basal it is most of the time set properly or so that it is flat when not eating. When I am in pain however it does not drop so just more insulin on top of insulin. I see a chronic management apt next week so hopefully will get something out of that.

For me it tells me how my body reacts to different foods. Sometimes it takes 8 hours for a food to reach the highest BG number. At least it seems to. Other times it is like 15 minutes. Keeping track of what you eat (Like a Food Diary) can be informative as to what you need to avoid. Anyhow that is my 2 cents worth.