So yesterday was the first sunny day in NH for a week, aka my first week here. I was actually disappointed because it was the first day I had plans to do something fun.
I woke up and watched two YOU CAN DO IT! project videos and cried three times (Yes, one video made me cry twice). Motivated myself to work out for 30 minutes trying to a little more yoga and strength training instead of aerobics (must built muscle, must speed up metabolism).
My afternoon was spent managing the drive into Boston. I went to visit my younger bro for much needed sibling video game time. We played through the first 3 chapters of the co-op of Portal 2 over…3 hours? I made the mistake of meeting my friend at his apartment, which required me to drive through Cambridge in the middle of rush hour. Apparently, he works 2 T-stops from where my brother goes to school. Silly Boston!
My buddy and I decided to grab Thai food followed by frozen yogurt. This was easily the largest meal I’ve eaten in a week. After SWAG bolusing and re-bolusing, my blood sugar crept up twice past 200 according to my Dexcom (Eggy to the rescue…). Sometimes, I get worried about over-reacting to the Dex. I keep bolusing and bolusing without checking how many lingering units are in my body (active-ins). Anyone have any tips for checking how long active ins actually stay in and effective? My doctor had me set my active-in time to 3 hours wayyyy back when and I have a feeling it’s changed. Post-prandials only seem to check I:C ratios…
http://climbingdiabetes.blogspot.com/2011/06/climbing-swirls-of-frozen-yogurt.html
A general rule of thumb is that if your BG is more than 40-80 points higher two hours after eating, then you didn’t bolus enough, regardless of how much it says you have left. I have my “duration” set to 4 hours, but after 3, I’ll correct assuming I have no insulin on-board.
Calculating an exact time is a futile effort… the pump assumes that the insulin acts uniformly across the entire 3- or 4-hour window, which (as we all know) it does not. If you know a better way, by all means let me know! How did you determine 3-hours oh-so-long ago?
If you’re still in Boston, give the Stanley Cup a kiss for me! The Cup hasn’t made its way to my neck of the woods for eight years. Then go visit Dr. Faustman and give her a kiss for me – 'cause when her cure is available to the general public, that’s what I’m gonna do!
Scott E- Depending on the pump it is not uniform. Omnipod is uniform. Animas and MM are a bell shaped curve just like it is supposed to be in real life.
I have had the best results checking my IOB when I do a correction bolus ONLY (way less factors). I give a correction and test every 15-30 minutes and see how long it takes for my blood sugar to go back to stable (this makes the assumption that your basal insulin does indeed keep you stable). I have noticed doing this that the IOB that the pump shows tracks almost perfectly with what my correction dose tells me I need to take (for the most part).
Well, my new Endo said the active ins looked about right, but I may be developing a little insulin resistance. Hopefully kicking that relaxing/exercising into high gear will solve it before we need to medicate the situation…
Apparently the estimate is bell shaped curve for everyone, but the duration is really some sort of estimate based on mass distribution (fat vs muscle) and insulin sensitivity from what I garnered.
