Sigh. Do you think it might be possible that you have gastroparesis - that your stomach isnt'd emptying properly after you eat?
I don't think so
PBJ on a piece of 22 carb toast totaling 30 carbs. I usually wake up normal eat right away and bolus 3 extra units, sometimes it works and sometimes it doesn't. If it works and my two hour mark is close to normal I then have to lower my basal for two hours otherwise I drop bigtime.
Sometimes it goes over 200 then I correct and do not touch my basal. I have fixes, just don't like that the intial outcome for the same amount of food is not the same everyday.
A couple thoughts, Karen: You might try eating a lower carb breakfast like just protein - eggs, meat, vegies and see if that helps. If you are normal at two hours and then dropping lower later you might want to reduce your basal altogether for that time period. Changing basal on the fly isn't all that effective because you have to do it two hours ahead of time. If you are fine when you go over 200 that doesn't preclude the fact that your basal is too high for the later time period.
My suggestion? Try eating something lower carb and more protein and also do some basal testing for that period of time you have been dropping. (Or skip the basal testing and just make a minimal adjustment to the time zone two hours before the usual drop).
Karen, I have had issues similar to yours..
I just now started the pump, so I have no idea how things will shake out with it... but when on MDI, if I ate more than about 20 carbs at breakfast, my BG would skyrocket. Then I'd correct at the 2hr mark and go almost low before lunch (kept happening with different ISF factors and different basal rates AND different timing.. I could not win..)
Then I'd try eating JUST protein.. maybe take a half unit just to help with it a little.. and I'm not kidding.. I would skyrocket again and have to correct, but with the 'just protein' I wouldn't go lowish before lunch..
So if I kept it lower carb with some protein (like Zoe suggested) I did better... and things were fairly predictable.. I would have a small amount of yogurt with a little fruit and some nuts and that was the most predictable breakfast by far..
I usually count PB, w/o J, as about 8-12G of carbs and still run up? I have 2x 15G pieces (I used to eat half but am eating more carbs to see what happens...) and bolus for 38-40. If you are "off" by 5-10G of carbs, and work it out, a 200 might be stem from the 25% "overage" and be sort of in line with what you are running into? It might not be carb vs. low carb but getting the food/ insulin ratio more precise?
but..... I don't always go high with my 3 extra units. Even if I did not eat I would go high after I wake up and when I tried increasing my basals to fix the DP it was a disaster with lows. When I do fasting bloodwork it is always a disaster, and thought it was white coat syndrome, but it was the DP, so now when I go in for fasting bloodwork I bolus 2 units when I wake up. I have tried no carbs for breakfast and it was better, but I was not satisfied. I truly believe just because you have a pump does not mean you can eat anything you want. I get very frustrated with some endo's that feel you can eat what you want and are telling newly diagnosed D's this theory. Whoops changed the subject.
Kathy, MDs aren't specialist in Diabetes that's why they shouldn't treat us. I've had D for 53 yeas and yes things do change but it's not been any harder then anyone with less years.
PS con't change the subject ...I was never told as I recall , that I could eat anything I want , because I went on a pump ...I went on a pump( 2001 ) to feel better and not having to deal with the NPH problems ...up and down and feeling pucky , headachy etc. etc. That problem was resolved :)
and diabetes causes other stinky concerns ...one day at the time :)
I feel that I get better care from my primary MD than my endo, she is very intelligent. I feel when I go to endo they see my A1C and say good, and I just feel like diabetes is what it is. It is never perfect, and the farther away from perfect numbers I am the worse I feel. I think when I was younger my body could tolerate higher bloodsugars and so I did not feel so awful all the time.
I have never heard that one before - of course, I'm no doctor!
FWIW, after close to 40 years with T1D, this is not my experience.
If I were having enough variability to be contemplating giving up the pump, I think I would first try re-grouping and re-thinking my whole approach first. IOW, try eliminating as many variables as possible.
From a food perspective, I would first go back to imitating MDI by having the same foods at the same times every day. I would also want to work on testing my basal rates since that sets the stage (as you already know!).
Since our bodies relation to glucose is way more than food, are there other changes that are taking place? Exercise, hormonal, job/life stresses etc?
I think this way: This disease can be a royal PITA, but it's a part of me. I have to keep it from taking over my life so I can be (here comes the cliche...) a person with diabetes and not a diabetic who just happens to be a person.
Keep the faith!
@ Betty J
Some MDs do specialize in Diabetes, and continue education and keep up with new and better options for treatment. I have an excellent doctor, she is not an endo and has never failed treating my diabetes, as well as the rest of me.
I'm gonna go outside the box here: could the difference be due to different absorption based on the sites? I mean, are they only variable for breakfast, or was the breakfast an example but you also get variability at other times?
throughout the day, almost every day is a roller coaster, but I consistently get DP, ha!!!
I think I'm hitting the "crossover point" numberwise. A while ago, it seemed to be drifting up, so I turned everything up. Now, it's running down so I'm starting to turn things down. I don't run up as much as have lengthy drifting down and eat lots of Smarties pounding it back up. I'll see how tomorrow goes and keep at it.
I still have the 722 reservoirs BTW!!
I have not forgotten about the reservoirs. :)
For your sake, I hope not. I have it, and most of the time I don't really notice it much, but as I watch my CGM after a meal I can see what it is doing. Like you the results are all over the place. My doctor used to give me a hard time about getting my A1C down, but after testing for it she apologized. I used to eat the same thing, same meals every day and BGs would swing 200 points. Now I know why.
how was it diagnosed
Have you ever thought about using the square bolus if you are on the pump. That seems to work well for me because I was having the same problem you were having when I bolus the right amount of carbs before eating..I always go to low after eating.