Correction Factor

I am on the Tandem X2 Pump with DEXCOM G6. Whenever I do a correction my BG tends to drop quickly. I started with a CF of 1:40 and have over time increased it to 1:50 and know it is still incorrect. When I use it; I cut the amount of suggested insulin some but am still going low too quickly. My guide is the latest Pumping Insulin book.

Am I confused? Does my CF of 1:50 mean that 1 Unit brings my sugar down 50 points? I hate to keep monkeying with it if the problem is operator error.

Also; I am still working on my IC ratio. I can’t get it adjusted so that I can get up, not eat, and my BG stays stable. It either goes high and if I adjust for that even a small amount; then it goes low. I don’t have access to a good CDE and am trying to use the book to guide me.

I know there are so many variables that affect everything and it is not an exact science, but I really work hard to stay on top of it and it gets frustrating. Any suggestions appreciated.

Yes that’s what it means and if basal is accurate you have to go higher. My correction factor is 1:70 and I had to convince my endo to go up from 1:40. Now I make all kinds of changes without asking. And my average Blood sugar has gone from 160 to 105. I have learned lots by research and trying things. If you experiment on yourself, be safe!

Thats an interesting problem.

Are you confident in the basals?

The others will roll their eyes at this, but this is how I adjust my baselines, just like in the olden days. It is a bit much, but its the only way I feel that I can really ‘sort it out.’ It takes me 2 weeks prior to an appointment. I try not to let variables overlap when testing - I first test basal, then bolus and corrections here and there.

I’m one week in and I feel good about the basals, so now I’m checking meal bolus and correction dosages…and how it is operating under automated controls.

Thank you and good for you. I am going to up my IC factor.

You may have confused your insulin to carb ratio (I:C) with your basal insulin profile or basal rates. The I:C is used to help you dose insulin based on the carbohydrate content in your meal.

Morning glucose levels fluctuate for a few reasons. When we arise, the body is programmed to give us the energy to start a new day. That means raising glucose levels to energize your efforts. Unfortunately, for those of us with impaired glucose metabolisms, that means glucose levels rising too high.

To counteract this unwanted morning glucose rise, you need to increase your pump’s basal rate a few hours before you typically experience the BG rise.

It’s great that you are experimenting with these settings as this is a skill set that you will continually need to use. These settings are not “set it and forget it.” Our bodies, schedules and needs change. When that happens, you need to flex your settings on your pump. Diabetes is dynamic, not static.

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I biggest problem is always the basal rate. That is always the area to start with first. If that rate is off, it will effect everything.

Case in point. I was using way too much basal but I found I could snack & not need a bolus. Came to discover, the basal is suppose to keep your blood sugars level, nothing else. So you need to split your day up into time frames. Most people start with overnight as that is the easiest because you are not eating. Eat an early dinner without a lot of fat or protein and than nothing all night. If using a CGM, you will be able to see if your overnight line stays flat. If flat your basal is good, if not adjustments maybe needed. Big problem here, you shouldn’t use just one night. You need to discover if it’s a pattern. This is why basal testing can take a very long time. And remember if it is flat but still higher than you might like, that rate might still be ok and you might need to adjust carb ratio from dinner. This is not an easy quick fix, it takes some work but once you get them in line, it will much, much easier to get the others in line. Carb ratio and correction ratios will be easier to figure out.

And if you can see right away that your correction is not working by all means do what you are doing and reduce it. Better safe than sorry! Good luck and keep asking questions! The book you are using is in my resource library and I pull it out every once in awhile when I have questions. Even after 49 years!