I’m high, which means I’m also very cranky at the moment.
My well-intentioned CDE suggested a LOT of changes to my basal profile today and asked me to be both brave and patient, reworking my 23 units of basal into 21 units and redistributing those units across the board into a profile she thought better matched my overnight and post-meal needs. She changed my sensitivity from 1:32 to 1:20 and changed my insulin:carb ratios from 1:8 to 1:6. She felt that my post-prandials at lunch and dinner were showing that my basals were compensating for low boluses on the meal and correction side. Okay, I get that. I’ve always had that problem to a degree - keeping high basals to compensate for bad carb counting or inaccurate fat/protein consideration.
So I leave the office with all my new settings loaded.
BG = 79. Bolus. Wait 20min. Lunch = 53g of carb (a large but otherwise modest wheat turkey wrap).
1 hour PP = 116. Uh-oh, maybe I’m going to go too low. Let’s watch. 2 hours PP = 177. WTF?
I do a correction with the new sensitivity factor, thinking "this is why my basal was higher here."
1 hour later = 163. Okay, give it time, Melissa. Takes a while to correct a high. 2 hours = 54. WTF (again?)
The correction factor seems too intense now.
I pop 4 glucose tabs and am starving, so I then bolus for a 26g snack on top of that. (I’m pregnant. I eat a lot…and often.)
2 hours later = 200. ARGH!!!
Seriously, why mess up basals that were producing nearly flat lines and give me this? My standard deviation yesterday was 18. EIGHTEEN. My avg BG was 117. If you could hear me now, you’d hear growling. You’d probably even hear my baby growling. She doesn’t need her blood sugar to be 200.
I will give it two more days…unless overnight goes much worse. At least my CGMS warm-up period is over and I will have my beautiful wavy lines in front of me.
In the words of a great piece of literature: “It has been a terrible, horrible, no good, very bad day. I think I’ll move to Australia.”
(In all fairness, if I’d had these numbers 5 years ago, I wouldn’t have seen anything wrong with it.)