Ok… Not a flatline day, but a reasonable “surfing” day, with close to 95% in-range. For some reason, I saw quicker-than-expected response from insulin today, causing two pre-meal lows. The lunchtime low was rather quick and surprising, so I needed to take a candy to stop it – and half hour later, I needed to take 1.5u to cover the extra carbs in my PB&J sandwich that would have been covered had I not needed that candy-- Timed that rather perfectly (lucky! 
). Dinner was a big bowl of chili with a few crackers - hard to guestimate, and needed an extra 2u to cut the spike. All-in-all, I think it went fairly well for a not-so-low carb day (100-110g carbs):
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I’d call that a flatline day!! 95% in range and it looks as if you caught the spike in the nick of time! Great work @Thas!!
No need to dismiss this day. 94.8% time in range and only 2.1% low is a nice day! Sometimes we do get a timing mismatch but knowing it at the time and acting on it makes all the difference. I’d definitely put this one in the win column!
I "celebrated" my 2-year diaversary w/ burger, fries, and real non-diet mtn dew. 150 grms carbs? No prob w/ #Afrezza pic.twitter.com/Xfy3TftXod
— Trevor Schug (@Wasson101) February 5, 2016
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Trevor, please follow us on Twitter @diabeteshf
and that is truly awesome!
Hm… Roller Coaster week this week – alternating good, flatline days and wild rides! Here’s the week’s best:
TIR this week: 90.1%, Avg BG: 100. If only every week was like that, eh?
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Very nice, @Thas. Even more impressive is the time in range for the whole week at 90.1%. No drama; I love it.
I can’t take credit for the line below, because I can’t explain it, but hopefully it indicates something has changed for the better.
For months now I have been dealing with either extreme highs or else complete rollercoasters that literally alternate between high and low non-stop all day. Or, more frequently, I’ve had both at the same time. Not a day has gone by recently where I’ve had a straight arrow lasting more than about an hour (unless you count hours of flatlining in the stratosphere—some days I’ve wondered if that counts!). My insulin resistance soared to the point where I needed close to 100 units a day and boluses were almost always in the double digits—and even with that much insulin I was still often high.
After doing some reading I’m positive that these changes are related to my recent diagnosis of Graves’ disease:
And then, almost two months to the day of starting medication, it was like a switch was flipped. On Wednesday night I spiked to 18.2 mmol/L after dinner and so took a correction … and within 45 minutes had plummeted to 8.6 mmol/L (that’s a drop of about 175 mg/dl for those reading in the U.S.). It was such a rapid drop that my Dexcom cut out and then (I think) tried to recalibrate itself and went back to saying I was still high—except my meter confirmed the drop was real. I proceeded to spend the next 24 hours constantly low (I did spike to 14.5 mmol/L after breakfast on Thursday, for some reason, but the rest of the 24 hour period was non-stop lows). I ate over 100 grams of carbohydrates without bolusing in order to treat or prevent lows. I then spent last night hovering between 12-14 mmol/L because I left my site in for three days (possible because of Flovent). I corrected with a tiny (comparitively speaking) 1.75 units sometime in the early morning hours and that dropped me from 14 mmol/L to 6 mmol/L (a nearly 150 mg/dl fall). After changing sites I was again low, low, low all day today. Over the past 48 hours I have lowered my basal rate by 20 units and halved both my carbohydrate and correction ratio (meaning I’m taking half the insulin for boluses and corrections as I was two days ago), and I am still having to eat to prevent and treat lows.
And so, while I can’t really take credit for this line because I’ve mostly just been eating non-stop to prevent lows (in fact, that slanted down arrow in the picture is now a 2.5 mmol/L), this is the flattest line I have had in weeks and weeks. I’m really hoping that this sudden, huge increase in insulin sensitivity is a sign that things are finally under control in the thyroid department. I get blood tests in a couple of weeks, so we’ll see. My fear is that all the insulin resistance that so suddenly disappeared will just as suddenly reappear. I’ve also got some chronic sinus issues going on which may have evolved into a sinus infection (I got a call from my allergist asking me to come in again due to some test results after I just saw him a week ago, which can’t be good), so who the heck knows how treating that will play into things.
All this to say: I’ve been knocked off my feet with diabetes control and I am still down—but hopefully this is a sign that I can start to slowly clamber my way back up.
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Jen - That’s an epic struggle you’ve described. I hope that your system has settled down and you can return to better times with your blood glucose. You should take credit for the better result since you didn’t give up and rode that chaos the best you could. I’m sure it could have been worse. That’s a sobering description. I hope Lady Luck smiles for you!
Thanks. Epic is a fitting word. Now I’ve been 13-15 mmol/L for the past four or five hours, so I may have overdone it on cutting back insulin. I’m doing a temporary basal rate to see what happens. I tried restarting my Dexcom sensor (day 21) and it wen tto ??? during the warm-up process (I think probably because I’m high), so I’ve restarted it a again, and if it still doesn’t work I’ll put in a new sensor. I think I’ve never been as grateful for or dependent on my Dexcom as I have been lately. I cannot imagine dealing with this without a CGM.
I have a question how much insulin to you give yourself for protein I have never done this and I am curious if I should start?
@audge – @Dave26 has not been active for a while. Please excuse me for jumping in here. I dose for 50% of my protein grams and count them as “equivalent carbs.” I divide 50% of protein grams by my insulin to carb ratio and then deliver that over an extended period at the maximum rate of 1.2 units per hour.
I should say I did do that as I just switched to multiple daily injections but still dose for protein. I’m on day three of this trial and still working out my bolus dosing. The pump technique I described above proved solid for me and I used it for four years.
It’s my understanding that our metabolisms prefer to use carbs for glucose and will not turn protein into glucose unless needed. Since I eat a carb-limited diet, I find my body does utilize protein for glucose.
Starting Tresiba tomorrow from minimed pump. Currently A1C has been about 5.0 - 5.2 following Dr. B and low carb. Anyone else off pump and on tresiba…do you like it. - how was the transition in keeping those flat lines! LOL thanks…
You might want to look a this thread Tresiba Basal Insulin , @Jacob2877.
Lots of discussion there!
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The figure I’d seen was that 53% of protein “converts” to carbs or is processed in a manner similar to carbs. I don’t count this as precisely as I count carbs themselves but usually use a sort of “chunk” approach of 5-10 extra grams of “carbs”/ bolus if there’s a hunk of protein involved as this will provide a bit of extra coverage for these items.
Sorry, could not resist posting this. Assisted by OpenAPS (DIY artificial pancreas system) at nighttime, a step closer to non-D glycemic control 
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@Dragan1, this is amazing control! And you’re consuming 100-150 grams of carbs each day. Do you suspect that you have any endogenous insulin left? If not, this is stunning.
I need to look into the OpenAPS system. I’m in the process of moving over the next few months. When things settle down, I’d like to start on the OpenAPS. I’ll need to find an old insulin pump to do this.
Your night-time numbers are flat, in range, and tightly packed. It looks non-diabetic to me! Thanks for posting.
Two images to share. One from a week ago, the other from today.
First, a 24-hour snapshot from early last week. Why, yes, I did indeed hit Dexcom’s HIGH and LOW display limits within the same day…
Second, an image of the past 24 hours. Not quite a flatline nor a no-hitter, but the best 24 hours I’ve seen in months. Trying hard to keep this going as long as possible!
And so the daily struggle, that is at times much more intense than others, continues.
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Wow, that’s amazing. I agree with @Terry4: looks as good as a non-diabetic to me!
