-----Flatliners Club-----


#1089

I love days like that! I hope it keeps up for you! It’ll be interesting what happens when the smoke disappears (supposed to happen this weekend). :wink:

I’m still struggling to stay in range. High all day yesterday, then had a mild low in the evening (3.4 mmol/L), low again overnight (2.9 mmol/L), low again this morning (3.1 mmol/L), now back to high (11.1 mmol/L currently). I’m hoping I can regain stability soon. I find when things go wonky like this just getting back on track and stable is the hardest part. Once I’m stable, things are “easy” and predictable again for at least a little while before the next bit of rockiness hits.


#1090

Just back from the clinic… waited only 90 minutes to be seen. This is my latest 2 week avg. My endo said she wanted to frame it and put it on the wall. It’s amazing, I’m amazing. My A1c is perfect. My cgm data is just… perfect. I am the best patient she saw all day. Even my labs are okay. Wow! I guess that I was worried for nothing. I don’t do what the gov’t guidelines and big pharma say to do. I do things weird. But obviously it’s working for me, for now. Yippee!


#1091

Nice graph - and nice job! Can you get my doctors to say similar things? :smile:


#1092

Gosh I was so worried about this visit. Usually she’s trying to jam statins down my throat. Thanks… sure, feel free to copy and paste. :wink:


#1093

Congrats on your great results and on your doctor’s intelligence to encourage you!


#1094

Thanks, Terry4. :blush:


#1095

Wow. You could sell that!


#1096

Thanks, beacher.


#1097

Well, the last 2 weeks (taking Symlin at 60/meal) have shown improvement – and no side effects:

Average BG was 103 (down from 112), SD of 23 (down from 25) and Time-in-range: 87% - improvement. though there will still spikes on the weekends that don’t show on the 14-day report.

Here’s the AGP graph:



#1098

How do you like the Symlin, @Thas? Have you been taking it for very long? I used it a long time ago. I had limited success with a little bit of weight loss. It made me feel nauseated, not every dose, but often enough. And it was one more thing to tack on to the D-habit.

Your numbers and lines are excellent!


#1099

I’ve had minimal side effects from Symlin – a little nausea, but only if I eat too much – which I should not do, anyway!

As for the success level - I’m not yet sure. So far, I have not seen any weight loss, though from what I’ve read, it takes a little while for that to happen with Symlin. It seems to have almost no effect on small meals, so I’ve stopped trying it at, say breakfast. For larger meals, it seems to soften the spikes – I took a “day off” from it yesterday and the spikes I saw were definitely sharper and higher than I’ve been seeing while taking Symlin. So, it seems to have an effect, but certainly not as profound as I saw with Victoza – only without the side effects (for me). I have seen no clear evidence of Symlin actually LOWERING BG, as the literature wants to imply that it does.


#1100

Wow, nice graph. How is Symlin going? I don’t think I want to try any more drugs… Am hesitant to try fiasp right now, after reading others’ experiences, off-label.


#1101

I thought I’d report in on my control, since it continues to be better than I’ve ever had before (thanks to Fiasp, setting my Dexcom alerts tighter than my actual target range, and eating a very low-carb diet).

My average BG is 6.4 mmol/L (116 mg/dl).
My standard deviation is 1.6 mmol/L (28 mg/dl).
I have 83% of readings in range, 14% high (above 8 mmol/L), and 3% low (below 4 mmol/L).

One new strategy I’ve been trying (inspired by those using APS systems that use lots of little basal suspends) is to use a 30 minute 0% basal rate prior to walking anywhere. Usually I have to eat several glucose tablets just to walk to the store or do any sort of commute anywhere. The briefly reduced basal rate works well at preventing that, although frequently I still have to eat a glucose tablet (but better than eating four or six). My pump unfortunately does not allow me to do temporary rates in smaller intervals than 30 minutes, so in future I might try suspending my pump to get more precision (I might try 35 minutes). I have to be careful, because I know already that 45 or 60 minutes without insulin will make my blood sugar skyrocket. I find 30 minutes causes my blood sugar to fairly reliably rise by about 1.5 mmol/L (or stay flat, in the case of exercise that’s simultaneously dropping it by 1.5 mmol/L). I’ve also used the same strategy to give my blood sugar a small 1.5 mmol/L bump if I’m running a bit low (but still within range) before bed or during the night. One thing I really like about Fiasp is that these temporary rates seem to kick in within 45 to 60 minutes, rather than having to wait two hours.

I see my endocrinologist this week and am going to ask him about trying metformin. The most annoying (remaining) part of my diabetes control is that hormones still throw me off as they cause 30-50% jumps or dips in my insulin needs. I saw Dr. Bernstein mention that metformin can help smooth these changes out for some women. I also hope it would help me lose weight, since despite eating low-carb and taking less insulin, my weight is just holding steady. I hope that my endocrinologist is open to the idea. I asked him about metformin once before and he didn’t think it would have much of an impact, so I tried an SGLT-2 inhibitor instead (and had to stop because of side effects).


#1102

Great report on your numbers! Before starting on an APS, I used temporary basal rates fairly regularly. I had luck with doing a one hour 50% basal reduction starting two hours before a one hour exercise period. After reading Sugar Surfing I would often reduce basal when I saw myself trending low, especially if my IOB was above a unit or two.

If you want to do a less than 30-minute temp basal rate, just cancel it after the desired duration. It’s more of a management burden but will work. That’s exactly what the APS systems do. They set a 30 minute temp basal rate but then re-examine the topic every five minutes and will set a different 30-minute temp basal, five, ten, or fifteen minutes later.


#1103

I think what I need is a slightly more than 30 minute temporary basal when I’m out and about, but not too long or I’ll go high. Using a 60 minute temporary basal and then cancelling at, say, 35 minutes might be a better idea than suspending, since at least that way if I forget to turn it off it’ll turn off itself at some point. I find that for exercise a longer but higher basal rate works OK (though to be honest I have not added exercise in to my current regimen, that’ll be my next major challenge, as during September to December I’ll be out and about walking around every day!), but it’s these quick errands that are not really “exercise” but often drop me low that have been plaguing me for the past year. The nice thing about doing a 0% basal rate is that if I’m going to go too high I notice it fairly quickly and can correct. All of this works so much better with Fiasp than it did with Apidra. I found temporary basals and the two-hour lag and one-hour lag for corrections very hard to deal with. With Fiasp, I feel like I’m working with 30- to 60-minute lags, which are much less work to deal with.


#1104

I remember telling my doctor one time about going low when I was only doing house-cleaning chores. Her questioning me about that made me realize that blood glucose lowering activity was not just limited to the time when you decided to “workout.” If your body is moving, it is expending energy and affecting your glucose metabolism. I think you could find some kind of temp-basal counter-measure for these “not really exercise” activities.


#1105

Yeah, so far the 0% temporary rate for 30 minutes has been working well. I think I like it better than the idea of a 50% basal spread over an hour because it kicks in faster and is easier to tell whether it works or not (at least with Fiasp). Sort of like the basal equivilent of a super bolus, putting the entire decrease up-front instead of spreading it out over an hour.

It’s hard for me because, not being able to drive, I walk or take the bus/train (which still involves walking) everywhere. So it’s a matter of trying to figure out which of these “counts” as activity and which do not. It also varies by time of day: my morning commute to work (which is an hour) doesn’t lower my blood sugar at all, yet the same commute in the afternoon always makes me go low.


#1106

How true! I live on the top floor of a walkup, and if I go downstairs to check the mailbox, that means going down and then up three flights of stairs. I can see the blip on my CGM. But if the mail is late and I have to check again, or for some other reason need to do those stairs, I’m guaranteed to go low. But it never occurs to me to take a pre-emptive glucose tab or two, or set a temp basal, for “just” checking for mail.


#1107

Ok… I usually post nice flat lines, but here’s a bit of a ‘troubleshooting’ one – still fairly flat (SD of just 15), but definitely NOT where I wanted it to be. That afternoon spike was a few cherries and a cucumber. I bolused for the cherries, so I blame the cucumber! WHY do cucumbers seem to spike me like that? Just a plain, fresh cucumber… :frowning:


#1108

Calorie King only shows 3.3 grams of digestible carbs per cup (3.7 ounce) serving of cucumbers. It looks like you posted the Clarity “trend” view that is often used for looking at many days instead of a single day. Although, the single day trace of this incident likely looks a lot like this view if you didn’t use too many days to look at. I think the cherries are more likely the reason for this BG bump. Did you weigh the cherries or do a SWAG dose?