Diabetes Data sheet 08_08_2020.xlsx (208.8 KB)
I don’t know if this makes any sense but heres yesterdays. I also woke up this morning with a 147 after an over night low of 99 on the cgm witch came back up to 147 by its self by 530am
Your data records are excellent. Fantastic job. Fire the Doc. A lot of Doctors would really be impressed with this record keeping. They would be interested and they would take extra time to help get you where you want to be. This is the best that any Doc could ask for. You are a good patient. You deserve a good Doctor. I’m impressed.
Let me look at and think about the data…do you mind if I make a fresh post where we would get some fresh takes on the data?
Honestly, considering everything your fighting against, the numbers look pretty good. You might be struggling a lot and putting in a lot of effort, but your doing a good job. The numbers aren’t ‘bad.’ That might be why the Doc doesn’t give a ■■■■.
You are not stacking your correction bolus (you wait 4 hours after giving correction before you give additional correction). That’s good.
Your doing a good job of separating these events from one another, over the course of the day, so that we can see the impact of each.
Just off hand, it looks, to me, like you might be running a little high across the board. Would you agree with that statement or disagree?
I feel like you are running correction insulin all day long. That might be a solid indication that you don’t have enough background basal insulin.
I posted a clean post with data here: New guy needs help
Lets see what the others think.
We are gonna start by looking at basal rates. But, just so you know where we’re going down the line…
When you look at this data, you want to have a matching blood sugar value at the beginning of the blue box and at the end. (2 hours later)
Lets take the 1st blue box.
BG = 112 @ 9:20 am
BG = 214 @ 11:30 am
That meal insulin lasts for 2 hours.
If its 112 at 9:20 am, then we want to see somewhere around 112 at 11:20 am.
Now, your blood sugar increases during that time interval. It increases by 100 points. That’s a lot. Thats too much. We know that something is wrong during this time interval. We can be even more certain of this because you have extra correction insulin at play. It still ends up higher that where you started.
You do not have enough insulin in your body during this time period.
Lets look at the 2nd blue box.
You make a pretty good assessment and do ok. Your still a little high. You have to take a bunch of correction. But, your treatment of the high is very good. You have a good intuition about how much insulin to take. Your good at this guessing game.
Let’s look at the third blue box.
BG = 184 @18:00, and after 2 hours, you are
BG = 221 @20:00.
You only miss it by 37 points. Not bad.
But, your still running a little high and taking a butt load of correction to do that.
My conclusion: You should start by bumping up your basals up a little bit (maybe a unit at a time). But, just a little bit because we don’t want you waking up below 100. Bump it up a unit, get 1 day of data. Bump it up another unit, get 1 day of data. etc
Your sensor numbers look better than your manuals. What brand of BG machine are you using?
Your goal, right off the bat, might be to make it so you don’t have to take so much correction during the day. Your doing a balancing act that is no fun. We want to gradually bump up the basals and stop taking all that correction.
One variable that is standard throughout the entire day - you always have an extra 3 units of correction on board. We want to make that go away by increasing your basal.
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I don’t think it looks horrible, just some tweaks needed!
Okay, a couple of things I can see you might want to consider.
First it’s common for people to get DP (dawn phenomenon) before they get up. It’s a hormone release to prepare us to awaken. Some people get it worse than others, yours isn’t actually horrible. You just commonly take an adjustment for it. Before my insulin pump I would wake up over 200, now mine has settled down now.
At breakfast, In the morning because of my DP or FOTF floor if I eat I have a higher insulin to carb ratio before 12 noon than after 12 noon because insulin resistance is still sticking around for a few hours after I get up, because of that early morning hormone release. But it could also be the delayed absorption because of fats, Your lunch meal is very high fat. When I eat something higher fat with carbs I need to take some of my insulin a half hour or an hour after I eat it, because of the delayed absorption issue of higher fats.
I don’t ever eat until after my levels are in a range I am happy with. Eating when I am higher is just going to cause me staying higher. I wait until my correction bolus kicks in before I eat, some wait for their sensor to show a trend down before they eat.
Whenever you make changes, make sure it’s small changes at first until you know how you respond. You don’t want lows because you over adjusted something. You have all the time you need to make a tiny change and see if it works before you attempt another change. This is not a race that we’re all in, we’re going for the long haul. Your numbers don’t look that horrible really to me, I don’t think it will be that hard to change them.
You probably need to do a basal test. It doesn’t matter I believe about your gastroparesis because you don’t eat for periods of time when you do a basal test, so food isn’t supposed to effect it. Doing one for the whole day is even better. I do that every 3-6 months.
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Good thinkin’, Marie. I hadn’t thought of that as possibly DP.
I don’t the numbers are too bad, either, especially as a new pump user.
Have the exact same problem Rieb, know what you’re talking about. Crazy high and then watch out for the low. Try to moderate my insulin dose in response but when you’re high, all I can think about is getting it down as I feel so icky!
Also relate to the bowel issues too. Have found drinking lots of water helps relieve that problem but am going to speak to my doctor about it soon.
You’d think with the number of diabetics in the world they’d have addressed this more thoroughly and easily. It’s a problem that’s not easy to talk about sometimes.
If I get any advice I’ll update it here! Take care!
Sheryl
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