Let me preface this with I know I need to speak to a doctor, but am in a weird scenario - my primary care and diabetes manager passed away. I was already on the path to bariatric surgery (modified duodenal switch), and I am 2 weeks from my surgery date. I am on the t:slim - she and I would have been working together to adjust my insulin dosing and monitoring, as well as thresholds to step down on treatment, but now I have a 6 mo waiting list for a new endocrinologist and a new primary care who acts as though she has never treated anyone for T2D.
I have sourced research on NIH and found evidence-supported guidance on reduction of fast-acting and long-acting (which we have to convert, obviously, for the pump). NIH study recommends cutting basal by 30% and bolus by 50% during pre-surgery low calorie intake. Post surgery is to discharge with 50% basal, and manually control bolus, with possibility that I may keep cutting by 50% at a time as I see what glucose ratings are.
I have Dexcom CGM, so I will never be in a situation where I can’t just decide to stop or change insulin levels if things are going awry. But the NIH recommendations are macro, not micro, and don’t get into things like correction factor or carb ratios, because they are assuming daily injections versus continuous pumping.
Any suggestions, experience, references or just plain advice on what to change? I can turn off control-IQ, I guess, and I can just change my personal profile to cut the basal rate by the recommendations, but I am not sure how/if/when to adjust the correction factors.