Urgh… I had one of those nights yesterday with stubborn sugars that just won’t come down. I didn’t haven’t anything out of the ordinary for dinner - had a small breadroll with some protein (meat, egg and cheese) and some lentil soup and a small apple which I bolus for 45g.
After dinner I saw my sugar climb slowly, levelled out about 100mg and after about 10-15 mins started to climb again and wouldn’t come down. I was micro bolusing around 0.5 units at a time on its incline and did it about 4 times and also manually injected 1 unit of insulin (I still had 4u of IOB left). It hovered around just under the 200mg mark for most of the night despite my repeated attempts to bolus it down with the recommended adjustment bolus (in addition to the microboluses I had given earlier). By the morning i was at 170mg and I waited an hour for my prebolus to kick in before I had my breakfast.
I am always paranoid that I had underbolus everytime my sugar is off but I’m not really sure I did. My breadroll is the one i usually eat in the morning for breakfast which i account for 30g (and thats being generous), there’s probably 10g in the soup and 5g for the small apple (which i had shared a quarter to my dogs) so it seemed okay.
The only other thing I can think of is I did a cartridge change yesterday with a new batch of insulin. But I just had lunch and my insulin seem to be working.
So no idea why my sugar was so stubborn yesterday. Even if I had under bolused, a correction should have brought it down nicely with the amount I was injecting.
Just to add to this, while this was happening, I was watching one of Stephen Ponders webcasts talking about how to manage and react to blood sugars (an author that @MM1 had recommended in an earlier post) Obviously my sugars were watching with me and educated itself to not let me overcome it.
I do think you under bolused for that meal. I would have bolused 15g for the whole apple or 11g for the 3/4 of it you did eat and 20 for the soup (assuming you ate a cup of soup). Grand total of 61 grams of carb and I might have extended the bolus a bit to handle the protein and fat depending on how much of those you actually ate.
Also your site may not be totally bad but just enough that you weren’t getting all of the insulin you were dosing. A good tactic for a higher BG after a meal is to exercise, jumping jacks, biking, push ups, basically anything that gets major muscle groups moving especially the muscle group that is closest to where your site is. Are you a woman? Our hormones can throw even the best of us off track for a few days here and there depending on where we are in our cycle.
The apple was tiny. It wasn’t the regular sized ones. And I think i overcompensated for the dinner roll hence reduced a bit here. And generally apples don’t have much of an impact on my BG.
You are probably right with the soup. I was thinking its red lentils (isn’t this largely protein?) and all vegetable so wasn’t that carby hence was a bit light handed here. made it myself so there was no fat but i did add a tablespoon of grated cheese on serving.
I did this for 10-15 mins - not intensive but just moving around and doing punches. When i was doing this, my BG was dropping. As soon as I stopped, it started to rise again. I couldn’t keep up.
Yes. The hormones are annoying too I had just finished my menstrual cycle last week.
A 1/4 cup or 50 grams of dry red lentils has 33 grams of carb, 12 grams of protein and 7 grams of fiber, depending on weather or not you subtract fiber (I wouldn’t in this case but that is up to you).
Was your site in a good place for absorption? A different type of infusion set may help you out. Either a steel set or a longer cannula could make a big difference to your absorption.
My cycle will affect me in a lot of ways from making my BG bottom out to making me really insulin resistant. Do you have different settings for hormonal days? I have one that increases my I:C ratio and my correction factor substantially in order to combat hormone driven insulin resistance.
It probably was under bolusing but I still find it strange my correction boluses didn’t really make a difference. My correction bolus usually works so i didn’t push to give an aggressive bolus amount yesterday as I didn’t want to end up in hypo state in the middle of the night.
Yeah it’s on my tummy which usually works but the site could be at the end of its life. Because of the bad absorption yesterday, I put on a new infusion set this morning. Having said that, I did do a manual inject of 1 unit on a different site and that didn’t do anything to bring it down either.
I haven’t really worked out when it does strange things to my BG. I haven’t noticed any consistent pattern over the years. In the book “think like a pancreas” it says that BG is higher on the days before the onset of your period and lower after it begins but I haven’t really figured out a consistent pattern. What happens one month doesn’t hold in the following so I often just disregard any observations. I think my thyroid being out of wack contributed to the inconsistency. So I have never figured out when I should increase my insulin and when to decrease. When do you do it? That may help me pay attention more now that I have cgms.
Well I have endometriosis which makes inconsistent hormones a given. I just change my settings if I notice a sudden change in how my bg’s react to food. Then change them back when my bg’s start to drop too much after meals. It’s different pretty much every time so I can’t predict what or when.
Since we were talking about increasing insulin, I’ll just have you know this - you know how I had all my doses set super high? I wasn’t getting any highs, but I was leaning a little low? Well, I lost access to my sensor for a bit and had 2 ultra severe in 1 week.
Maybe a little high is better than a little low during these strange times. Not being able to maintain at all without a sensor is a sign that I am overdosing too much. Maybe I’ll set things up more like you have them - so there’s a tendency to run a little high.
Are you the type of person, @tedos, who is more freaked out by highs or more freaked out by lows?
You know after being on CGMS for over 10 days now, I think reliance on CGMS is growing on me and it is the only way to get good sugar management. I’m starting to think, CGMS is more important than the pump. You can replace the pump with MDI but you can’t replace CGMS with finger pricks unless you want to end up with no fingers😅
Yes by highs! Is that bad? Lows can be frightening but they are easier to resolve. When you run high, those damn blood sugars have a mind of their own and I feel like crap for hours.
This is probably wrong but a part of me feels like I’m being judged when I’m running high but I don’t get the same feeling when I’m low. It’s sort of related to the concept of HB1AC. It’s a screwed up indicator. If it’s high you are doing poorly, if it’s low, well done but that as we know doesn’t indicate anything! You can have a great HB1AC and be in hypo land all the time.
Even if I had under bolused, a correction should have brought it down nicely with the amount I was injecting.
I had just finished my menstrual cycle last week.