That’s a great idea Trudy. Thanks, I will look into that.
I will correct anything greater than 130 or less than 70. Sometimes I will correct at 75 if I know I may have over done it on the insulin and I’m pretty sure I’m sliding down.
I should have prefaced this with this statement- I have no hypo symptoms at all and I have gastroparesis. I do pump and cgm so the statement i made about not correcting a 210 without eating should have been more like I tend to run a bit higher just so I avoid having a low, so generally I’m eating a meal with that 210 and therefore I’m correcting the BG and covering my food. My ranges allow me to have a buffer to avoid crashing. Hope this makes sense for you guys that were wondering!
Yes, that makes a whole lot more sense!! 
Talk to Gerri and KellyWPA about gastroparesis – they’re both managing it extremely well and may have some tips you hadn’t thought of! Good luck with it – it’s a really tough game to play! 
Neither my son nor my daughter can feel their lows either, but no gastroparesis that we know of. Like Natalie was saying, Kelly keeps herself in a really low range, I think that her Dex is set for 120 for the high. She seems to have found a way to manage tight control, and says that staying on top of the numbers when the food does decide to digest is key. Running a bit high to avoid lows is one way to manage, but I think that accepting that lows are going to happen and not being overly fearful of them will keep you in better health generally.
I wonder too if some people’s doctors might contribute to the sense of concern about “lows” that might be better classified in some sort of “middle ground”, “buzzed” without being zonked out of one’s gourd? The MM software distinguishes between “below range 60-69” and “hypo” of < 60 which I think is an important distinction? looks at report while I got 8% in the “below range”, only 4% were “hypo” so to me, that’s somehow better than 12% hypo or whatever? Sometimes I think the data gets a bit skewed because I’m testing more when I’m running low and perhaps because I am sort of inclined to run lower before meals when I’m testing too.
I am lucky in that I don’t seem to have the same problems with not feeling the lows either. While I don’t seem to get “the sweaties” as much as I used to when I had wider swiings, I still feel a definitely perceptible loss of concentration. I also have noticed that I can really feel it if I’m running as my energy level drops perceptibly. Not huge but there’s enough there. Most of the time, I’m staring @ my CGM all the time anyway, because I’m sort of OCdiabetes that way but I am still feeling it too.
Interesting this is a topic. I just had along talk with my endo on this very topic. My A1C was 5.1. The endo freaked a little and we discussed my control. I have my CGM set for low at 70 and to alarm me for a high at 200. My target was 100, so depending on the situation, I would correct for anything over 130 and anything less than 70.
However, the endo felt that was way too tight control. I have to admit that I kind of agree with him, but I have been so terrified of complications that I keep it that way. I am always low. I rarely have highs and it is usually something I can point to as the cause. (However this heat has wreaked havoc on my BG!) So, after consideration, I changed my target to 120 and set my carb ratio a tad bit higher–from 1 to 10 to 1 to 12. I am really having problems following this, because I am so used to pumping .5 units to correct a 135 down to 100. So if the bolus wizard tells me .2 units, I sometimes raise to .5. It is an ugly circle.
The low thing is really beginning to concern me, as I do not remember things as well as I used to. I commonly have BGs at 23, 33, etc. So, I am going to continue to give this s try–change my whole outlook! Can I do it? We’ll see!
Good luck with making the transition. I use similar targets and was starting to get too many lows in the 40s a couple months ago. I made some small changes (cut back a bit on basal, changed a ratio or two) but I also now “hold back” about 1/3 unit of insulin when I eat my typical lunch. I was having too many lows in the first couple hours. I’ve discovered that I usually don’t need the extra when I test 2 hours post. I’ve found that method to be easier to stick to than changing ratios.
Maurie
I like the idea as long as we always remember “buzzed driving is drunk driving”
I have my pump set at 80-120 and treat any low under 70. Of course, timing is everything. If I’m heading to bed and test lower than 85, I will generally eat something like peanut butter to ward off any middle of the night crashes.
My pump target is set 90-100. I will correct anything less than 70 or above 110-120 if no IOB. My CGM limits are.set for 70 and high of 160. We are TTC so control is tight. I also have OCbetes as Acidrock likes to call it.
What’s TTC?
Trying to conceive
wow, if my BG is over 120, I correct it. I run a tight ship. I have my pump set to give me an alarm if I’m below 65 or above 120. I follow Dr. Richard Bernsteins approach to type 1 diabetes and highly recommend it. He advises eating only 30 grams of carbs per day but I eat more than that…always keeping it below 70 of total carbs per day…usually closer to 50. It’s a very individual thing, if your A1C’s are where you want them to be, no worries, if not, I’d suggest tightening the reigns a bit. My goal is to never let my glucose get over 140 (because in a normal person it doesn’t go over 140). My goal for my next endo appt is to have an A1C at 5 or below. if you’d like to read more about this method, you can read THE DIABETES SOLUTION by Dr. Richard Bernstein…he is a type 1 himself and has been for over 50 years. even if you don’t do his method, he has good ideas you could adopt into your own method of treatment.
Okay so when you guys correct do you correct at the two hour mark? Also, if you correct with say one or two units do you have to wait at least 4 hours to eat/bolus for your next meal to ensure you are not overlapping boluses? Corrections is the thing that I STILL have not been able to figure out. It is so scary/confusing to me as I do not want to overlap boluses and I am on shots so do not have the IOB feature on a pump.
Yes I correct at the two hour mark. I don’t wait to eat. I generally eat five hours apart, so with a duration of 3.5 hours, there really isn’t much left (some people use longer durations). But the bottom line is to keep track of the IOB. If you are on a pump, yes, the wizard does it for you. But I used to do it myself when I was on shots, rounding it off to the next lower whole number to be cautious. The use of insulin is not actually evenly used but when I was doing the math myself I just assumed it was for convenience. (Since you figure your ISF as well as your duration based on trial and error it will come out right whichever way you are used to doing it).
If you are bad at or hate math, yes you might find it easier to just wait, but for me I’d much rather do math than wait to eat!
I am not good at math. When I was on shots, I would correct at two hours but would give only 1/2 my usual correction and would only correct readings over 11 mmol/L (200 mg/dl). This was mostly because at the time I didn’t have half-unit pens so the least I could give myself was a unit, which lowers me 2.5 mmol/L (45 mg/dl). With half-unit pens it would be easier to correct lower numbers without ending up low.
At night I also use half my usual correction dose, even now on the pump and regardless of whether it’s been several hours since I ate last. Your A1c is really good already, but for those of us with higher A1c’s it’s better to correct a high even partially than to spend hours and hours high while waiting to eat and/or overnight.
One thing is that if you are honeymooning (I see you’ve only had diabetes for a year and a half), this could be different. I’ve had T1 for 20 years and if I don’t correct a high it will not budge until I throw some insulin at it, even overnight. So if I go to bed at 11 mmol/L (200 mg/dl) or whatever level, I will wake up at 11 mmol/L (or whatever) eight hours later if I don’t give a correction, and it’s obviously not good to spend so much time high. If you are still honeymooning and a high comes down on its own over a few hours, I can see how waiting might make more sense.
I correct at 1 hour all the time, usually if it’s heading up steeply after getting carried away with carbs or even just miscounting I’ll figure I missed a few and do a CB which I think is really more about catching the missing carbs before they run up too much? Sometimes I’ll guess “oh, that’s about 35” and then reconsider that it might’ve been 40-45 even 50 if I overlooked something here and there.
My insulin is not finished working at the 2-hour mark, and so I wait until 3 hours, when it’s pretty much done. I am lucky enough to have a CGM, so it’s very clear when and whether it will come down again. If I didn’t take enough insulin to cover the meal, it will go up and stay up, whereas if the insulin is still working, it will start to come down, and if it hasn’t come down enough by the 3-hour mark, I do correct.
When I was on shots, I had a terrible time with lows, because in my fear of highs, I would stack insulin, and that REALLY doesn’t work, LOL! I think that’s the biggest problem with correcting at the 2-hour mark. And the other good part of the pump is that if you tell it you’re 180 at the 2-hour mark, it will tell you whether you have enough IOB and whether to correct or not – I couldn’t deal with trying to figure that out in my aging brain!
Stacking insulin refers mostly to corrections. There is no reason to have to wait at least 4 hours to eat after a correction. Just give yourself the insulin for the meal if you feel the correction is going to be enough to bring you back to target. No reason to worry about overlapping boluses in my opinion, as long as you are using the right ratios for your carbs.
The pumps all figure out IOB differently anyway, with the Omnipod only subtracting IOB from the correction part of the bolus. Otherwise it assumes that you have both IOB and food still digesting to use it up.