How am I Doing?

Approx 2 months on an insulin pump, 3 months since I was retyped from Type 2 to Type 1. Here’s my data from last week from the pump (Diasend).

Any suggestions?
4461-pump.jpg (111 KB)

Data’s in the JPG attachment.

Good job! I wonder if maybe your basal is a shade light since it’s a bit < 50%? That’s sort of what I shoot for, sometimes I fiddle around with stuff and correct a lot but a smoother basal might, in turn, lead to less ups and downs? 80% (I’ll round up!) in your goal range is really a good result! Another thing I do is set my high “alert” w/ my CGM to 140 so it vibrates when I get there. A lot of the time, I sort of watch it like a hawk but, if I keep an eye on it, sometimes, I can get out my 9 iron (CB…) and beat the hell out of a high while it’s starting, instead of after it’s got it’s teeth into me…

Great job!

It’s very hard to answer the question how you’re doing because I don’t know how you were doing before the pump but I do have a couple of suggestions -

  1. The standard deviation is pretty high. I know that John Walsh writes that the goal should be a standard deviation under 50 but I think setting a lower goal makes sense. Having flatter numbers will help you feel better.
  2. Testing 7.4 times a day makes it hard to get the most out of a pump. Testing just once after each meal plus bedtime makes it likely that you’re missing quite a bit of useful information. I try to test at 2 hours post and 4 hours post for every meal. Doing so has taught me a lot about my patterns.
  3. You’re waking up high. Tweaking your overnight basal after some basal testing might be helpful.

Maurie

How are you doing? Of course you are doing great. Moving to insulin is a challenge and then moving to a pump is another. You have lots to learn and with a pump, if something goes wrong, like an insertion set is messed up you get a high blood sugar, not a little 140 mg/dl, a whopper. Can you improve things? Certainly. I expect you will. There are certainly people that have a lot of experience and can help. But round these parts, being so with in sulin and pumping, I think your doin great.

Thanks - so what exactly are you doing when your BG is higher than 140? I assume that’s after meals? That’s one thing I really want to get better control of…I feel I’m spiking too high after meals.

The one thing I don’t really get about the pump is the post prandial stuff, particularly when I need to guesstimate the carbs I eat.

If I start out at 130, eat an estimated 40g carbs, take the correct amount of insulin to cover the carbs and the high, then two hours later I’m still high (say 170), I feel like I should take more insulin.

I understand I still have on board insulin, which should correct me down to 100, assuming the correction rate is right, but what if I was way off on the carb estimate?

I guess the safe thing to do is wait until the IOB is all gone, then correct, but that’s 4 hours of high BG.

Hi Maurie. Here’s some background. I was diagnosed Type II in 2008, was in perfect control 3 months later on Metformin for two years (A1C under 5.5). Then November of last year, Metformin stopped working. BG’s shot up into the 300-400 range with even a tiny amount of carb.

Took 3 months to get referred to an Endo, during which time I ate extremely little, 10-15g carbs a day. I couldn’t get out of the 200-300 range. Lost 40 lbs. C-Peptide test pointed towards LADA.

When I finally got to see the Endo, he confirmed the LADA diagnosis, and we started on MDI. My A1C was 8.9.

Right now, I’ve gained 25-30lbs back and am almost at a good weight, so I’m eating quite a few carbs still.

I’ll take your suggestions to heart and start testing more after meals. I know my waking numbers are not ideal. My Endo just bumped up nighttime basal to 0.5, but I think it can go a bit higher still.

I’m overall very happy with the numbers, but know I can fine tune some things to get tighter with suggestions.

Thanks!

Yep - had one get messed up 3 days after getting the pump. I inserted it badly…hand was shaking. It’s amazing how quickly BG shoots up when you don’t get the basal dose.

Hi -

Hi-

Good for you for putting back most of your weight so quickly. It took me years.

Low carbing is an option for Type 1s but if you can manage more carbs then go for it… I eat 150-160 net carbs per day and do ok… But I weigh everything and even take a scale to restaurants and friends’ houses. It looks silly but my dosing is more accurate.

If you’re spiking after meals you might try adding more good fat to your diet. Things like olive oil, peanut butter, almonds and avocado will slow your digestion and give your insulin a chance to catch up. They’re also fattening :slight_smile: which can sometimes be a good thing. However, you may discover that you’re going higher at 3 or 4 hours although your 2 hours are better which is another reason to test more.

Good luck,

Maurie