I've been using Apidra in the Omnipod for about 2 and a half years now and last week I switched to Novolog. With Apidra I was all over the place, high, low and everything in between. My endo and I decided it was time to try something new and since Novolog was covered by my insurance and Humalog wasn't, Novolog it was. The good news is that my readings have been more stable in the last week than they've been in years, no more sharp spikes after meals followed by equally as sharp drops. The bad news is that they have all been around 200, give or take. So my question is how do I know which one of my settings needs adjusting, basal or IC ratio? Even my correction doses don't drop me into normal range. I've been holding steady overnight and in between meals like never before but as I said, I've been way too high. If I could just take this new flatline and drop it 100 points, I'd have it made. Thank you in advance for any advice.
Obviously the insulin to carbo ratio needs to go up and the sensitivity needs to go down. A flat to slightly downslope graph overnight and long after eating shows the basal is right.
Do you have a copy of Pumping Insulin by John Walsh? He walks you through the testing process, will need to do a basal check to confirm basal rate is good then follow up with test of DIA, then C.F. and I:C ratios.
If you have CGM it's fairly easy, as the trend lines show a Hugh amount of data you can use.
I actually just ordered a copy the other day, it's supposed to get here next week. Hopefully it helps. Also, I do use a CGM. Thanks for the reply!
If your blood sugars have been elevated upon waking and then before meals when you have clearly been fasting for 4-5 hours then your basal needs adjustment. Pumping Insulin as well as most sources will tell you to get your basal rates adjusted and then work on your mealtime/correction ratios.
Hi Steve. "You asked How Do I Know Whether It's My Basal or Bolus That Needs Adjusting?"
The first thing you need to do is basal testing as 2hobbit1 suggested. The book you ordered will guide you. No answer is obvious, or certain until you test. So before you begin making adjustments to one or the other, do the proper testing and you will KNOW. Good luck.