I am sitting here tonight 2 am in the morning. I gave myself a correction bolus of 8.75 units around midnight. What is a safe number for IOB before I go to sleep. At last look I still had 7 units on board. This is one of the reasons I have now decided to get a CGM. Waiting for insurance approval.
A correction of 8.75 is a lot of insulin in my opinion. In my world this would mean that I am far beyond normal levels - actually I would call it uncontrolled. It would be an exceptional situation and there would be no guarantees that this will be safe. As a consequence this means that normal sleep is over: bells ringing every 2 hours for testing and so forth. Why do you think you could handle this situation by exact dosing in a way that you could sleep safely?
I was over 300 when I gave myself the correction last night. earlier that night I had to much IOB left so I ate some snacks to try and compensate. I thought everything was fine until I took it at midnight and saw it was over 300. I finally went to bed with 4 units active and BG was at 181. My ISF is set at 25. I was still nervous about going to bed then but figured I would be OK which I was. Woke up this morning at 125. Thanks for your reply Holger.
I think ICF is not an exact number for all BG ranges. Typically with higher BGs, you will need more insulin to drop 100 pts. But a 'pure' correction factor assumes no 'food on board' that was not covered with bolus.
As for a safe number for IOB before bed, I think it depends on whether you have 'food on board' at the same time. I like to have a snack before bed, so often have both IOB and FOB !
But it's good to be more cautious at night time, especially without CGMS. So glad to hear all worked out fine.
When you had snacks earlier in the evening, to cover IOB, had you checked your BG ? If you BG was ok, next time you may want to wait before making a 'food correction'.
Glad it turned out alright. I agree that we all have different ISF's but I don't know that I trust mine enough to go to bed with that much without testing during the night. I also agree with MegaMinxx that I wouldn't "feed the insulin" by eating a snack because there was IOB earlier in the night unless you were actually low (in which case I'd recommend glucose tablets for quicker more exact correcting). The kind of roller coaster you are describing is worse than a simple high or low. If you are finding you are taking too much or too little insulin and having a lot of highs and lows I would go "back to the drawing board" and look at your basal than your bolus and tweak doses.
My basal rate is good. Just did a 24 hour check on it a couple of weeks ago. Stayed between 80 and 120 the whole time. When I ate the snack I was at 112 and I still had 7 units of IOB. I got worried because I was close to wanting to go to bed. That didn't really work out all that well for me because I definitely over compensated and still had to stay up way longer than I intended.
Just trying to understand the timeline here. When you ate the snack at 112, you had 7 units of IOB and were close to bedtime. How long before bedtime do you eat? I for example, eat will eat dinner around 7 tonight, so I'll bolus around 6:45. I don't go to bed until midnight at the earliest so I'll have no insulin on board. Even if I tested at 9 and was high and then corrected, that will still be mostly out by 3 hours later. My suggestion is to put some more time between dinner and bedtime so you don't have to worry about having insulin on board (or not much) when you go to bed. Given how high you went after that, either that was one hell of a snack or else you really didn't have that much IOB. How long are you calculating your duration for? And how many carbs do you eat for dinner? Another option is to reduce carbs because a 7 unit bolus seems like a lot for a type 1.
I ate around 7 and then rechecked around nine. This is when I ate a snack. At Midnight I only had a couple of units on board. duration is for 4 hours. When I ate my meal i figured it was 111 carbs and bolused around 12 units. You are right I do need to reduce my carb intake.
Last night after I ate my BG went up to 298 after eating around 65 carbs. I did do a correction bolas a couple of hours later of 1.5 and woke up this morning at 109.
I don't follow Bernstein (low carb) but I do like his Law of Small Numbers. What he says, basically is the more carbs you eat, the more insulin you use the more risk you are of going either too high or too low - that is of making really bad errors. Less carbs = less insulin, = smaller errors or none at all. If your meals in addition to being very high carb are also high fat, you are extending the time of the spike and making it very hard to bolus for accurately. Some foods such as pasta, rice, cereal are just near impossible for some of us to accurately bolus for. Try reducing it some by eating more protein, salads and fresh vegies and you will see both a corresponding drop in your insulin needs and your accuracy in bolusing.
The other risk in eating a lot of carbs and needing a lot of insulin, is developing insulin resistance and gaining weight.