Do have any strategies that have worked for pushing up the time spent in range? Recently started adding a large source of protein at meal time and that has allowed me to lay off the carbs a bit (thanks, Dave, and everybody else). I think that has pushed the post-meal spikes down. But, I'm still only managing to reach about 30% time in range. I think that's really on the low end of what everybody else is able to achieve. I'd like to reach 50% time in range. I think my basal/bolus are adjusted as well as I can get them. There's so much variability in the data, now, that I'm really having trouble collecting meaningful data for my Doc. I would like to, for once, walk into my next appointment and show her that I had improved something. I have a hole bunch of really crappy data, so it shouldn't be that difficult to do.
I'm really experiencing difficulty on the tail end of Humalog boluses, especially when there's added Humalog correction. One problem with the data is that I am essentially increasing morning basal via correction doses and that blocks out a four to eight hour window where I can't even test meal bolus. Why in gods name does it take the correction 4-8 hrs to disappear, but it only takes meal Humalog 2-4 hours? That just doesn't make any sense to me and I hate it. Does it help to eat 15 grams of carbs and does for 45 grams?
I might not be timing morning correction very well - sometimes I give one giant 12u bolus, mid-morning, and sometimes I break it up into two 6u boluses and deliver as needed at varying times. Both strategies have varying results. Lately, I have seen days where I required no insulin increase in the morning. Anyway, assuming that the amount of morning insulin required, varies between 0 and 12 units, that seems like lot of difference. I don't know how I would program a pump to do that. I think that I would deliver a healthy temp basal, say, a unit per hour for four hours, and I would assume it is active in my system from the moment of delivery, until four hours after the final temp basal dose is delivered. Wash, rinse, repeat.
Any ideas/experiences/suggestions would be greatly appreciated. The data seems to improve when I eliminate meals, but its still not very good.
I've been reading the artificial pancreas algorithm papers online and I am simultaneously very optimistic and very pessimistic. Mostly, just frustrated. Excited for the more rapid acting insulin that Dave or David mentioned to me. If I happen to grow any, maybe I'll experiment with your inter-muscular injections.
Here's a picture of a puppy to reward you for having the tenacity to read this. Diabetes makes me so sick of hearing my own thoughts. Thanks for any of yours that you have.