Free? Will do!
Thats pretty good stuff, thnks.
To increase time in range I try not to eat carbs after 4 pm. With a meal or snack at 4pm I check BG numbers at 6pm and if they require correction I still have 4 hours to work it out before going to bed around 10pm with nice stable and low BG.Another idea, I do not practice it, though, is to have one or more fasting days during the week. This way you will get 24 hours of time in range instantly. :)
The splitting shots might be a good idea. One reason that the 12U bolus takes longer to disappear is the fluid dynamics of shots > 7U makes them take longer to absorb. Dr. Bernstein cites a study. I did a *VERY* brief experiment with that as my NPH shots were 25-30U. I reread Dr.B when I ordered a pump and then had 30 days of logging, fidgeting, etc. so I tried doing 4 or 5 5-7U shots vs. one big one. It seemed flatter and may have had the added benefit of perhaps reducing the "turbulence" of NPH a bit however once I got a pump, it was like night and day.
I've noticed that weeks seem to have circadian rythyms, at least as far as my weight goes, irrespective of workouts, eating clean, etc. I always seem to go up Monday, sort of hover towards the middle of the week and then drop on Friday, maybe it's joy or something?
The thing I noticed with the pump is that little adjustments, .025U/ hour or .1GCarb/U will make a perceptible difference in both a "target" BG area (fasting= basal, eating= bolus...) and very often the subsequent time or times. It's hard to adjust that precisely with shots although I was always fiddling with the meniscus, above or below or on the line or whatever.
I've been doing that a lot lately in order to check my bodys behavior on the basal. It decreases some of the 'noisy' events, and definitely helps me because it decreases some of the complexity of the data, but it doesn't give me 24 hours in range. It worked, like a charm, yesterday, but today its fluctuating all over the place in new and unpredictable ways, again.
ahhhh, OK. Maybe if I need a big 12 unit bolus, I could do 6u in one hip and 6u in the other hip, thus encouraging the insulin to 'disperse.'
Its definitely something hormonal, or related to mood, something that can't be measured or controlled or even identified. No patterns anymore, but I'll get a bunch of data and see if something doesn't pop out.
About those little pump adjustments? If you pump it up 0.025U in an hour, will you been able to identify the result of that adjustment within a few hours? How long do you wait before seeing results? Prob not four hours, like my big manual adjustments...an hour or two?
For minor basal adjustments I see them within 1-2 hours. I also use this knowledge for exercise, I set a temp basal 1.5 hours before I go for my standard 1 hour workout.
Basal rate tweaks are the main reason I went to a pump.
Gottcha. That's nice, quick turn around.
Basal tweaks on a pump are all relative to each person and their overall insulin needs. I have a pretty low TDD(Total Daily Dose), ~26u, so tiny basal adjustments have a noticeable effect.
I don't bother looking for a change for like 3 days on basal but it might sort of seem zippier. I don't bother doing "basal testing" as I like eating and any sort of basal change will get sort of fuzzed out by the static of eating, working out, etc. I have so many basal rates now that if I change the dinner time ones, I won't see anything until the next AM or dinner time or whatever chunk of time. I am having a lot of issues in the AM and almost all of them are "cooked" a bit, with some basal adjustment or corrections or both these days. I'm also on the cusp of firing my doctor however am not due for another appointment until april so I'll hem and haw about it until then but I think I can get in early if I switch docs.
I hear that! I'm also a 'good eater.' I like to cook with basal, but my Doc will fire me if I bump it up anymore. I'm trying not to anger the dragon.
Riddle me, this???!!! Thursday: No DP. (applause) Friday: The opposite of DP (still OK). Saturday: The DP is back! I believe the data is too chaotic to interpret or treat in any reasonable way, but I will post it just to hear what your response. Some women in the forum have been discussing concealing their pumps in spanx, so try this data on for size, boys. https://www.youtube.com/watch?v=fNfK8bGuXtg
I am wondering if the data is so dynamic that any pre-programmed pump settings will make it worse, instead of better. Does that makes sense? I'm trying to find a better time in range before I participate in intense exercise. I'm a downhill skier and sometimes I ski all weekend. Its pretty aerobic and I gotta loose the wild swings or I'm afraid I'll fall of the lift. There's a bunch of flashing lights when I ski through the trees and I had a partial seizure on the hill last year, which scared the crap out of me. Trying to do better. I have to start with a good baseline before adding exercise into the equation because that's where things really go to hell.
I think the best way to cover that type of activity on MDI is to somehow figure out the rate at which you burn carbs in the absence of IOB and eat that many carbs/ hour or 1/2 hour or whatever can be made convenient. If it's hourly, have 2x the 1/2 hour dose but I think that it's better to have 2 smaller doses to prevent spiking, if that makes sense.
Thanks, man. I think that makes sense.
I'm really having difficulty translating manual injection doses into pump doses. It seems so foreign.