Increasing bolus needs

So I’m not sure what’s going on here but I am beginning to get pretty frustrated. I’ve had control that was very very good ever since I’ve gotten a handle on this situation but lately I’m having more and more post meal spikes-- pretty much always requiring post-meal afrezza corrections even when I take more and more novolog before meals. For example-- today for lunch today I had a BLT with double fiber bread equaling 24g net carbs. For years I’d have just dosed for the bread and not even counted the tomato or other garnishes. I’d have dosed at 6:1 so probably 4u of novolog and not expected to see a dramatic rise in my bg post-meal-- particularly if I’m active after eating… well today (and this pattern has become prevalent lately) knowing that I’d been seeming to need more novolog lately, rounded up to a full 5u-- giving me a ratio of more like 5:1 (which seems like quite a lot for a t1/ LADA)… was 99 before eating and an hour later after being active (working on my truck) I was at 212. I decided to go for a brisk hour long walk and was still at 190 at 2hr. So I know these flukes happen but I’m afraid this is becoming more of a pattern than a freak incident with me. I took a 4u afrezza correction with knocked it down to 80ish in only half an hour-- which is a godsend… but I’d really like to avoid the climb to 200 to begin with.

Why didn’t I just dose with afrezza initially instead of novolog? Well lately I’ve been noticing a slowing of my digestion that is seeming like I digest food slower than afrezza acts so had been tending toward novolog primarily for most meals and then just doing corrections with afrezza.

Any suggestions? Why am I needing more and more bolus and responding less and less to it even when I take more?

Don’t fight or disbelieve the data (BGs and dose size) you’re seeing. You have to be ready to add more insulin when your body asks for it. It really doesn’t matter what your body wanted yesterday, if it wants more insulin today then give it. I’ve done this increase before and then have to pull back a few days later. This is a dynamic disease. I have stuck with old trends for too long. Believe your observation, dose accordingly, and be ready to change tomorrow if needed.

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Kudos to my doctor— who while on vacation on the east coast just called me (at 10:30pm his time) and talked it over for a full half hour— his bottom line was: if your blood sugar is too high there’s only one inescapable conclusion-- that there’s not enough insulin in your body-- so take more." Pretty simple but I think it’s what I needed to hear reaffirmed from him and now you. He was also happy to hear I ordered the cgm and said I can link it so that he can access my clarity data from wherever he’s at and he’d be willing to pour over it any time-- thought that was pretty cool of him.

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