I set my AIT time at 5 and I’m having fewer lows. I also gave up carbs because I just couldn’t cover them. I’m on a ketogenic diet again, unless I’m eating sugar for lows, which I was on last year for about 8 months. I’m still getting low at 3 p.m. I don’t know what to do. I have a few different CR, but what is the best thing to do? Raise the CR number starting at around that time? or an hour before? What do you think? Please share your thoughts.
Also about the lows, I think the pump keeps on making me low because I have to eat quite a bit of sugar 4-5 tabs to get out of it, and the pump doesn’t know I’ve eaten, so remembers the rise for the next day. I was in a be 50s yesterday. Couldn’t check my meter today and just ate the sugar. I don’t know how to stop this trend.
Caveat: I’m not an expert, let alone a certified trainer, and my problem has been with the pump not being aggressive enough about highs rather than letting me run low, so I’m not sure how helpful my experience is. But this does sound a bit contradictory: you’re struggling with lows, but also not being able to cover the carbs? Setting the AIT that high will certainly make it a lot weaker in responding to highs, so there’s that. I would have thought it would cause you to run higher in general, but setting it to that extreme a value may have other consequences in how the algorithm interprets and reacts to what’s going on. I’d guess that dialing back AIT and working more with CR would be the way to go, and yes, any CR adjustment should take account of the lag between when the ratio change starts and when it takes effect in your body. Theoretically you’d raise the number in anticipation of when you tend to go low. But you should definitely have some more expert advice about which parameter to alter first and how much, since making multiple changes at once can lead to confusion about what’s actually going on. Do you have a trainer who can help with that?
Hi DrBB,
The trainer had me go to 5 on AIT because of lows, but didn’t really say anything about CR. The trainer has not made contact in quite a while. There was a response after I e-mailed her stating I was uploading to the carelink site, so long gone I guess.
Thanks
Have a great day! 
I see your confusion to my post now. Every morning after a breakfast at 0500 of a 15 carb piece of toast and an egg I would end up going crazy high about an hour or 2 later. If I took a bolus large enough to cover it I would go low in later in the morning. So I just gave up most carbs.
Later in the morning with the lows, the pump would kick out of auto due to giving minimal blouses for 90 mins to safe mode. When safe mode would start it would begin giving me microboluses, even if I was in the low 50s. No turn off limits in safe mode. So I’m afraid to take morning blouses because I can’t always get to my meter right away at work to take the requested BGs immediately. I still get lows in late afternoon now at around 3pm after not even taking any bolus at lunch because I eat few if any carbs. So I wondered if I could increase the CR number to have the pump deliver less insulin via microbolus before 3pm.
That’s what I meant.
Have a great day!
Ah, gotcha. That is a tough one. I would definitely try increasing CR in the afternoon and see how that works. My experience is that it takes some days for any change to take effect–part of what makes it so hard to get these things dialed in. If it seems to be doing the trick you might set a higher pre-breakfast rate as well and see how it works with your morning toast. As I’ve said a few times, I think it’s better to think of these parameters as just dials you can turn to get the thing to do what you want, and not worry about whether the value you’re putting in is actually your CR or AIT in any absolute sense.
Thank you! Today I am running about 180 at 3:30pm instead of below 70. Yay! (Although I have been running unusually high since this morning) I saw posts about coffee raising BG. Why is that? I have a coffee with real cream with no carbs, but sometimes I just go high after. I have another question I haven’t heard mention of as of yet about the max basal. Mine was set at 2, but often I’m either kicked out of auto mode from max basal for too long, or minimum basal for too long. I am changing it to be a little higher to see if that helps. I may be under bolusing sometimes due to the higher CRs than my old one and the fact that you can’t adjust a doses without falsifying the number of carbs entered.
I hope someone had info or ideas on the max basal
Thanks again!
Have a great day!
Hi again, I gave up changing the max basal because I don’t think it changes anything in auto mode. Keeping at original.
Have a great day!
I was confused by this too, but here’s the answer: yes, there’s a Max (and Minimum) basal setting you can adjust yourself, but those settings only pertain to manual mode. In auto mode, the algorithm sets these limits by itself and it doesn’t have anything to do with the manual setting. Early on I thought I was finally getting a handle on things when I started getting the same warnings you’re referring to and thought, “Aha! It’s running into a limit of how much basal it can deliver, that’s why I’m running high! I’ll just raise this limit!” But nope. In other words–
Yup.
Not sure why I didn’t think of this before but have you tried setting a Temp Target during the afternoon to deal with the lows?
I have done it when I was getting late morning lows. It’s so hard to do anything at a set time at work. It’s hard just to take a BG when the pump asks. I had set it in the morning for 12 hrs. I got low today at 5:15pm but was ok at 3:30. Maybe the increased CR is working. I will try extending the time with the higher CR. Thanks for all of your insight!
Sue
Have a great day!
I have a 670G gathering dust because Medtronic will not supply sensors. Latest update - possibly by the end of December. Does anyone have more information about this problem?
Thanks.
How is it going? Looking into the 670 for my 17 yera old, she’s been on omnipod and dex for 5 years…
really? that’s weird… looking into getting the 670 for my teenager, she is also on dex and we have some extra sensors since she restarts them after a week. I wonder if she could start the 670 and still use the dex till the new sensors come?
I’m in week 8 of auto mode now and as of the last 5 days or so my Dawn Phenomenon seems to finally be getting reasonably in control. Basically high fasting a.m. numbers were throwing off everything else, b/c I’d still be too high at lunch time for pre-bolusing to do much good, then post-prandials going way too high and so on. For me that was the biggest battle, so I’m feeling more hopeful about the whole thing. But I’m still questioning whether it will ever get me back to the ~6.0 A1C’s I was getting with a standard pump. Seems like the people who are the most pleased with it are the ones who are getting into the 6’s with it. who were seeing 7’s, 8’s or worse before. That seems to be the really sweet spot.
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Today I was notified that no sensors will be shipped until 2018.
Sue, are you referring to the generation of MM sensors following the Enlites? And if so, have you ever used them, and the Enlites? If 'yes" did you find the newer ones any more accurate? My doc says the newer ones are just a little bit more accurate. Nothing earth shattering.
Hi, Dave,
My doctor prescribed the 670G and Medtronic shipped everything but the sensors in September.
The sensors that go with the 670G have not been provided. Whatever they are called, I haven’t used them.
I have used and like the Libre, but it is not integrated with any pump.
Thanks,
Sue
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Sue great for you that you don’t do Facebook
DrBB I’ve been having hypos while doing intense 1-hr sessions on my bike trainer. I use the temp basal, but I I am still going to 65 or lower. Any suggestions? Should I just raise my sugar with phantom carbs like I was doing with the “dumb” pump? I’m concerned that will mess with auto-mode.