Thank you for that. I am going to take a serious look at what you say.
One of the reasons my daytime Basal is so much higher is that I am on Prednisone, a steroid that sends my sugar through the roof. I am, what used to be called, a brittle diabetic. I have always felt that if I got something right, my body did something else. These Basal rates were actually worked out with, and suggested by, my Endo. For most people, they do not make sense . I live it, and it does not make sense to me.
One positive thing I have noticed with these changes is that my Control I Q pretty much takes care of, catches any highs during the day. I do have to pay attention before doing a manual bolus when my sugar is rising or I create the low.
I do not like seeing 200ās, even after meals. More often than not, it goes there after a meal, though it does not linger very long. I am never happy with my stats that show me out of range, or over 200. At someoneās suggestion I changed my insulin duration from 3 to 5 uhr. The past two nights I have had no lows, and my blood sugars have stayed steady throughout the night. This is in sleep mode. I think that change may have affected the daytime readings negatively. Yesterday, the same meal that worked the night before, sent my sugar through the roof when I ate it for breakfast. I do not fully understand how that factor plays in the overall picture.
I recently adopted the Mediterranean Way of Eating, both for my diabetes, and because I had heart bypass surgery last August. Quite an incentive. I always ate healthy, and was careful, but am learning so much more is possible. I have other autoimmune diseases that affect things too. Itās complicated. I keep trying to figure things out, make adjustments where I can, and work for the best outcome.
Thank you again for your thoughtful response. I will take a look at your suggestions and let you know what changes help.
@Nan - have you ever considered altering your insulin:carb ratio for morning meals? My insulin resistance is significantly higher for several hours after rising (due to morning cortisol your body releases). Simply put you likely need far more insulin to cover the same carb meal in the morning than you would in the evening.
I have my basal rates as low as 0.075 on a Medtronics pump in the afternoon and at nite. Basal insulin is less than 20% of total. For me, accurate basal rate testing is very important. When testing basal rates, I verify with extra finger sticks,
The 50% basal insulin is just a rule of thumb carried over from MDI. i havenāt found any actual studies supporting 50% basal.
Rules of thumb in managing blood glucose and insulin dosing may have some validity in preliminary determining basal rates, insulin:carb and correction. We are all unique electro-biochemical packages.
And there came be changes with hormonal cycles, physical activity and other changes in life.
For these reasons I am of the opinion that extremely automated insulin pumps are not the way to go for some of us.
I use the Tandem X2 with C-IQ and am comfortable with it. I have a couple of basal rates, can over or under ride a bolus. Giving up the ability to fine tune my dosages as needed would be a reason to chunk the pump and go back to MDI.
My experience with the DIY Loop automated insulin dosing (AID) system is much the same. I require that any AID system must allow for changes or adjustments of any and all insulin delivery at any time for any reason. If the person using such a system is a competent and informed adult, they should never be treated like a hostage! I understand that not all people with diabetes share my point of view.
