I’ve kind of split the difference and my X2 is in the closet on an extended year long vacation. What I use now is an InPen. It gives me a quick and dirty dose calculator where I can set my DIA at 3 hours and my target at 90. It also keeps track of my IOB. I considered looping but first wanted to see how it went with InPen. I use Tresiba for long acting and it’s a very smooth ride. And when numbers are higher than expected there is a whole lot less to troubleshoot when injecting doses rather than pumping. Mostly, it comes down to carb counting errors or did my insulin go bad. I have felt badly about that great technology, paid for by insurance, sitting unused. I’ve hooked it back up twice in the last year only to take it off again within a few days. I kind of feel guilty about that.
Absolutely true, I have more control of scheduling food, exercise and insulin since I retire. And then there’s the added benefit of stress reduction. There was a lot of stress in the work place, but the biggest contributor was being on-call for 7 days. Calls in the middle of the night to drive 50 60 miles and then work your regular shift that may not end because of another emergency.
I have that same problem. I try to pre bolus 20 minutes before eating but it’s hard to do. Also, I can’t take back insulin that I infused so it can be dangerous to prebolus when I dont know exactly when the food will be on my plate as in a restaurant. I don’t think it’s really possible to get rid of after meal spikes unless you consume no carbohydrates. The less carbohydrates I consume the lower the spikes but there are still after eating spikes.
I am going to try Fiasp again when I get my next insulin refill. It is notorious for clogging and not working well in Tandem pumps, but some people do OK. I have also read of people mixing it with Novolog to stop the clogging but still get faster action. TBD….
Try 80 percent fiasp and 20 percent novolog or humalog.
I understand that’s the magic number, but I haven’t actually tried it because my insurance doesn’t cover fiasp
Hi Timothy, My doctor’s PA saw how much better my tir was w Fiasp and she has found a way to provide samples on Anna’s needed basis. I have always had trouble w discipline to not eat while reg kicks in.
I think fine tuning your carb-insulin ratio and basal might help. Other thing, at least for me, is eating too many carbs at once over whelms insulin and my system. So I limit the amount of carbs to less than 15 at breakfast and 30 or less for other meals.
As an aside, my insulin runs about 20% basal (confirmed by basal testing) and 80% bolus. The low basal (about 3.5 IU/day) leaves almost no room for basal automation to work, so I don’t give it any consideration.
You make a good point William, times where I eat a lot of carb and I have to take more insulin, it’s seems the absorption is slower. Any site can only absorb so much.
Times where my sugar is very high from a failed site or what ever reason, I’ll inject a correction with a syringe in another place.
I agree with others who have said waiting 10-15 mins should do the trick. The other suggestions I have are: (1) go for a quick walk after your meal (this has helped me maintain a flat line on my glucose curve!), (2) try eating more slowly, and (3) eat your carbs last. All of these things should help. You should be proud of your 5.7 A1c btw!!
Me too. I try to stay under 35 carbs per meal. I bolus 20- 30 mins before a meal
I felt the same way, which is why I’m struggling with deciding on a new pump or just sticking with my trusty old standard-transmission Paradigm.
When I was still using novolog or Humalog (both the same for me) it could take 45 minutes or sometimes seemingly just not kick in at all, particularly on high-stress workdays where it had to work against my anxiety-elevated adrenalin output. People complain about “Fiasp fade,” which is a thing I guess, but I don’t have that “ok, where the heck is my insulin?” problem nearly so often since I switched. It may not be a lot faster than Novolog, but it is a heck of a lot more reliable.
I also am using Tandem Control IQ and I love it! But as with all things, we don’t all have the same wants and needs. Somethings the Tandem pump does might be a deal breaker for some but I find it works well for me. I did work pretty hard before making the switch to make sure my numbers were in a good spot. I put them all in and set it up like the company suggested.
I find a 15 minute pre bolus works well. I will shorten or lengthen depending on blood sugar, higher-I wait longer, lower- I eat sooner. But watching that line will tell you when it’s time to eat.
And with the pump turning off, I find it isn’t off longer enough to cause any major issues. And on those afternoons when it’s off for 20-30 minutes, that means I really messed something up. It happens, sometimes more than I would like but the cool thing for me, I don’t worry about it. It’s off for a reason and sometimes when it kicks back on after treating, I might have to give myself a .2 unit to help buffer the climb.
I do think pre bolus was a huge game changer for me back in the day. I had always thought I was doing okay until I took an intensive insulin class and learned about pre bolus and testing 2 hours afterwards to see how I did. Timing is everything with insulin. And if your blood sugars come down into line well after eating, that usually means the ratio is good but the timing is off.
Good luck with your next diabetes experiment. Each and everyday is a learning experience!
I picked up my Fiasp today and it will be time to change my cartridge later this afternoon, I think I’ll start with 80% Fiasp and 20% Novolog and see how it goes. All week I have been shutting off Control IQ during the day and using it at night. My numbers have been great and this may be the best way to go longterm. I have been amazed at how many times I flatline at 90-100. But if I were using Control IQ with those numbers it would turn off my basal. It will be interesting to see if Fiasp makes a difference in using Control IQ all of the time and if my insulin stays potent for the life of the cartridge.
I think this is an effective tactic, one I would likely try if I ended up with the Tandem pump with CIQ. I’ll be interested to see how your Fiasp/Novolog 80/20 mix goes. In particular, I wonder if that mixture works dependably in the long run. Good luck, Laddie! I look forward to your future report.