I am looking for examples of a daily log from someone taking MDI that includes timing of insulin injections (and type and dose), mealtimes, exercise, etc, and even includes CGM data to support timing/dose decisions. This data would show -at least on paper - what life with T1D is like. Anyone willing to share? Or, know where I can find this? I don’t need personal names, just the data.
Here is link to some options. (I don’t use it but looks good.)
Link has logbooks to download.
I think @mohe0001 has spreadsheet with lots of data.
Thanks, although I am actually looking for data, not the actual logbook. I’m not concerned with the format of how it’s presented, but just want to get an idea of the detail in the life of other T1Ds. How many injections per day do other T1Ds take? When do they inject? Do T1D eat at regular mealtimes or only when their BG goes lower?, etc. etc. If anyone has any of this data or know where I can get it, it would be much appreciated!
Have you read the book “Think Like Pancreas” ? That will provide helpful information on food, exercise, insulin dosing.
Yes, I have, but good suggestion, thanks. I was looking for personal data on a spreadsheet so I can help educate others in my pharma company. We are developing long-acting and pre-mixed insulins and with personal data, I was hoping to show them this is a bad idea for T1Ds.
That’s going to be a tough sell when Novo Nordisk makes premixes and are king of the hill of cash from selling diabetes drugs. Check if your company already owns a dataset with the info you need from Medtronic, Dexcom, Abbott, Tandem or Insulet.
In the US asking for HIPAA protected information for commercial use without disclosures might be a problem.
Its not quite that formal. I probably didnt communicate it that well. I appreciate your reply though. Im T1D on MDI for 45 yrs. I take about 5-10 injections per day. Im just curious to know what others do. Maybe thats too personal for others to share…
I think there are a lot of other factors at play.
I am one of the few individuals that Joslin has been unable to type definitively, so I may or may not be Type 1, and yes, I have had all the tests for T1/T2/Mody, etc., over the past 35+ years, and all that Joslin knows is that a CGM + insulin keeps me in control with an A1C in the 5.6-6.0 range. I am on MDI and use a digital pen to scroll through for history. It will download to a log, but I do not use the software. In the past 72 days, my pen shows that I have taken 404 injections, an average of 5.61 per day.
That does not tell the entire story, as my pattern may be quite different from another based on my personal habits. For example, I eat OMAD (one meal a day), which means I would most likely take 2-4 fewer daily injections than an individual who pre-boluses and then takes a correction dose for three meals a day versus my one meal.
Additionally, I periodically fast for three days, and on those days, I can have only two to three injections per day, so that also affects my average. I only use Humalog fast-acting insulin.
I am not sure this helps you in your quest for the data you are looking for.
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Type 1 dx 1959. Normally I take Tresiba and Novolog injections before breakfast, Novolog before lunch and Novolog before dinner.
I do have days when I take my regular shots but need another unit here and there. A few times a month I use a small amount Afrezza.
I try to stay between 60 to 140.
Hope this helps.
Awesome, thank you all. Even this little bit is helpful!
I don’t mind posting. Internet is mostly anonymous, after all, but since you’re asking you should post too. This isn’t just the good days, this is good and bad, pretty representative.
T1 for 49 years, next march will be 50 years.
Daily history from xDrip. Blue range is 65 to 140, though as always cgm is only approximate. I record bolus insulin injections green numbers, red dots are BG tests. I also take daily Tresiba in the morning, but don’t record that on graph. I don’t record carb intake, but larger meals with mixed carb, protein and fat is after larger bolus injections, usually 30 to 60 g carb for meals. Then mostly fruit or other carb when trending down, probably all told another 30 to 60 g carb per day. In general, a Mediterranean patterned diet, medium carb.
I bolus for lunch and dinner, don’t usually eat breakfast other than eggs or nuts so bolus not needed (except if it is). Corrections are the smaller injections.
Most of these days include exercise of 5k rowing machine or 10k runs. Also includes some painting to prepare for a rug install, a plane trip from New Orleans, and some of the incredible meals down there and a G6 sensor change a couple days ago.
(Removed since OP never came back and has disappeared).
I should add because you asked for more info that I usually try not to eat with readings over 100. I eat breakfast between 7:30am to 8:30 am, lunch is anytime between 11:00 and 12:00, and dinner is usually between 4:30 and 5:00. Then I don’t eat anything more until breakfast unless I am hypoglycemic.
I eat a low fat plant based diet. I don’t eat between meals and I am never hungry. I usually eat about 275 healthy carbs daily.
More info: Tresiba 9-10 units and humalog 2 1/2 units before breakfast, Breakfast consists of black coffee, and a bowl of oat groats with several kinds of fruit, 1 1/2 Novolog before lunch which usually includes some black beans, tofu or quinoa, green salad and a cookie made with sweet potatoes.
Dinner varies a lot but I take 2 1/2 units of Novolog before eating.
Total of 16 1/2 units.
I almost always ride my exercise bike after breakfast for 30-45 minutes. I will exercise in the afternoon if I am running high.
I usually have a couple of weeks when my diabetes is very easy to control and a couple of weeks when control is a bit more challenging. I will take a few more units of insulin when I need to.
My A1c is in the 4.6-4.9 range.
I’ve spent some time in pharmaceutical-adjacent firms and can imagine being in a situation like you’re describing. I was in marketing and web-presence stuff, so not part of the product-development path, but having worked with the guys (mostly guys) who on that side I can vividly imagine the difficulty of breaking through the silo walls with a reality check.
I am curious though why you think such a product is a bad idea from a T1 perspective. Lot of people still prefer MDI as pumping is more complicated with a LOT more failure points. I’ve had times of seriously questioning going back to MDI, now that reliable CGM eliminates a lot of the downsides. I don’t have any MDI data I can share but I’d be interested to hear more about what you’re hoping to establish with it.
This is great info, thanks all for contributing!
It won’t let me attach my log because I’m a new user. But, I’m willing to share with anyone if you send me a message.
My HbA1c was 6.9 a couple weeks ago. My TIR is ~75-80% and StDev ~40-50%. I take ~5-15 injections per day. I eat ~3000 calories per day and burn about the same. Most of that comes from proteins and fat. Most of the time, I eat meals based on where my BG is at, so my life revolves around that.
It’s a premix with 50:50 basal:bolus. The basal lasts ~one week. I wouldn’t take that because that’s just too long if you take even slightly too much. But the real reason it’s not a good idea is the amount of bolus you would end up taking with basal. Right now, I take 16u of degludec once per day. I take ~5-10 injections of Fiasp, usually most of those are 0.5-2u. I rarely take more than 4u at one time. My total Fiasp for the day is ~70% of basal right now. If I took a 50:50 premix that met my basal requirements, then I would be taking 16u of bolus. I would be so hypoglycemic in an hour and would require hospitalization, I am sure.
I did not respond immediately, because I was on a 7-day cruise and did not pay for wifi. I really appreciate you sharing though.
Wut??? You’re right, that does sound nuts. I mean, the idea of a basal with a week-long effect actually sounds like a potentially good thing on its own (though it has risks as you point out), but the idea of somehow combining it with a bolus insulin shows a profound lack of understanding about what a bolus actually is. It’s a little reminiscent of the bad old days of R/NPH, where the effect curves were so long that a lot of us did do a combined shot first thing. But that wasn’t because anyone preferred it that way. That whole regimen sucked. You ended up having to eat to the insulin clock or you could find yourself on the wrong end of an EMT call. It was a bug not a feature. Plus if you’re only taking the basal portion once a week (???), how’s that supposed to work with this bolus-mixture idea? And then the 50/50 thing—did they pluck that out of some 30-year old medical textbook? It still pops up from time to time but it’s just an old shibboleth from back in the days of sliding-scale and guesswork dosing. AFAIK it was just a kind of rule-of-thumb; there wasn’t any real medical basis for it once we had insulins capable of being used with carb-counting.
Really curious about what benefit they think they’re going for. Fewer injections? Anyway, it’s completely impracticable as you describe it. Unless they’ve invented a new bolus insulin that only takes effect when you eat something. That would be nifty.
The benefit is that 50:50 is suppose to closely mimic physiological conditions in non-diabetics. The belief is that it will mainly benefit T2D, but perhaps T1Ds also. I totally disagree though. Thanks for you reply!
Is the long acting insulin a once weekly dose like the ones Novo Nordisk and Lily submitted to the FDA for this year? Or a once daily dose with a 1 week active time?
I know rapid & long acting mix insulins existed but never looked at them so my first reaction was similar to @DrBB. I took a look at NovoLog® Mix 70/30 (insulin aspart protamine and insulin aspart) injectable suspension 100 U/mL | Health Care Professionals to try to understand. Looks like its useful for honeymooning T1D, T2D, hospitals and long term care facilities looking to reduce the number of medications and injections.
There is also the chance that a team formed to do the work on the drug just because the pharma job market is so volatile and its a place for people to work while they look for other jobs until the company shuts it down. I’ve never worked in pharma but I enjoy Derek Lowe’s In the Pipeline blog to keep up on what is coming in 5-10 years and occasionally things that go FOOF.