You can try to get the server to give you a kind of heads up about 10 min before they will bring the food. I usually just guess when it might be out and depending on my BG at the time I will determine when to bolus. I always expect there will be at least 60 grams of carbs so I early bolus that amount and “catch up” when the food gets there if I need to.
Both ways sound like great ideas for handling it - one to avoid the heavy carbs for a bit until the insulin starts to kick in, two to pre-bolus for what you can safely anticipate and then “catch up” after you receive it if need be. Thanks!
That’s pretty much what I do, Kristin, only minus the endo…lol. That’s one reason I come on here, because I tend to be a bit premature in responding to patterns sometimes, so I rely on all the great experience of TuD’s in general, and now pumpers, since I’m new to that mode of insulin use. I appreciate everyone’s input. Thanks, Annabella. I had read in Pumping Insulin that you need to make changes for 1-3 hours before you need them but forgot.
Zoe: You’ll get there. Read all that John Walsch has to say in Pumping Insulin about testing for basal rates and follow his advice. Make small changes to your basals and it will fall fall into place. It will take some time, but once done you’ll be amazed how stable you can get. Pumping is for sure the easier, softer way. Good luck!
Just make small changes, & don’t change more than 1 thing at a time. When I fiddle with basals I usually only change the rate by .025 or .05, that is why Animas is great you can use tiny increments.
But don’t expect to set your basals for life, the human body is not a machine, there’s hormones, stress exercise etc etc to mess it up & of course sun spots & the diabetes gods. Just recently I had a couple of weeks with higher BG no apparent reason, now for the last week I’m too low, even with reduced basals, & infusion set sites have varied for both. Of course for us females there is that pesky monthly cycle thing, I’m way past that but I am told it can still affect one. That’s why I have all 4 basal profiles set on my pump so I can switch easily. I do the setting myself now, I don’t wait for the endo.
Yeah, I don’t know if you have DP either, or just ‘varying basal needs’. In my own experience, my DP was causing me to hit 300-400 fastings…even if I was fine the rest of the day. Very obviously a dramatic increase at a very specific time of day. With pumping my fastings are between 70 and 110 most days.
Thanks guys. I wasn’t really expecting to set my basals for life, and am mostly bemused (and a tad frustrated) to find that some things are moreoff kilter than when I was on MDIs, rather than less! But the explanation of how my Levemir was covering my morning rise and I didn’t even know it made sense and bottom line I know that I have way more control of things than I did before but it will take awhile to get it all in line. It’s kind of the same thing I’m currently experiencing in my online teaching. Seems every year or two we switch to a new “course management software” and the IT people stress how many more options we have to organize things differently with the new system. But when I’m learning it all those options seem overwhelming and way too complicated. Once I pass the learning curve than I appreciate them. I think this is the same.
I’m not an exerciser and I don’t have hormones influencing me anymore, so at least I’ve eliminated two variables…now if I could do something about those pesky sunspots! I don’t work with an endo and my PCP admits he doesn’t have a clue, so yes, I set my own numbers too, Annabella…with a little help from my TuD friends of course!
Thanks David. Very comforting words. Between the new pump and the new CMS I’m a little out of my comfort zone right now!
I’d like to see the attempt at expressing it with interpretive dance though…
That’s the best way to make the changes - do them yourself, in small increments and if you’re even unsure contact your diabetes support team/nurse. No one knows your body, and how it will react better than you do. The endo/doctor can only make educated assumptions (and sometimes not even that!).
Ok, I could definitely see that with the hands going up and down to show trends, either very slowly or more quickly and if it was too quick then the whole body would sink down to the floor…ok, I really do know you were kidding…I am a frustrated choreographer in addition to the other dozen or so lives I never lived.
Me too! Video please!!
Zoe, Our bodies’needs for insulin constantly change… After my round of steroid injections in the fall, I had to take up to 50-65 units a day. basal, just to stay stable. Now I find that my basal insulin needs are about 18 unts a day. I set a higher basal rate for about three hours before I get up, as I find that unless I have a higher basal. almost as soon as my feet touch thef loor. I have to be careful with adjustments, though.I found that I had raised it too much and was waking with a 72- 75 that could quickly lower to fifities on three recent monrings. I find I ned more insulin on arising and for meals from 6:00 to 9;00 a.m. on average, but I am still basal testing to see exactly how much more need. I inched it up too much, now I am slowly inching down , in .5 increments Testing , Testing, Testing,and then take a break is how to do it… The Cgms helps me to see when I start rising falling , finding the “Trends” Is mst important!
Thanks, Brunetta. I remember that awful episode of steroid influence you went through! Yes, I’m pretty insulin sensitive and I tend to be a little too generous when I make changes and then go the other direction. Good reminder for me. Lots of fine tuning.
It would be…bad. =/
But we would get a kick out of it, and it may just become the most popular video on TuDiabetes!
LOL. I wouldn’t have a clue how to make a video, I would think the fact that after being on here two years I finally got around to replacing my generic hand with pink flowers might be a clue to my technological level. FHS is right…it would be BAD!
I just have a slight basal bump, .90U/ hour instead of .85U and that seems to keep my BG smooth in the AM? Perhaps w/ Lantus there was a smallish “spike” that was ‘covering’ that need for you that you don’t get w/ the flatter delivery of the pump? If you are sensitive, it might not work. The other thing I do is to bolus like .2 or .3U before I disconnect to shower, etc. in the AM. Before I had the CGM, I’d turn the coffee on, test, see what it was, have a bolus (plus CB if it’s running high) and then go back and get ready and test again, to get a ‘line’ instead of a ‘point’. That way if the DP is more significant, and I find it varies, I would give it a shade more insulin? It’s perhaps sort of dicey but it seems to work ok for me and I don’t mind doing the extra tests that much since I usually am walking around in a stupor in the morning anyway, until I have a couple of cups of coffee! The routine is a bit busier since we got a dog last summer and I just keep an eye on the CGM.
Something I’ve noticed switching between MDI and pumping is that my insulin needs are just not the same… and I’ve had stretches where I’ve had a wicked bad DP (rising to 300+ for no reason after 2am) and other times where I need less basal over night… it’s just the nature of the beast. Just like someone without diabetes will have variable insulin requirements, so do we, and staying on top of changes can be challenging.
I’ve always needed more insulin in the mornings though - for me it usually gets wrapped up in covering breakfast, I just add an extra unit or so to make up for the rise. If I don’t eat (and don’t bolus), I can go from a fasting in the 90’s to being in the 160’s within a couple of hours.
Thanks, Sarah and Acidrock. By the way, AR, there was a very cute segment on my local news last night where they were showcasing a new ice cream place here in the Bay Area where they serve very non-traditional flavors. One of the flavors was mushroom something (yeah, weird), and the guy that was tasting asked “You mean mushroom like…” and then the video and music went into this psychedelic phase for a minute or two before the guy said, “No, not that type of mushroom.” I cracked up.
Anyway…the basal changes I made yesterday thanks to everyone’s suggestions seems to be working very well so far today. I’m at my baseline of .475 from Midnight to 5AM then bump up to .525 from 5AM to 8AM for the highs I’ve had in the morning, then back to baseline to 1PM, then down to .425 for lows in the afternoon, then back to baseline. I’ll let you guys know if that continues to work well!
yuck! I recall the Top Chef segment where Marcel made bacon ice cream and people who were hot at the beach were like ‘yuck’