Come on! I test 8-10 times per day and I'm not even on insulin!
There was a study done (I don't remember who did it--might've been the ADA) about how adding extra finger sticks reduces A1c. There is a linear correlation between testing more and having a better A1c. In my opinion, as long as you guys are okay with testing, those "medical professionals" should get a life! (Also, it's important to test! How often do they think you should test--just before meals?)
Are you using the Ping? If so, go to History, then Total Daily Dose. The breakdown is at the bottom of the screen.
Have you tried Diasend for uploading? The Ping software crashed my pc so many times, I finally gave up on it.
Our Dexcom 7+ died 4 days before we got our G4 last November. It was the longest 4 days! CGMs really is an eye opening experience. I hope the process goes quickly for you. :)
You might find some helpful info for after you're set up with your own G4 at this link:
http://www.ucdenver.edu/academics/colleges/medicalschool/centers/BarbaraDavis/Documents/book-insulin_pump/pump17.pdf
And the Dexcom group here at tudiabetes has a lot of helpful info as well.
We do lots f trampoline and swimming in the summer and skiing in the winter, but it can raise him is he’s having a spike - oh the never ending bgs!
They recommend 4-6x a day. I told them they need to write the Rx for 300/month or 8-10x a day or Id stop by the office every week and clean out their samples because we didn’t have enough. That fixed the Rx problem pretty quick. Now they just roll their eyes at me when I make reqests but at least they follow through with it.
Standard deviation is a great idea, I’m goin to e an excel geek this weekend! I don’t know how we’d function if I wasn’t OCD. My husband is the polar opposite, most of our arguments stem around my OCD and his fly-by-the-seat-of-his-pants attitude in regards to use tea management. He’s it ten better over the years but even my psychaitrist doesn’t understand sometimes the extreme nature of dealing with diabetes from day to day. It’s Troyer though, I have many many more hours than anyone else that know my son or is close to him so I need to take that to heart and use it to be more assertive: great ideas and points mentions here, thanks so much for the advice!
Awesome I totally missed that in the history, thanks for helping me find it! I haven’t tried using the diasend, I don’t think t works with apple computers, I’ll have to look again.
I’m already missing the Dexcom as it has only been 5 hours since we gave it up! The thing that makes me sick is the fact that they just throw away the meters and sensors after the clinical trial. So much money and perfectly good equipment - in the crash. It makes me sick to think about where our trial meter will be in a week.
I just joined the Dexcom group and the insurance can’t go fast enough to get this baby in our hands! Soooo excited!
I have no idea if your son was over-insulinized. It sounds like he wasn't, if he wasn't getting bad low BGs along with his high BGs. He wasn't, right?
But I will say from my experience that too much insulin (over-insulin) can lead to experiencing both very high highs and very low lows. You don't spend all your time with low BG - instead over-insulin makes your BG very erratic, bouncing from low to high without any good explanation. I believe I was in this state a few years ago - swinging from 30 to 350 day after day - and it was very hard for me to figure out why my BG was so unpredictable - the same food would do completely different things on different days. The problem is that your body's hormones (adrenalin, etc) are in overdrive trying to counteract the extra insulin you are injecting. This keeps your BG up artificially, until your BG crashes when your hormones simply can't keep up.
It wasn't until I looked at my TDD that I realized that I was taking too much insulin. That was when I started testing my BG a lot more, and started tuning my basal and bolus insulin ratios using the recommendations in "Pumping Insulin". After doing that, my TDD went down significantly, and my management (A1c's) were a lot better. Best of all I wasn't seeing the extreme lows and highs that I had been experiencing routinely.
We do bounce all over, it hasn't been as dramatic but its still happening as I tweak. The thing I'm noticing is that if I back off in any area, then he uses "more" insulin elsewhere. i.e. if I back off on basals, he uses more corrections. If I raise his I:C ratio then we do more corrections as well. Whatever way I put it, he's having highs if I try to lower his TDD. It feels like no matter how I tweak, he's still using around 30-35u per day. one day we had basals at 8u/day and a TON of corrections. Another day we had higher basals, and less corrections but it still worked out to be 31u that day. If we adjust his I:C ratio that will cover his corrections for carbs better usually but again still the TDD doesn't change in the end. To keep him from being high, we are either 1) using higher basals with less correction/lower I:C ratios OR 2) lower basals with higher I:C ratio, and higher correction factor. Even if it's 50/50 still the same usage of insulin. I just don't get how at this point less insulin will equal out to lower BGs. You are right in that we don't have a lot of lows. If we have a higher basal we'll see more lows but the roller-coaser is usually between 150-400 range. It's hard to get him to come down when he's that high.
Diasend is web-based so it will work with any computer. I use a MacBook to access Diasend. It's a great site in that it can combine pump, meter, and CGM data into integrated reports.
If your son can tolerate the extra site (I don't think it's painful, at all.) the perspective it gives provides great insight and timely realtime warnings.
When you get the Dex, I highly recommend using the Studio software, Unfortunately, that software will not run on an Apple. I use a cheap 4 year old netbook running the old Vista operating system. It works well. Studio allows you to analyze past trends and can help you make intelligent changes going forward.
I had similar issues for 20+ years. It ended when I did a thorough basal test. It turned out that my fasting needs were surprisingly consistant, much lower, and completely different from the basal rate(s) I was taking. BG has been much stable, since. I also quit eating all the foods that raise my BG rapidly, but that's a whole other can of worms. Life is certainly easier with stable BG. Good luck.
I work to get my BG flat by whatever means necessary and the doc sounds like a dingbat for using a formula instead of experience and what sound like great results. Everybody is different but we are all the same in that if our BG gets high, it's not good for us. Of course, it's not great if it gets low either but being in the middle is where you want to be!
It’s a Goldilock’s disease.
Well there you have it, I am such a dork! We currently don't use the meter that goes with the pump because it takes more blood. David likes the freestyle lite butterfly strips for his little fingers. Maybe I just have to suck it up and switch back so we have more data to work with.
I'm not sure I understand what an extra site is? Are you talking about the CGM site or does Diasend have its own site? David really liked the Dexcom so we've applied for it. Crossing my fingers for a July approval and delivery!
So is there somewhere you can refer me to (link or url) that I can get a good understanding on how to do through basal testing with David? I've never done it for him, we've just tweaked based off of what our Endo recommends or what I feel might be the culprit.
hahaha, Goldilocks disease - love it! So true!
http://www.integrateddiabetes.com/p_basaltest.shtml
There are different ways to do it. I averaged out the basals set previusly, ate only non-glycemic foods, and tested every hour over a weekend. (there are easier ways) I raised if my BG drifted up, and reduced when it drifted down, until I achieved a flat line. I did find I needed a little less when I slept, so I set a separate rate. The rates I concluded were about half those that my CDE had set.
I second the advice to test and adjust basal - if your basal is set incorrectly, then your BG will always be unpredictable. If you prefer to read it in a book the best that explain the process in detail are the "Pumping Insulin" book by Walsh, and the "Think Like a Pancreas" book by Scheiner. I think these are well worth having, and I would also recommend the "Type 1 Diabetes" book by Hanas for any Type 1 or parent of a Type 1.
When I tested my basal rates last year using the Integrated Diabetes protocol that Sam Iam links to above, it left me with a very satisfactory even BG without eating. It was great to be able to confidently sleep safely through the night.
My post-basal test rates were appreciably different than what I had lived with before. I'm still using those rates as the foundation for subsequent changes. And change they will!
All very good resources. I found Pumping Insulin to be much more technical. Scheiner is just really good at explaining complicated things in an uncomplicated way, & making it an enjoyable read. Hanas is my go-to for any new issues. Short & concise explanations.
Basal testing on a kiddo is not going to be easy, but it's worth the hassle I think. Also, it is necessary for anyone pumping to at least know how to do a basal testing. Here is a link from NIH, it explains the basal testing (and lots of other useful pump info):