I was misdiagnosed a T2 at age 49, then lada at 50.5. Current tdd seems to be about 50-60, about 33 of that being basal. On the omnipod since November.
I am having practically no luck at keeping numbers low by bolusing before meals. even when I am using very specific package carb numbers, I end up high 2 hrs later - even with a 1:6 ratio. I feel like I am taking insulin (1:6 ratio) for almost no reason, as it doesn't seem to have much effect.
A correction bolus (1:20 right now) is very effective, bringing me down in a very timely manner.
What am I doing wrong? Should I just start correcting 30 minutes after a meal and keep control that way? Does it make any sense that I can't seem to prevent a rise in blood sugar with insulin but can correct one?
I've been trying to consciously bolus before meals more since my endo kind of called me on it, and have gained at least 4 pounds in a month. I am so perplexed!
Try reading up on TAG and Super Bolus. I had the EXACT same thing happening, and was told that as I aged, my breakdown of food was different (unbeknownst to me) So I was bolusing like an active tennager in high school would. 2 hrs after meal I was always 250+. By stretching out the insulin out over a longer period, and accounting for some protein/fat breaking down into carbs 2-3 hrs down the road, I have almost no post meal spikes now, and my average meter reading over a 24hr period is 116. I am using some of both principles at this time. I am using the TAG conversion rates for protein/fats and adding insulin to cover that over a 3 hour dual wave bolus (may be named diffrent on the Omnipod, Im on the MM) I have been using it for just over 3 weeks now with total success. I hope this helps in some small way.
By the way, I was told by my CDE that I needed to dual wave bolus for most meals, snacks, etc… except for items like cokes or energy drinks (i know i know) because they are straight shots of liquid carb. Thus far he seems to be right on the money as far as that is concerned.
Has your endo tried adding metformin to your regimen? Is aapears, based on your ratios that you seem to be insulin resistant. Like Solo said, you may have lumch with a dual wave/combo bolus, especially with meals high in fat.
Maybe your carb:insulin ratio needs to be tweeked.
I agree with solobaricsrock - check out the TAG group…there is more going on with your Bolus than just covering carbs as protein and fat grams also break down into glucose after a longer period of time in your system. The spreadsheet available in the TAG (total available glucose) group should give you support for dual or square wave dosing. Try the calculation and remember to take a copy of TAG to your next appointment. As for gaining weight, you’ve been good about chasing your post meal high with insulin but extra insulin will cause weight gain. You want to get to the lowest effective dose. Excercise is a component of weight management that is difficult for diabetics as sometimes the liver will actually raise BG during and after physical activity and the “runners high” does not seem to work for T1’s. It’s important you add moderate exercise to your scheduling though, and perhaps you can talk to your endro about adding symlin injections to reduce post meal highs and help with weight reduction. It’s a process…keep trying.
I typed all this (in good faith) and went out for Chinese (on 4th of July none the less lol) and exercised for a bit, and now im teetering on the 200 mark. This all goes to prove a point though. Its a constant learning curve, and even when you do your best, sometimes things go wacky. Its a lot of trial and error to know how to bolus and when and what type, and so on. Speak of which:
I was giving a bolus last night when we had dinner, and I swear I needed a degree in algebra to figure it out. Add the 2 now divide by the square root of the parabola of the 2nd square root…Aye Carumba!! Its not always cut and dry, or easy, so don’t get down if its not working perfect just yet. It will eventually.
Just when you thought you had put eigth grade algebra far behind you! Someone on another post mentioned the development of smart insulin for T1’s future use…hope this happens before my short attention span disapears entirely. Perhaps I can once again be friends with my liver. Happy 4th guys.
Sounds like a bad I:C ratio. Mine was pretty far off too when i got on the Omnipod.
Try turning that down some… one point at a time. It should start coming more in range.
These are great suggestions! I think I will start using the extended bolus right away while I try to figure out the TAG system. I am insulin resistant, clearly, but haven’t talked the endo into metformin yet. Next visit. I was on it when they thought I was type 2 and I wasn’t impressed actually. What I am trying to do is ramp up exercise to help combat that. Which of course is followed by more unpredictability (for me) of BGs. Thank you guys for taking the time to respond!
Numbers, please. How high is high? How many minutes is “a timely manner”?
Also be aware that exercise can result (sometimes) in “Runners High” That just means the body will dump sugar in the blood when you exercise to supply the muscles with energy, which will have an effect on BG levels. If your insulin resistant (even to a minor degree) you might need to see if you spike post-exercise. If so, you might need to set a higher “exercise” temporary basil rate to cover those times. If you test post exercise and your the same BG or less, then congrats. Mission accomplished.
symlin is the only thing that killed my mealtime spikes. When I forget (yep it ahppens) it is very apparent in the numbers
Sorry. Those WERE vague! High =- like 227-288…
.in a timely manner meaning that my numbers were within range by my next 2 hr check.
another thing to read up on…
