i am in a funk. my BG had been PERFECT for a month. (100-125 or so)(A1c of 6.5) now, i am spending most of my time doing correction boluses just to keep my BG in the 200 range. how about you? i changed my site, infusion and opened up a new vial of Novolog.i am going right to my endo this week.
anyone else have this problem???
If I am having continuous numbers in the 200 range not accounted for by meals I will definitely tweak my basal. I'd say my average is about 4 tweaks per month.I can't imagine staying between 100 and 125 for a month!
I'm sorry for your frustration! Diabetes can be a difficult puzzle.
I have learned that my body does not have one perfect basal rate profile. Basal needs are not a fix-it-once and forget-about-it tactic. I find my basal rates need adjustment, both up and down, a few or more times per week. I use a CGM so I'm very aware, for example, when my overnight rates need adjusting.
Have you ever done basal rate testing? Gary Scheiner's basal rate testing protocol is a good one. It takes some time and patience but is a very worthwhile experience. The reward for adjusting your basal rates to near your actual present need is that you can probably make smaller tweaks without having to do the full-blown basal rate test again. Doing this without a CGM is tough but can be done with frequent fingersticks and good recordkeepping.
I tweak my basal probably once a week and more often if I see a pattern developing. I wish it was set up once and forget about it but never works that way.
I adjust my basal rates when a pattern occurs, which is what it looks like you are dealing with Daisy Mae. I have learned to start small with adjustments to my basal rates. I hope you are not coming down with something, that might explain the highs.
Sort of when I need to. I have set my pump up w/ 22x basal rates (this is down a bit from 34 I started with...when I made a "big change" to cool a .7875U rate out of 1/2 hour of .8U and 1/2 hr of .775U, it seemed to work as my A1C oozed down a bit...) but if I see a pattern of highs based on basal repeatedly, I will make an adjustment to the "time zone" that is out of whack.
i have 3 profiles in my pump (Standart, A-&B-Profile, and they are all 20% higher or lower( one at 0.8U/H, one at 0.95U/H and one at 1.15 U/H) if i need something else, i usually start trying around with TBR (temporary basal rates) until i find something that works, then i will change that onto my definite Basal rate. makes sense?
Interesting approach. I'll have to ponder that.
I've been trying to Temp Basal my way through the "WTF??? BG" times which I still have no unifying explanation for. But that approach might be easier. I might give it a try.
-iJohn
Have you considered the impact of the 2nd or 3rd day of an infusion set on your glucose levels?
my problem kinda is, i start with temp basal, and that only lasts 24hrs, so i have to reset the temp basal every 24hrs, and i can go on for days like that, too lazy to rearrange the entire profile, and then i forget to redo the temp basal, which leads in high or low BG. but it is still a great approach, and maybe you arent as procrastinating as i am ;)
I'm constantly doing temp rates. I prefer them to actually changing the profile so far. I have several rates in the profile now starting and stopping at different times.. my cde has advised all of those so far. It sounds like you need more basal for some reason.
As others have said, I adjust my basal rates on an as needed basis and the CGM has been a wonderful tool to help spot the areas where the adjustment is needed.
I also use TBR quite a lot. Lately, it seems as though I am using it daily to help me get through high activity days.
Are your corrections having any effect? Are you moving your sites around enough?
Have you considered the impact of the 2nd or 3rd day of an infusion set on your glucose levels?
I think I have taken that into consideration. I have pulled infusion sets early only to have the "sticky" high BG continue. This sometimes happens to me for a day or three. It's puzzling. Perhaps it is just a result of being very inactive, hence my interest the proposed three different groups of basal rates.
Eventually I get back to a more normal range. And then I'll do some moderate walking for an hour or so and I'll drop like a rock later that night.
As I say, I don't really have a unifying theory at this point. The exercise driving me low I sorta get. Also I've been that way for as long as I can remember.
The sticky high BGs are something I never really was that aware of until after getting CGM. Now that I know it happens maybe eventually I can figure out why it sometimes happens and other times does not.
In the meantime, I'm trying to come up with schemes to help me manage better. As appealing as Temp Basal is as a concept, it has it time limitations.
-iJohn
It would be so great to just program and forget! I have 4 profiles, work, work w/smylin, off and off w/smylin. My off w/out is 24.708 and my work w/out is 14.1. It is a work in progress and change when patterns pop up. Always had problems w/ monthly cycle. Had different profile for that 2 week before time and he week of. Currently at that time of my life when I don’t know when the next one is happening. That might be another pattern( sorry about having to think about another thing) to look at on a monthly basis. Good luck and keep fighting the fight!
My BG is constantly on the move, it’s always going up or going down. I probably have only made a permanent change to my basal rates maybe 3 times in the last 8 years. I just use my CGM and correct my BG with small corrections throughout the day. My A1c has not been over 6.0 since I started using a CGM. I’m sure my basal settings could be better but I can skip meals anytime without going low and if my BG starts setting off my upper limit I just do a little correction…managing BG with a CGM just takes the guess work out of it…
Hey. Its a season change. I go through this 2X per year–fall and spring. Same thing. I am running temp basals at 150% and still read 384 overnight. For me, I know it will take a week or so, and then will crash-and often burn a bit- dramatically back to the usual. Weather changes are very difficult for me. Chin up! It will improve!
I recently changed my CDE’s set basal for me because I felt she set it too high. After trial and error I found a “sweet” spot and am doing very well. Of course, I realize this could change but for now I a happy at being a fairly straight line on my CGM.