Questions for Champions!

Type 1 and LADA
1

You are champions, those with Type 1. I need some advice. (Sorry this is long....)

For the past three days:
Thursday
7a 258 correction
12a 90 Unfortunately, it was a burger big bite from 7-11, only ate 1/2 the bread, but it was an unknown food substance, so a guess....
130p 279 correction
230p 284 continues to rise, so correct again (I know, BOB, but I also know that when my glucose is above 200, it takes a LOT more insulin to bring it down)
5 p 197 small correction
6 p 156 dinner, left BOB to do its job
9 p 118 finally a good number

Friday and Saturday were a mirror image of Thursday.

Now today:
7am 134 correction + food with a small breakfast (13 carbs)
11a 167 correction + food (something I eat all the time and know how to bolus for)
12p 297 correction
2 p 227 correction
3p 187, new site, new bottle of insulin, additional correction.

I did have a hard low on Wednesday night, so I can chalk Thursday up to its aftermath. But no lows, obviously, since then. I have changed sites twice, changed to a new bottle of insulin (just recently) and am running out of ideas. Even tried a brand new site, never used before, which is hard after 10 years of pumping! What worries me is that this is becoming a very unhealthy trend, one I am not used to (average glucose is 80 to 110)

Now, this was a road trip with the grandchildren and their parents. We ate in the condo every night, so there were not secret restaurant carbs to accuse. Great cool mountain weather, not sick, no idea what is making this happen. Oh, no ketones.

So the Question for my Champions is HUH?!?!?! Ideas? Just looked at the CGM numbers and glucose had fall en to 175, but has risen to 175 in 30 minutes.

2

Hi Spock. Might be nothing more than some changes in your basal rates need to be made. I mean you've done all the logical things, changed sites, changed insulin, and if that is not making much difference maybe its more just a tweak in your basals need to be made for whatever reason. Good luck, I know I hate when my numbers get screwy for no apparant reason.

3

Not sure what time it is for you, but I'll be interested to see what happens the rest of today. It sure screamed "site problem" to me. I also had a spate of "absorption problems" awhile back where the site wasn't exactly "bad" because with enough correcting it would eventually get down, but then it popped back up again. Have you tried switching to another location on your body?

4

I thought about basal, and have adjusted some. Afraid of comittment for the long haul...

I truly suffer with site absobtion issues, after ten years of pump and four of CGM, I am running out of real estate. My husband always says it is the equipment. I have gone through three infusion sets in 3 days.

Another question: I have tried to site the pump insert on my thigh, but could not sleep. Hard to reach the behind, and the CGM goes on the abdomen. Where do you use?

5

Looks like maybe your I:C ratios at lunch could be tweaked up some. and maybe upping basal rates (I'm not on a pump so i'm not sure how thats done lol)

6

Not a champion :) , however will this question fit into your picture : road trip sitting in the car longer than usual and less movement ??? I use the temp basal and up it by 165 percent , starting one hour approx prior, when inactive .
I use my thighs, outer arms ...
I also use a 1/2 cc needle when to correct at over 10 ( 180), and no insulin on board ; comes down faster for me .I disconnect , correct and let the insulin flow on 'where ever " ...so I have a record of the correcion in the pump .

7

I rotate between thigh, abdomen and hips. I like my hips the best because they seem out of the way, but there isn't as much space there.I don't have a CGM but can't the pump infusion set be on one side of the abdomen and the cgm on the other? I think the abdomen has the best absorption. Just curious, why would the infusion set being on your thigh keep you from sleeping? I never feel the infusion site (unless it's bad and gets painful). it's only the pump itself I have to arrange for sleep. I use the 43 inch tubing so I can really put the pump wherever I want regardless of infusion site. Since I sleep on my stomach or sides I just swing the pump around to my back and it doesn't bother me at all.

8

If it keeps up, you might try to correct with a shot or even switch to shots for a few days to see what happens if you eliminate pump/absorbtion issues.

9

Hi Spock, You have used a term that I like "Champions". There are some true Champions here. I'm not one of them so I will leave your question to the Champions.

Gary S

10

These readings are from finger sticks, not CGM correct?

I know others may disagree, but I am very wary of changing basal levels or IC ration throughout the day without specific reasons. I would seriously consider increasing your overall basal a little, though. Maybe decreased insulin sensitivity. You could've lost or gained a little weight. Hormones?

See if the fresh insulin helps first. I had a similar pattern, once, with a bad bottle of Apidra. Good luck and let us know how it turns out.

11

Stomach, lower back, thighs, upper butt. I find the thighs can be unreliable. I stopped using CGM partially because I'm concerned about scar tissue.

12

Also, not to get too picky, but some of the most knowledgeable people here are T2. I would assert the diabetes is diabetes to a large extent.

13

I agree that there are most certainly Champions of both types. But I also feel the issues that we deal with are quite different.

14

I agree with Zoe ... I don't want to be picky either : Sam , Spock posted this in the type 1 Forum ??? Oh my , hate to ASK : another war or what ...and I do know of type 2's on pumps !!! ( a bad question just before my eve. meal??? )

15

The variable is probably the trip...Road trips always drive up my BG and air travel days are a disaster...I just try to enjoy my trip...don't sweat the small stuff it's just going to change again...;-) I have days, weeks, even mouths of great BG and then I have a few days of high or low BG and there is never a clue as to what causes it. I'm sure there are many others that are faced with this unpredictable cycle..If your average BG is 80 to 110 just count your blessings and enjoy your life...;-)

16

True to some extent. We T1's tend to have a lot in common. T2 tends to be more of a "spectrum." The more I learn about D, the more overlap I find.

17

If I'm high for pre-meal BG a couple of days in a row, I'll change my basal rate a click or two and see if it fixes the problem. If I'm high 2 hours after a particular meal, or meals, for a couple of days in a row, I'll change the carb/insulin ratio for that particular period. I find the Medtronic Carelink software works pretty well for that, as the "pie charts" that show %age high/ within goal/ low/ hypo for particular timeframes will suggest where to make changes like this and confirm the results over whatever time period out to 30 days that I want to look at.

18

All were blood monitor readings, not CGM. The CGM really helps me, but it is often inaccurate, so I never trust it for dosing.

19

I am actually a good road tripper, as I have done it for work for many years--flying, driving, log stretches away. This was an outdoors trip, so there was walking. moving, etc.--more than normal for me. I would have thought the exercise would make it low, not high.

Doing better today.Got up at 97, so I would chalk it up at this point to the insulin. IT had been on several road trips in May, and may have just been tired.....

20

Just my 2 cents.

I find that I get the best absorption on my abdomen. This presented a problem since I use a CGM and was running out of real estate on my stomach. I decided, against the instructions from Dexcom, to mount the CGM sensor on my arm under the triceps muscle. The CGM gave me better results and has been staying in place for 2 weeks despite the fact that I work out every day and sweat a great deal.

This doubled the real estate on my abdomen.

That said, every spot is different. If you notice that the absorption rate is very slow, or that you need much more insulin than normal, try a new site.

Good luck