Yeah, I think that’s definitely a possibility in my case. I’ve never changed this pump from the default so who knows how accurate it really is about that. Another reason why I think being able to avoid a correction or dual-wave bolus is key. So far my post-lunch spike is 180, higher than I’d like but not as bad as sometimes, now that I’m really watching it. Normally I’d do a correction bolus, and I generally do see it start to taper downwards later in the afternoon, but if the insulin is still kicking in from that on top of the basal and the earlier bolus it could be mounting up more than I thought. I expect exercise to push my BG down but it seems to disproportionately amplify the effect of any IOB beyond the basal. Though that maybe just a subjective impression.
Agreed with Terry: 5 hours for IOB is generally a better choice.
I did the finger stick today waiting for the bend. It came about 5-10 minutes earlier than the CGM was showing but still about 50 minutes out from bolus. I say that though I shot at the bend I ended up high after eating the same frigging thing I have eaten a million times before and never gone high before! Don’t know what happened but ended up at 210 and had to correct. Don’t all cringe but I actually changed my insulin time to 2.5 hours. Knew I had to correct but calc from pump was saying .15 which I knew wasn’t enough. When I changed it to 2.5 hours, suggested went to .95 which I took and bingo was in the zone.
I exercised today but did some weights for the first half hour and did elliptical for a half hour. Did 90% for 1/2 hour prior and during, then went to 125% about a half hour later for 1.5 hours. I went low about 20 minutes after I was done which I treated with 12 grams of carbs. I am getting damn close to having this worked out. Sweet.
One big takeaway from Sugar Surfing for me was the the discussion of variability. If you think “I ate the same thing and it was different, WTH?” he very much suggests that this should be embraced as part of the deal and just develop skills to management. For instance, eating at the bend, which I believe Dr. Ponder calls “taking the drop”, works great, I’ve been doing more of it and it seems to be making a useful difference for me. At the same time, Terry eats quite a bit less carbs and probably more sensible ones than I do (ok, I have chicken wings on the grill and some potato chips…but there’s a hockey game come on soon!) so he might want to be a bit more judicious since he’s not working off of the same spike I will get from junk food or cereal or stuff like that.
Sugar Surfing doesn’t get too into exercise too much but it’s a great conceptual framework to hang your hat or surfboard or flip-flops on. Oh wait, we have diabetes, no flip flops… When I run, I’d always notice spikes at the end. I live by a river trail but up the hill from the river so I always do an uphill bit at the end. And I’m a horrible “holy crap, I’m almost done, get me home!!” runner so I am always pushing it, which probably feeds a spike too. So I kill my temp basal with a couple of miles to go and that seems to have helped mitigate post-run spikes. Bicycling is different. I’m usually trending down towards the end but am not interested in cranking it up and don’t push it as much as I do running as I’ve been out in the country booming along at 25 mph but then get back to town and it’s sort of pointless to ride aggressively through traffic so it’s sort of anti-adrenaline.