Someone Help me Get this Straight

"When I check my BG level 2 hours from the moment I put the fork down... Let's say my sugar is at 220 now. DO I CORRECT THIS? or do I wait FIVE hours and check before the next meal."

OK, I'm too lazy to read all the replies, so I'm just going to answer this one question to the best of my ability:

The answer is NO, you do not want to correct again before your last correction if fully metabolized, because then you will be in danger of STACKING insulin, which can be very bad, resulting in hypos. What you do want to do is NOTE the time and the value and then use that information to adjust your correction factor in the future. Then you want to test again at four hours and, if you're still above target, do another correction.

For example:

You test and you're at 320. Your current IC ratio is 1:20. You're correcting to 120.

You calculate a correction at 320 - 120 = 200 / 20 = 10 IU and you inject that.
(Let's ignore the bolus part of your injection for now.)
You test at 2 hours and you're at 220. You resist the impulse to "stack" and wait.
You test at 4 hours and you're at 180.
OK, what did you learn? Your injection of 10 IU was supposed to drop you 200 mg/dl (or one unit for twenty mg/dl or 1:20), but in fact it only dropped you 140 mg/dl (or one unit for fourteen mg/dl or 1:14.)

Make a note of that "dropping power" and use it to adjust your correction factor in the future. When you're more sure about your actual correction factor, doing additional corrections (not waiting for the next meal) will become more safe. Sometimes I do (conservative) corrections right before bed, because I'm so sure of my factor after tweaking it for months.

Maybe next time you'll need to correct a 220, and perhaps you'll calculate it thus:
220 - 120 = 100 / 18 = 5.5 if you have a half-unit pen or syringe.

That is, you inched down your correction factor to a number between your original 1:20 and your suspected new ratio of 1:14, because it's usually not a good idea to make sudden moves in treating diabetes. That 1:14 might have been a fluke due to exercise, alcohol or some other factor; don't leap down to it, inch your way down to it and test, test, test.

If your factor is off the other way, raise it to 1:21 or 1:22 and test, test, test.

I have fairly crappy insulin resistance and my doc's started me at a correction factor of 1:30, which was like injecting water. Now I'm at 1:4.8 (morning) and 1:6 (evening) and this seems to be about right. I didn't leap there, however. I inched there, because there are so many other things to take into consideration: dawn phenomenon, infections or not, exercise or not, (for women) hormonal weirdness or not, usual and customary carb intake, usual and customary protein intake, whether or not you calc for gluconeogenesis from the protein, insulin resistance caused or ameliorated by other medications or conditions (e.g. thyroid, steroids), alcohol consumption or not, etc.

Sigh. Truer words were ne'er spoken.

I’ve tried two apps on my iPhone: Glucose Buddy and Diabetes Pilot.

Glucose buddy is free and well-reviewed, so I tried that first but found it to be difficult to input data (I log a LOT since I’m new and trying to figure out how everything affects me) - it just took a while to put in data and didnt seem very flexible if I wanted to add a note for an entry or something like that.

Diabetes Pilot cost a few bucks but I find it to be totally worth it. It’s easy to punch in a quick note (snack, meal, exercise, meds, etc) and I can make notes as I want (why did I take that extra unit before eating, etc.).

I’d suggest trying a free one or two first and see how you like them - you may have a completely different experience than I did with glucose buddy, for example.

The only thing I’ve found is that I’m way faster at writing stuff in my notebook so I’ll have to go back and update my app later if I miss a few entries. Ive actually got about a week’s worth of data to load so I can share it with my CDE.

Thanks everyone for the amazing help. I believe I have a better understanding now of the "basic" part. And sorry for my math error. I do that sometimes when typing!

OK, this was way confusing to me when I started out, so:

ISF = insulin sensitivity factor = correction factor = CF = synonyms for how much insulin you have to inject to lower your blood glucose a certain number of "points", either mg/dl (milligrams per deciliter, the measure used in the US, Italy, Germany, France, etc.) or mmol/l (millimoles per liter, used in the UK, Canada, Australia and other countries.)

OK? This native English-speaker born in the USA would say, "My correction factor is 1:6 -- 1 IU (international unit) of insulin will *usually* lower my blood glucose 6 mg/dl."

Is it confusing that we in the U.S. use "international units" to measure our insulin but mg/dl to measure our blood glucose? Why yes, it is. But you'll get used to it, eventually.

Your own research project that every diabetic has to perform that the government gives no grants for. Love that comment!!!
The best thing I can tell you, Matthew, is to realize that the docotor is not God in the figurative sense, I know you did not mean it literally. You are your own science experiment. So very much of diabetes treatment is trial and error. I think that acceptance of the self-reliance needed to get the evidence and knowledge needed to take care of oneselfis one of the hardest things for new diabetics ( and sometimes us oldies too) to do. . There is no one way that works all the time). but you will learn it. As other posters are commenting and encouraging you to do, we do not get it right all the time ; there are just so many "variables" as abellseamaon writes to manipulate.. that we just can do our best. Hang in there you will NOT GET IT "RIGHT" ALL THE TIME AND DO NOT BEAT YOURSELF UP.

Take small steps. Read and use the books Gerri suggested, Using Insulin and Think Like a Pancreas. Both are excellent at explaining that whats, whys, and whens of Insulin usage. I greatly encourage you to read and/or purchase them.( Purchased as "Used" on Amazon, they are pretty cheap.

God bless,
Brunetta

So... I am so embarrassed to admit this but I believe that I know what the biggest issue I was having was.. I was eating too much!

When I would have a high, for some reason in my head, I was supposed to eat with my insulin, even when I should just be correcting...

Today I ran levels between 101 and 149 with no lows and no spikes that I caught.

Thanks for all the help. That simple piece of advice may "help."

We all eat too much, so don't sweat it. I went to the Atlanta Food and Wine Festival yesterday. Had a GREAT time, met great people, tried small (very small bites) of lots of different foods, tried to bolus coreectly and did quite well. It was worth all the calculations and considerations I had to make!