What methods do people use to spot patterns of how various things affect their blood sugar?
The usual software is pretty useless to me because I don’t seem to have regular patterns. I don’t tend to go high or low at one particular time of day consistently. I might go low some nights but not others, or high after some meals but not others, and I want to see what might be causing these. When I look at a modal day graph of my readings there is just no pattern. When I did a CGM for a week two years ago there was also no pattern. I have tried testing basals and such but, again, two different days will result in two different results!
I have cut back carbs to usually around 70-80g most days hoping that would help since so many people find success, and it has not helped much. I will stick to it but I think I need to start looking at other factors.
Also related, curious how many Type 1s here are able to stay between 4 - 11 (70-200) most of the time. Especially young women (like 20s and 30s) and those diagnosed as kids.
I don’t know if I’m just being unrealistic but I would really like to be able to get to a point where I can stay within this range for an entire day at a time! I know there will always be highs and lows but right now I am not able to stay within 70-200 in any given day which I just find frustrating. I don’t know if I’ve ever had a day where my overall range has been less than 100-150 points. This is not a new thing—I was looking back at my records from about two years ago when my A1c was in the high 6s and even then I was not able to stay between 70-200 most days. When I look back at my records from when I was on MDI and even before that as a kid/teenager, my control is even worse (like 50-350 on an almost daily basis)!
I really, really want tight control and am willing to put in the work, but at the same time continually feeling like I’m not really getting results does not help my motivation at all.
I too often get frustrated that I’m not doing as good as person X or person Y says I ought to. Or even just as well as I’d like to be doing. At some point psychologically I have to work on me and what I can attain, and not what someone who has very easy to control diabetes is able to maintain.
I do have a hard time when someone comes to a discussion board moaning about how awful it is that they hit 140 and that’s the worst their bg has ever been and how come they can’t do better like they’re supposed to. Mostly I can keep my mouth shut and not say anything condescending but I’m not always that successful.
I never thought of it like this but this “no pattern” thing is my situation also. It is always interesting when my endo sees 2 or 3 days of lows or highs at a certain time and says ‘here is a pattern’ and wants to change something. The fact is, it is not a pattern. Because without changing anything, the next three days will show something else entirely. Someone said the other day that posters are the “cream of the crop” of diabetics. Well, that may be true for most, but certainly not for me.
No, I do not stay between 70 and 200.
Do you have a cgm? I do not but I have decided that is the only way to control the BG range, at least for those of us with bouncing BGs. I hope to get one after the first of the year. I have been trying to wait for the new smaller MM one since I have a MM pump. If only we could get progress info from FDA…
Jen, I figure you’ve done this already… have you looked at meal logs next to the modal day? I know you said the same meal produces different results - just wondering if you’re eating the same meal at the same time of day? (Just fishing here.)
My endo often says he can’t find any patterns in my readings. Which makes me feel a bit better because at least it’s not just me … But I’m the same way. Even if I happen to go low twice on two days in a row, I can not change anything and the next day I won’t be low. Or I can adjust my pump settings and the next day I’ll go high instead of low. It drives me crazy. It’s like I fix one thing, move on to the next, and as I’m fixing that the first thing goes out of whack again. For example, I thought I had my overnight and morning readings nailed consistently being between 80-120 and was trying to work on after-breakfast readings, but now my overnight/morning readings are all out of whack again only a few weeks later. I understand always needing tweaking, but I constantly feel as if I’m just trying to “get the basics” down, never mind fine-tuning!
I don’t have a CGM and at the moment can’t afford one (and health benefits will not cover one), but I am definitely getting one as soon as I’m able to, because I think it would help a lot.
I do eat pretty much the same things every day as long as I don’t eat out. I think I need to start keeping logs that record absolutely everything but then the problem I find is how to use all that information in an organized way that can show cause and effect. And also how to decide how much to record without constantly writing stuff down.
Unfortunately starting tomorrow my schedule is no longer consistent (it’s been really consistent the past three months) and that is going to make things even harder, but is not something I can help.
Finding patterns often takes me many weeks to figure out. I’m like you - so different from day to day.It also seems like once I figure out what’s wrong and make a change to a basal rate or an I:C ratio, I mess up a whole other part of the day! My ranges can be pretty big too sometimes. Just to give you an idea of where another T1 is…the past few days have been:
10/24: 46-187
10/25: 56-204
10/26: 44-213
10/27: 44-256
10/28: 58-137 (ok, that one was actually pretty decent)
10/29: 47-258
10/30: 88-170 so far
Your range looks similar to mine:
10/24 - 56-362
10/25 - 41-266
10/26 - 83-194 - Great day!
10/27 - 59-230
10/28 - 104-238
10/29 - 92-214
10/30 - 52-212
Thanks for letting me know it’s not just me! I also get what you mean by feeling like you change one thing and it messes some other part of the day up.
It is a total pain writing everything down… I did it last week. I transferred all my BGs, food, stress, exercise, etc. to a spreadsheet organized by time, then organized it by time of day, then by meal… I did discover a few things. Not having a regular schedule will for sure throw yet another monkey wrench in the works ;(
I’m the one who mentioned “cream of the crop”. I didn’t mean to imply that you had to have great results, but the fact that you’re here learning about and discussing diabetes puts you in a special category. My endo indicates that she has a huge number of patients who hardly test at all and won’t follow most or any of her instructions.
I think there is no doubt that some of us have an easier time getting good BG results than others. Certainly the stage of life you’re in can make a big difference. Raging hormones for teenagers, women at that time of month, etc. can make blood sugar go haywire. And I think that some people have more hormone interference at each stage than others. Although the term “brittle” is outdated, I still believe that this journey is harder for some than others.
What I find so frustrating about Type 1 is all the things that can influence blood sugar: food, type of insulin, timing of injections, hormones, activity level, stress, type of carbs, pump site effectiveness, etc. and etc. I can’t count the times that I’ve had great willpower and “followed all the rules” and then had a pump site go bad and send my BG into the 300’s. Or eat my normal breakfast and then get a post-meal reading 150 points higher than yesterday.
I do think that my expectations for my BG readings are highly influenced by reading these message boards. If I eat any carbs, it is unusual for me to stay below 140 after the meal without going low later. I’m incredibly insulin and carb sensitive and often I struggle to identify meaningful patterns. It’s unbelievable to me how many people here say that they can almost always stay between 70 and 140 and sometimes I feel stressed because I can’t do that. That just isn’t the diabetes I know. However, I’m 35 years into this disease with no significant complications. I manage to keep my a1c’s below 6 despite some of the huge peaks I have. So I have to think I’m doing just fine.
These boards are great and I learn so much from them. I’m inspired by everyone (well, almost everyone) here. Anyone who takes time to read and/or post here is “cream of the crop” as far as I’m concerned.
It is human nature to see patterns, even when there are no patterns. To me this means that if I cannot see a pattern then there really is no pattern. I had a hard time letting go of the dream that my BG will do the same as long as I do the same. This simply is not the case. I experience a high degree of randomness. The randomness seems to be more of a good day/bad day randomness than randomness within a day. I suspect that insulin absorption plays a big role. I am lucky enough to have a Dexcom 7+. The dex tells me whether it is a good day or a bad day and I adjust my insulin accordingly. It is important that I recognize as early as possible what day it is. I can never assume that today will be like yesterday.
Does whatever gizmo you are looking at give you the Standard Deviation? That’s the first thing I look at most of the time these days. The pump sort of keeps track of some of the other numbers but if I look at that and it’s ok, I relax. Then I remember that I have to get the “real” number from the doc before I can really relax.
I recall your other report that there were some post parandials that were running up, did you try shooting more insulin (ratio-wise…) at them to see if that would help? I had this wierd stretch recently where my middle of the night numbers were running up and up and up so I turned my pump up, and them up some more and then some more and it finally fell into line. Now, of course, it’s running low every morning so I guess I got carried away but, as I’m out of it in the AM and have an A1C coming up, I figure “I’ll get around to it”…
Love the duck Helmut 
I attribute the randomness to what we don’t know about D, the factors we’re not even aware of. We have a lot to learn.
I’ve checked out Diabetes Pilot which is what I’ve been using and it doesn’t have standard deviation! Something to e-mail them about and request. It doesn’t seem to be available on my meter, either (Ping), but I haven’t checked ezManager and it might be available there. What kind of SD do you aim for?
I haven’t tried upping my I:C ratio because it’s already at 1:7 which I think is kind of ridiculous … Plus, my readings after meals are sometimes high but sometimes fine. I’m nervous of upping it and then ending up crashing low. I want to wait until I get needled infusion sets and see if they help at all before fiddling with pump settings.
Those are good reasons to be calm about making changes. I usually aim for the 20s in general and now seem to be ‘aiming’ for the low 20s as opposed to the high 20s. Maybe its sort of the “continuous improvement” philosophy I learned in Tae Kwon Do or something? I had it on the One Touch Ultra Smart and the MM meter reports also provide it.
I don’t look at ratios as “ridiculous” as the goal is to have the BG be ok, regardless of what the ratio is? I agree about waiting for new sets, etc.
If your I:C ratio seems ridiculous, it is possible that you are taking too much insulin as bolus and not enough as basal. How many units of each do you take each day (on average)?
My basal is equal to about 25 units (24.9) and my boluses for the past few days have been 24.6, 18.8, 20.6, etc. (eating about 70-80g of carbs). A lot of those boluses are made up of corrections rather than covering carbs. My basal and bolus rates change about every two weeks, though, going up or down by about 0.15-0.20u for the basal and the ratio changing by about 1:2-1:3 (and correction ratio changing correspondingly). I think this is a big reason that testing these settings is so hard! I’ve been having random lows at night (some nights, but not all) so I’d be nervous upping my basal rates overall, though maybe just during the day would help …
I just find 1:7 ridiculous because my ratio used to be more like 1:10 to 1:11 (during this “phase”). I’ve never taken as low as 1:7 (and 1:6 if I up it even more). I think I might be having problems with infusion sets/insulin absorption so have ordered sets with a needle instead of cannula to see if they help at all. I should hopefully get them sometime next week and will fiddle with pump settings after that (am hoping it might get my I:C ratio back to where it used to be, though).
But as I said in the post, I don’t think my problem is as “simple” as just adjusting one or two pump settings. I think if it were that simple I would have achieved a desirable range years ago (I have been putting in a really concerted effort for about six years now, minus about six months I went through major burnout).
The Ping meter is pretty similar to the UltraSmart so I’ll have to take a closer look and see if it’s somewhere in there.
I just downloaded my pump data and it is in the ezmanager software. My standard deviation for the past week is 3.9 (70 mg/dl). For the past month it’s 3.4 (61 mg/dl). For the past 90 days it’s 3.6 (65 mg/dl). So it seems to be holding pretty steady, at least.
Our DD has had Type 1 for more than six plus years and though we do have days where she no higher than 200, with no lows they are rare. I think you hit the nail on the head when you specify those diagnosed as children because I believe LADA has a longer, slower, gentler progression, although it is still Type 1. I, too, would love for her to be able to stay within those ranges, but it is unrealistic and not possible. We test often and treat the highs immediately; as well as the lows. As far as “pattern” is concerned, there is a pattern of sorts. But within this pattern, there are basal adjustments almost every day, either up .50 or down .50. I call this “tweaking.” She also has subpatterns, where sometimes she has dawn phenom and sometimes not. As long as there are no major adjustments, such as during puberty, the rise and fall in basals will become evident and we will tweak up or down. It is more difficult when a major increase is called for in the evening hours because it will not last and there will be lows. We have a somewhat stable period (when whatever the basal is, it will stay within that range) from 1:30am thru 4pm. In that stable period there can be the Dawn phenom rise from 2 to 6am (or not) and a possible drop from 2pm to 4pm (or not). I guess what I’m getting at is that there are two or three familiar basal pattern subsets that overlay the basic basal pattern. You kind of intuitively know when she goes high at 2am, to apply more basal because tonight she is having dawn phenom, etc. Once that happens it tends to occur two or three days in a row. Constantly moving target but if you keep a written log, I think you may be able to identify your own patterns and I believe they will be multiple. In short, if you are willing to wear a cgms, that would be your best bet because you can then proactively manage your blood sugars. Type 1 is diabetes mel., uncontrollable. And I believe it is exactly that, uncontrollable swings in blood sugar that can be managed. Not controlled. The younger the age of diagnosis, I believe, the more severe. This does not mean you cannot have good A1cs, by the way. But on a cgms, your graphs most likely will never be flat.
While we are often told that our bodies are like a simply machine, our blood sugar is “only” affected by what we eat and if we just counted our carbs our calculated our boluses we could achieve control. Sadly, this is just not the case and some of us have more problems. I think part of what can drive us crazy is that there are lots of variables. We know about some of them. Stress. Different blood sugar responses to different foods that have seemingly the same number of carbs. Allergies. And then there are variables that we are not aware of. And that is the challenge in spotting patterns. If you already knew what variables affected your blood sugar, you would have spotted them long ago.
So what do you do? Well, one possibility is to just start a journal to augment your log. You already log your carbs, blood sugar readings and all your insulin dosing. And you probably write down things like exercise and stress level. But do you write down what kinds of things you ate? Wheat, eggs, dairy, soy, etc. What about how large the meal was and whether you were full for hours. What about how you felt, headache, stuff nose? What about how much water/liquids you drank?
Perhaps others have suggestions for things they look for or that they discovered in their patterns. Maybe this will help.