Good morning all,
Just wanted to say thank you for all how share their knowledge here in the DOC.
Have received my latest A1C 5.4 and done so with out any lows.
Would not have been able to do this with out your collective knowledge.
Thank you all and keep up the good fight!
Congratulations are in order!
What do you think are the top 3 (or 1 or 5) changes you made to achieve the 5.4 AND to avoid the lows?
Congratulations! Without any lows at all? Pretty impressive!
Congrats, hobbit! It's nice to read about PWDs that challenge the common notion that low A1c's always mask dangerous hypoglycemia. While you are an exception, you are not the only one. I know you work very hard at controlling your BGs and that you have some residual pancreatic function. We all have to play the hand we're dealt in life and you've played yours well. It's a long march; I wish you well.
For anyone interested, 2hobbit1's posts in the Flatliner's group provide an incredible level of detail with how she deals with controlling BGs.
Thanks Terry, I'll take a look!
Mike,
I got to this point in steps. The first step was finding the DOC since I was called a T2 in the ER when admitted in DKA simpley because I was 60. Did not seem to click with the Hospitalist that 10u of insulin should not drop a T2 from 500 to 120 in 2 hours!
The info here on how to get a correct diagnosis was invaluable as I told my PMD what to order.
Went on basal boulus quickly, and was happy to get my dexcom 6 months from dx. That was an eye opener. I though I had things down with good pre and 2 hour post but boy was I unprepared for how much I swung in between. That started me on the path of pre bolusing as much as 30 minutes before meals depending on where I was running before the meal. I started to do a standard pre bolus and then if the meal was more I'd top off with an extra shot.
Was glad to get my tslim two months after the dex. Was able to do my basal testing, CF and IC and DIA using the dexcom. Ive really been able to dial my pump setings in. Getting the DIA correct makes a big difference for me.
I'm actually using U50 novolog, my TDD is around 10U and the tslim is quirky with its basal rat. It can increment to 0.005 but nedds a base of 0.1. That did not mean anything to me when I chose the pump. I went with it because I prefer the microdelivery system. It cant dump a full cartridge of insulin on board if it malfuntions. Important because of how insulin sensitive I am. My TDD droped by half when I went to the pump!
Finding the Flatliners Club as well as the TAGgers United group gave me a new perspective on things. I want normal numbers if I can get there safely.
I have found if I set my target to 85 that I get to 95-100 on a regular basis with out wild swings or going low. If I do drift low I know who much a single skittle will bring me up and always have a tube of them on my person. I try not to over correct so as not to get on the rollercoaster.
When I'm spiking after a meal at work I'll climb the steps - I can do 10-12 flors depending on the building I'm working in - with IOB I can stop the spike in about 10 minutes. At home I get on my treadmill and crank the incline up to 40.
I have my dex set up to help me - range is 70-120 and to alarm for single arrows with repeats every 30 minutes. If I tweak when I start to rise/fall too fast or go above 120 its a lot easier to meet my true goal of being 70-140.
I have incremented down to the 120 decission point in steps as I found I could do it safely - started at a peak of 160 and then worked my way down.
Tweaks can be based on what was my meal - lots of fat - add in a temp rate for a few hours. Carb miscount? Add in by 5 -10gm carb increments every 30 min till the arrow flattens. If I over shot then dial down the basal.
I upload by dex data on a regular basis and look at all of my data. If I see a repeating trend in a time frame I will address by either a basal rate adjustment or a IC and CF change as needed.
It takes work and a lot of attention to detail, and I'm also early enough on this journy to still have some pancreatic function preserved. Everything I read points to tight control helping to maintain whats left and preventing future complication.
My joke with my son this morning was A1C of 5.4 - I'm cured! NOT!
Hoping I can stay in this range safely for along time.
Do I get there every day? Not by a long shot, but the more I work at it the better I do. Do I still party with freinds and totally do a carb blow out - every now and then - life still goes on. I'm not on an ultra low carb diet. My pump upload puts my 3 month carb average at 140gm/day, But I do eat to my meter - I have learned how much and what I can or can not eat to stay within the lines.
The only lows I had on my dex for this 90 day block was when I had a sensor failure and it was pinging me at 40 and crashing when I was really at 85 and steady. Had two of them do that within a week. First was at the end of 20 days which is a bit short of the month I was getting in the past. The second was a new one that never was right form the start. Currently I'm using one from the same lot and its working fine.