So I’ve changed schedules temporarily for a work assignment and it requires me to get up at 03:00. I am on MDI (never been on a pump either) and do my lantus around 20:00. For this week-long assignment I’ve been doing a basal split that gets me doing 80% of my lantus @ 03:15.
Today something happened. I plowed through a numb mind until about 2 hours from my house, when my Dex started yelling. I knew right away, I forgot to do my basal. I figured I’d start bolusing to simulate something normal. Despite having the Dex, this is how my tests and shots have gone:
05:30 - When I realized I forgot my shot. BS @ 250, took 5u for correction, 2u toward basal
06:15 - BS 270, figured the insulin wasn’t working yet
07:30 - 2 hours after last basal fake, BS @ 131 (falling slightly), another 2u toward basal, 1u for snack
09:45 - BS @ 136 (climbing), took 5u not sure at this point whats basal or correction
12:00 - BS @ 76, a steady decent from previous #. Dex shows I might be rebounding back up again. Lunch aught to be fun, I’ll give the insulin a 30 minute handicap before eating.
So far, not bad. Yet far from a smooth curve… I’ll admit, I feel a little odd. Since the basal shot that I missed was about 17u, I figured I’d be missing something like 17u/24hr = 0.7u per hour so I’ve just been taking 2u every 2 hours.
Any better suggestions?
Wow!!
Good Luck!
Just one of those things we diabetics must live with.
I work rotating shifts and lots of 16 hour shifts with only an 8 hour break. Sometimes 2 and 3 16hr shifts in a row.
And it is over 100 degrees outside here where I work. I did it for a while on MDI using Lantus and Humalog. It was tough.
I woke up and took basal at same time instead of trying to adjust to my ever changing schedule.
I use the Pod now and it is wonderful for me and my lifestyle. Would not go back to MDI.
Like I said, "Good Luck."
marty
I think you’re doing great so far keeping up with it! The Dexcom must be invaluable to you today.
I agree with Marty… “just one of those things we diabetics must live with”. I had a few terrifying moments when I was on MDI trying to remember if I took my Lantus or not (or took it twice!). It became such second-nature that I honestly couldn’t remember! Fortunately, nothing terrible ever came out of it. But it’s part of the reason I switched to a pump.
Yeah guys, definitely one of those things we deal with. I guess I’m odd for enjoying the challenge. Indeed the Dexcom should get most of the credit for any success here.
Since 12:00 I ate lunch, spiked a little and oddly leveled out a bit… I think that’s odd because I (theoretically) have NO insulin on board at all. I have a 2 hour drive coming – of course I’ll shoot up, but this is really the critical stuff.
You are doing it just like I would 
If you are replacing basal, correcting, and giving for food what else is there?
One difference- I will usually just give my basal “dose” every 4 hours so I do not have to do as many injections. I also find it is easier to keep track of correction/food vs basal if I am giving less shots. The only rapid that dosen’t last 4 hours for me is Apidra in which case my basal “dose” would have to be given every 3 hours. Your line would probably be even less smooth doing basal “doses” less frequently but it is only temporary. Good Luck!
Good job!
In case anyone can use this information someday, let me just mention how things turned out.
I went home tested at 17:30 with a BS of 85, new I was due for another bolus comp, took 5 units (based on how I react to workouts), jogged 2 miles, noted a sharp spike upward, corrected, weight lifting session, continued a spike, corrected again, ate dinner through a SHARP downward spike, leveled out… stayed between 80-90 until I fell asleep.
Then I took my lantus at 20:00 thinking the slate was clean and I could start administering my bolus at that time every night again. Had a steady blood sugar when I went to bed, woke up this morning 340 (so you know how today is going) which is so out of character I cant recall the last instance.
So I must ask, is it really possible for your body to recognize that I tricked it yesterday? I mean as far as I am concerned as soon as the new lantus dropped it should have been doing its job, but the night went as if I had no bolus. Diabetic karma?
Lantus isn’t really a flat 24-hour curve that begins the instant you take it. I forget what the delay is before it starts, but that’s likely what caused the spike…
I have often heard that if you miss your basal one day, the day after is worse than the day you miss it. Not sure if it is karma,but it is a pain in the you know what!
Kelly, I’d be curious to know exactly why.
As Scott mentioned I know Lantus isn’t a perfect 24-hour curve and I’ll admit things are still a bit blah, but despite any start-up time for the insulin to start working I’d say it should have been for a while now.
I’ll chalk it up as some cause/reaction that may have little explanation… I need an automated database of situational info to remind me of these things in the future.
They say the delay is about 2 hours.
I’d say your Dex reading is something to be envied ! Good job-