Time in range challenge

I use Sugarmate, too, as well as Nightscout and Tidepool.

Sugarmate can read boluses from Apple Health if your pump writes this info to Health. Loop does, so I do get boluses In Sugarmate. The graph is not as clean and easy to see as your Tandem app though, or Nightscout and Tidepool. I get boluses on xDrip+, but not basals. I’m using an old version so maybe basal display has been implemented in xDrip+ by now.

I almost got one yesterday. It’s those damn postprandials! Soooo close!!!

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Yes, post-prandial is always an issue. I guess you do pre-bolus. I try to stagger the overall bolus with maybe 30-50% in pre-bolus, then corrections along the way. This helps to keep me from going low while eating. How about doing a bit of exercise after meals? Even just a bit of walking or stretching? I do, and it does help. My problem is that I will always go low during the exercise, and then promptly spike up again after the exercise! You might have better luck though. Try just 10 minutes and see if it makes a difference.

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I had exact same issue after dinner last night. I’m back on track now.

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Monday I was starting to challenge myself for a 7 day run but messed it up on Thursday when I was running low of insulin at lunch so I thought I would just do an injection and change the set after work. Threw me off as my pens are Fiasp and I take Novorapid in my Tandem. So, thought I would go back to the challenge this coming Monday. I typically run mid 90’s TIR with the target being 3.9 - 10.0mmol/L which is 70 - 180 mg/ml.

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Nice flat line, @Timothy, you probably achieved a 100%! And @Dave4, it looks like you are doing swell, with several 100% days!!

I’ve yet to achieve a 100% day since I started this. BUT, I am averaging 98% TiR, 2% Low for the last 3 days. That is really good for me!! I think this Challenge is responsible, just making me more conscious!

Today was a bit of a roller coaster due to the exercise (cycling, running, walking) but I managed to stay in range 98% so far today. I did have a Dex signal loss of about 30 minutes but I think I remained in range during that time as I was just driving home from the beach.

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All right, I’ll play, but my latest 24 hrs is not going to put me in the winner’s circle. In recent years I’ve been less carb-avoidant—started with bread at lunch and progressed to the odd spaghetti or pizza or other carb infraction at dinner. But one of the trickiest things about TIR is managing exercise and yesterday is a for-instance. It’s hard to know exactly how to bolus for a lunchtime sandwich if I know—or suppose, or at least think—I’m going to go for a bike ride later in the afternoon. So I’m only 74% IR for the last 24, but that’s partly from a semi-deliberate post-prandial spike of about 180 before my ride, which was coming down to about 140 when I started, so I turned off basal (somewhat belatedly but whatevs) and I just touched a low of 77 toward the end of my ride, which pretty rapidly rebounded into range on its own:

… Plus ok, guilty: I had a potato with my steak last night and there’s a bit of a fat delay effect so it bumped around a bit and finally hit 164 after I was asleep before it curved down again:

BUT!!! Clarity only has nice things to say about my last two weeks:

And I just had my A1C done last week, and I scored 5.7. So there’s that. This is all with my funky old Paradigm pump and Dexcom, none of your fancy-shmancy loop stuff though there may be a case for trying that again in here somewhere. Still trying to decide.

But who knows what the next 24hrs will bring? I’ll be back to play again tomorrow.

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I just got back from 3 days/2 nights camping on top of the Colorado National Muniment. Beautiful, but 104° with no shade. Man that wreaks havoc on my sugar.

Does anyone else not do with in full sun? It wasn’t exactly a choice to go camping during a heat wave, just more that we couldn’t get doctors appointments lined up on the same days and it was too far to drive back and forth.

After a few hours of not being able to keep my sugar up, I switched my pump to exercise mode (140-160), and was still fighting lows, so reduced my basal profile and still kept it in exercise mode. Even then I was terrified to bolus for meals. I sound up having quite the rollercoaster of a few days. Short spikes after meals I didn’t bolus for before the big plummet again. Most of those days were around 75% TIR bringing my 7 day average down to 89%, and that’s with the increased targets for this round. I usually run 98% 70-160.

Off to a good start since getting home, though.

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Sun warms your skin and causes insulin to work better. At least in me. Hot showers cause me to crash too.

I’m 95% right now. I’m determined to get 100% today. It’s Sunday, easy day.

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I’ve been using Tandem just over a year now, and A1C has stayed about the same since then. Prior to that, I used the older 523/723 Medtronic and Dexcom, with similar A1C results. I didn’t track time in range, but suspect higher with Tandem CIQ doing the work with lower/less frequent highs. (Except cartridge changes, but now only slightly more time once getting used to it.)

My a1c was in the high 6 range sometimes 7.
On tandem for a little more than a year and I’m at 5.4.
That’s consistent too, over the past 3 tests.
For me, the difference is going to bed at normal ranges.
I didn’t like doing that before the tandem ciq. So I’ll go to bed at 80, where before, I wouldn’t go to bed under 130.
I also have a mean dawn phenom. Ciq flattens that out, like it’s not there.

It’s not for everyone, people who are good at MDI can have tighter control.

For me, this works out nicely.

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Shooting for perfect and settling for excellent is a viable tactic for me. I don’t think, however, that I’ll ever run more than three or four days 100% TIR. But that’s just me.

I was slow to join this discussion since I’m aware of the negative feelings it can induce in some members. It’s held me back many times from sharing glucose management success.

Let me assure you that I do still live with T1D and I do struggle with management on some days. This birthday dessert of two scoops of vanilla gelato with a few blackberries and blueberries not only drove me high that evening but led to a poor night’s sleep and it took me two more days to rein-in the glucose variability. This is a lesson I’ve learned many times, but I was suckered into thinking, this time will be different! Live, learn and move on.

In addition to managing all the built in vagaries of managing blood glucose with the coarse tool of subcutaneously-delivered insulin, we depend on glucose monitors that can suffer inaccuracy.

On Saturday, August 7th, I enjoyed great BG management with the exception of a 15-minute period just before 11:30 am where Dex reported 56-54-58 data points. When the sub-55 alarm was triggered, I did a finger-poke and it showed 73.

Anyway, I’ve enjoyed a great run the last three days even though I didn’t hold the TIR (60-180) at 100%. I’m more than happy with these results.

Here are the glucose traces for the last three days.

This day included the 2-hour warm-up period for a new sensor. I am fortunate to enjoy great access to CGM supplies and I now change my sensor every 10 days. Pre-soaking (the new sensor was pre-soaked 20 hours) irons out most of the first-day erratic readings but I always depend on several fingers-sticks on day one to closely manage the CGM accuracy.

Last night’s overnight numbers are a good demonstration of the power of automated insulin delivery through the night. (I hear you, @DrBB, I lean on the algorithm a lot and wonder how I managed without it!) When settings are well-set (background basal rates and insulin sensitivity factors, in particular) the Loop algorithm does an excellent job while I can concentrate on the crucial pursuit of getting a good night’s sleep. Loop permits me to target 83 and that usually lands me on average in the 90s.

I think managing glucose during the night is one of the strongest features of any automated insulin delivery system. I’ve only ever used the DIY Loop system with an old MiniMed pump, but I’ve seen good overnight reports from people using other systems. When you wake up to readings like this, it makes it so much easier to enjoy a good full-day performance.

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Excellent observation! Sometimes it takes me a couple days to recover from these self-induced highs! And yes, I still say to myself, this time will be different! I’m a slow learner, or maybe it is just wishful thinking! Despite the ice cream, your graph looks nearly flat, and you spent only minimal time high! We are always hardest on ourselves in achieving BG control! Btw, was this ice cream for YOUR birthday?? If so, Happy belated Birthday!!! Hope the new year is fantastic! Congrats on the 100% IR, too!!

For me, I had a bad pod last night, wasn’t getting insulin for about an hour or so and that was enough to send me high. Changed the pod around 2am and eventually came back into range, but no 100% for me. Still 90% so far, and I’m good with that.

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I appreciate your sentiment. What I didn’t show was threatening lows that followed heavy-handed insulin tactics. Those early morning lows led to some stubborn late afternoon highs the next day which led to hypos just before midnight that disturbed a second night’s sleep.

Things finally settled down with my last gelato-consequence with another stubborn afternoon high two days later.

I salute your discipline to interrupt your sleep to replace a bad pod. I think keeping a low tolerance for out-of-range blood glucose nips a lot of errant glucose excursions in the bud. Keep up the great work!

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I just saw this topic yesterday but I have an appointment today so I’m dumping my data:

Exported from Tidepool Basics: Aug 10, 2021

Reporting Period: Jul 12 - Aug 10, 2021

Avg. Daily Time In Range (mg/dL)

250 0%
180-250 1%
70-180 99%
54-70 0.2%
<54 0%

Sensor Usage: 95%

Avg. Daily Time In Automation
Manual 4%
Automation 96%

@bsmorgan – Great numbers! Would you mind describing the diabetes tech that you use? It looks like an automated insulin dosing system. What insulin pump and sensor do you wear?

Yesterday was similar to the day before; I was in range (60-180) all day except for three 5-minute data points of 57-54-56 around 3:30 p.m.

Starting fresh this morning with 100% TIR since midnight.

I think I’ll forgo future reports until I enjoy a successful run of a few days or more.

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I used a restarted sensor and it was hella wonky. It was telling me 54 when I was really 88, so my numbers are crap right now.
I just installed a new one and today is a new day to start over

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Yet to get a 100% TiR. I inserted a new sensor last night and it was giving me lows right off the bat. Not too low, but lower than finger sticks, which showed me in range. So no 100% in store for me today, either. I will also forgo future reports 'til I get a 100%.

@Timothy I’m using a Tandem t:slim X2 pump with Control IQ, 100% sleep mode, using Humalog. The pump uses a Dexcom G6 for CGM input.

I have very high insulin usage (Avg. Daily Insulin Ratio Basal 61.7U, Bolus 37.3U) and exceed the pumps basal limits at night. At my last appointment (3 mo ago) it was a choice between switching to off label U-200 insulin or adding Trulicity and Farxiga. We added the medications. My appointment today was canceled so I won’t know what we will change (if anything) until next month.