I’ve never been a huge data tracker, but lately I’ve had a renewed interest. Besides bloodsugar, meal-related data (carbs/insulin), and activity level, what other kinds of data do you find useful to track? Also any suggestions on good tracking tools? Web-based is preferable, but any suggestions are welcome 
I created my own spreadsheet to enter my data and do the calculations for me.
In addition to BG, insulin, exercise and carb intake, I record any daily BG excusions - i.e. BG below 50 or above 200, with the time and approximate duration. I check and record my urine ketones too, since that is a pretty good indicator of how severe my excursions have been. I have found that high BG excursions cause my carb-insulin ratio to change dramatically (I become significantly more insulin resistant) for several days - and the data I recorded in my spreadsheet was crucial in starting to make sense of what had been my seemingly impossible to predict BGs.
I use my spreadsheet to calculate my carb-insulin ratio every day - I have found it to be central to understanding all my other results. It’s pretty easy for me to calculate my carb-insulin ratio while I’m at work, since my breakfasts and lunches are much more predictable than my dinners. So I also record my pre-meal BG and 4 hour post-meal BG, which I include with my carb-insulin ratio calculation. As part of that I record not just the carbs I eat with my meal, but also any correction carbs (in my case almost always fruit, which I weight to get an accurate carb count for) taken in that four hour meal time period so I can include it when calculating my carb-insulin ratio.
I also keep notes of any changes I’m making and the results. I’m trying lots of things now (different insulins, different insulin timing) to improve my overnight results - if I don’t write it down I won’t remember all the details of the different things I’m trying.
That’s cool, but I’m trying to understand how you handle your carb/insulin ratio data. You use your carb/insulin to determine your dose for a given meal but what guidelines do you use to determine, retroactively, if it was the correct dose from the correct carb/insulin? If you’re using 4 hours post meal, how do you know if it’s your carb/insulin and not your basal or TAG?
I’m asking because I’m kinda new to calculating carb to insulin and it seems like I’m still trying to figure mine out.
Thanks!
I keep track of BG before, 1, 2, and 4 hour post meal, and at bedtime. I graph every point and keep track of how many high and low excursions I have every week, month, and 90 days. I use my Dexcom to mostly keep track of how much time I spend within, below, and above target BG range.
My BG app automatically calculates a standard deviation for me and I look at it as a general yardstick for BG variability in conjunction with all my other data.
I also track insulin dose because my insulin sensitivity varies a lot during the course of the day. I usually have an “unofficial” A1c done monthly to keep track of if and how my excursions are affecting it.
I don’t include protein/fat (TAG) since it is not generally accepted as being necessary, and since it adds unnecessary complexity. The primary reason it isn’t needed for my calculation is that my breakfast and lunch (unlike my dinner) are almost the same in protein content from one day to the next. So even if the protein had a noticeable effect it would be the same every day and thus can be ignored. Furthermore the only paper I’ve seen that goes into this in depth (referenced in the Hanas book) says it takes three to five hours to get any BG effect from protein anyway, which is at the very tail end of Humalog action - and I haven’t observed a BG bump at this time.
Same is true for basal - I am only comparing days where I have been taking the same amount of basal insulin. If my basal changes then I start a new sample group. (And my current basal rate seems to be good based on tracking my BG if I don’t eat a meal or change the meal timing, which is of course the necessary test for having a good basal rate). My exercise is also consistent - I exercise on an ergometer for 20 min. burning 333 calories every other day. I found that the frequency of exercise has a detectable effect on my basal requirement. I found that if I exercised every day for a week that it did change my basal need significantly (my sensitivity increased and my need for basal went down). But I returned to exercising every other day, and my basal soon returned to normal.
So in other words, I am controlling the outside confounding variables as much as I can to remove the uncertainty they cause. This probably sounds incredibly boring, and in fact it was hard for me to make my existence so predictable. But that was made easier in part by my getting a bad case of plantar fasciitis about six months ago, so I couldn’t run or play squash for exercise (walking was tough for a while) and was restricted to exercising on the ergometer (which was fine for me since I used to row crew in college). Breakfast and lunch were easier to make the same - I just started making my own meals at work instead of buying them out (which saved money too). BTW my plantar fasciitis has resolved - as has the beginning of numbness in my toes, both of which really scared the cr*p out of me - thanks, I believe, to the improved control I’m experiencing now.
If I have an unusual day - e.g. go out to lunch with friends and eat something where I don’t know the carb count, or get sick - then I just disregard that day, rather than guessing. When I go out of town and everything changes I disregard those days too. BTW, I haven’t found any real effect from “stress”, which I personally think is a way over-used crutch used to explain away confusing BG results.
Whew - so then if you remove all these variables, its a fairly simple matter to count insulin and carb for this four or so hour period and compute the ratio. I correct the amount of insulin I took for my BG before and after (I do this a few different ways) and use the spreadsheet to compute my carb-insulin ratio.
When I started this process I thought I would find pretty much the same carb-insulin ratio every day - but was really confounded when I saw radically different results. I actually measured ratios that differed by as much as a factor of 10 - which is why it had been so freaking hard for me to figure out how much insulin to take when it seemed like every day was a complete crap-shoot. It took a lot of head scratching and testing and book reading before I realized I was getting a major effect from frequency of exercise (explained above - so that I now exercise consistently) and from BG excursions which I found have a lasting insulin-sensitivity effect of a few days on me.
I’m now at the stage of trying to figure out how to keep my BG more stable within that four hour period (longer overnight). So I’m trying different meal types (carb from veg or carb from bread), different breads (rye, wheat, oat, etc), different pre-meal injection timing. And I’m really puzzling over how to deal with my apparent dawn effect, trying different insulins with dinner (Regular instead of Humalog), etc. I know that dealing with dawn effect may eventually lead me to a pump, but I’m trying other stuff since I’m hesitant about getting a pump until they tie it together with a CGM to make a reasonable semi-closed loop AP.
Just about none. My pump and glucose sensor track a lot of data on their own and I examine it every three months at my doctor appointment. My A1c stays below 7 and I don’t stress out about every number that comes across my meter or pump screen. Everybody wins.
I use our project Glucosurfer.org for tracking.
Here are the pros:
-full anonymity (we do not even collect mail-addresses)
-free of charge (your donations are welcome)
-supports WAP for ordinary mobile phones (you should have a WAP or data plan in your contract)
-supports HTML for smart phones (you should have a data plan)
-allows to share your diary (like I did with the link provided)
-unique charts
Cons:
-not very focused on numbers but charts (might be the wrong tool for statistic freaks)
-minimalistic approach - this is not designed to be your digital patient file. We try to focus on diabetes and want to collect as little personal information as possible.
Is this your company or a personal project? Also, how do you track time (ie is there an x axis)?
I checked these out recently. Do they publish all charts publicly? I saw a bunch of menstrual charts displayed in their gallery, seemed a little suspect as far as privacy of data goes…
I’ve been waiting for the pump/cgm as well. Being a skinny T1 I don’t have a lot of surface area to work with for insets. It sounds like you take a very methodological approach to your data tracking. This is one of the things I’m interested in is finding a context for otherwise separate data. Would you mind providing a sample of your spreadsheet for me to check out? It’d be much appreciated Thank you for your detailed response!
Well, the Glucosurfer is my personal project and I am my own company so to speak. The Glucosurfer is not a state-approved nonprofit organization if this is the subcontext of your question.
At registration you will choose your current time zone. Every time you are opening your WAP or HTML page from your mobile device the current time of the server will be translated to your local time. This way your time and date will be already filled in when you open the page. Of course you can still decide to overwrite the date and time field with other values as you like.
I don’t use any. My most recent A1C is 5.5 so I am doing something right. Once my honeymoon period ends I’ll probably start tracking it but most of me readings are between 70-140 so I don’t feel the need to track.