Has anyone on here found a successful way to lasso the up and down roller coaster dragon? Haha I know there has to be some way to bring that baby back home and get the straight levels back to norm but whenever this happens I usually find myself in the swing of things for at least a day if I’m lucky.
The biggest thing is to be careful with treating both lows and highs and be patient—it takes a while for both glucose and insulin to do its thing, so if in the meantime you take more (which is tempting when you still feel very low and your brain is screaming at you to eat all the sugar), you can drive rebound lows/highs. I’ve learned via my Dexcom that I rarely need very much to treat a low unless it’s one being driven by a lot of insulin or a persistent one from a ton of unexpected or uncompensated for activity.
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Now I’m going to switch the topic…how do you acquire the patience needed to scream and bear it through the waiting period? Haha 
I’m yo-yo-ing all over lately. My system is totally broken.
I’m under pressure to fix it because I have a new Doc and he wants me to run some tests on my bolus dosages before my next appointment.
Before I can even look at my bolus rates for meals, I need to have my basal stabilized. I starting by stabilizing my overnight basal rates because those are obviously broken. It has taken me almost a week to double that rate. I’m running out of time and my new Doc is gonna think I’m a deadbeat.
I can’t imagine that he would think that, just show him that Kermit picture and let him know how you feel and he will give some encouragement if I had to predict. Lol
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Unfortunately, it takes forever for insulin to work in me. I actually had better control using the old school premixed 70/30, because I learned to ride the rollercoaster and the schedule worked for me. Unfortunately, I often forgot to take the shots, and my car rolled right off the tracks. So that didn’t really work, after all.
Six months ago, I started on my first pump, which makes it impossible to missed the shots. Yay! And has pretty much completely eliminated the lows because I always correct back to 100 mmol/DL. Except… There’s that awful hump after I eat. I don’t even eat a lot of carb, but it doesn’t take much to jump my BG sky high. Then I have to stay there for three hours until the insulin starts working.
Pre-bolusing is obviously the answer, and that’s great if your insulin starts working in the normal 15 minutes or so. I’ve found it nearly impossible to anticipate every meal by there hours, though.
A few days ago I started tweaking my basal profile to do the pre-bolusing for me. I basically took the low end of an average bolus and spread it across a 2 hour window, that ended about an hour before I usually eat a given meal. I then subtracted that same amount of insulin from the basal spread across the next few hours. (the size of my window depended on the range of potential meal times.). I still have to bolus for me meals to replace the basal I subtracted and adjust for the actual amount of carb I ate.
So far this seems to be my miracle! These are the most even I’ve ever seen my numbers. I guess the moral of the story is to keep trying until you find a solution that works.
It often takes more insulin and a longer time period to bring a high down than it does to prevent a high. You may find that, even though it takes three hours to recover from a high, you don’t need to pre-bolus by three hours to prevent that high. I find pre-bolusing by 30-45 minutes makes a major difference to my postprandial blood sugars. Before I began using Fiasp (which is something else that may work better for you, as Fiasp is supposed to begin working faster than other rapid-acting insulins), it was not uncommon for me to pre-bolus by an hour before eating.
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That’s not my problem. I’m good at keeping in range before meals. It literally takes two hours and 45 minutes before any bolus starts decreasing my BG from any starting point. I’m pretty sure it’s the side effect of unknown source of inflammation. I’ve tried every insulin, except apidra because it crystalizes in my pump, with little difference. I tried the usual pre-bolusing routines. None of that worked fast enough. Hence my just building it into the basal program with wiggle room for real life fluctuations.
Explain this a little further of you don’t mind. I actually get more lows with the pump or Omnipod. [quote=“Robyn_Hovey, post:6, topic:65948”]
my first pump, which makes it impossible to missed the shots. Yay! And has pretty much completely eliminated the lows because I always correct back to 100
[/quote]
I’ve never used anything except my Tandem t:slim x2, so I’m not entirely sure how other systems calculate boluses. I have mine set too a target of 100 during the day and marginally higher at night, just in case. I tell it my best guesstimate of how many carbs I ate and what my blood sugar is, and it will automatically calculate how much insulin I need to bring my BG back to 100, never lower. So unless there’s an outside factor I didn’t account for, like exercise or traveling across elevation changes, it never goes low.
I did have a problem with lows when I first got the pump, until I learned there’s a programmed stupidity. I’ve actually fought with the pump developers over it, and they claim that it’s something all pumps do, that everyone is different though, and they would consider it for coming updates. There’s a lower range of glucose values where the pump assumes you’ve already eaten and Ignore the insulin on board because it’s counteracting the impending raise in glucose from that food. Seems idiotic and dangerous to me, though. They didn’t consider pre-bolusing or that sometimes people guess wrong on carb count. Anyway, I had a bunch of lows before I discovered that it didn’t always account for insulin on board and I was getting a double dose. But I know now to check the calculation if I’m below Target.
Pretty sure the more common solution to going low more often with a pump is simply that your correction values and carb ratio aren’t set up properly for you, though. Maybe they once were, but have changed. I used the mySugr app to help figure mine out, and find out that they’re actually different throughout the day.
Usually whatever bolus I give to control a sudden and unexpected high, the fastest I can reduce it is 40 units per hour. Strangely, unexpected highs in the morning seem to be a mile wide and an inch deep, since the normal bolus required for reducing those numbers is much less than for normal highs, and the rate of reduction can be 120 an hour rather than 40. Just another mystery of human physiology, which doctors are so skilled at never being able to understand.
Ditto and Ditto.
Pre-bolusing was the game changer for me. As long as my carb-guessing is in the ballpark I’ve managed to rid myself of terrible highs. As far as correcting lows, I like to use Sweet Tarts. Dextrose-based candy works pretty quickly for me. And since 1 Sweet Tart raises me by 5mg/dL, it’s pretty easy to do the math if my brain is fried. 
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