I ordered insulin last week, and it was shipped Monday night. I was worried because in April the gel packs were room temperature.
Well these didn’t arrive until this morning and was still cold. However, I think this was first off the truck and in April it was last off.
I stress out every time I mail order insulin.
The new bolus ratio seems to work okay. In fact, it might still be too high, but I’m giving it a few days. Especially in case I have another — “got to have everything a diabetic shouldn’t eat in one day” day. Still amazes it that it took 3 days to recover from that. Good learning experience though.
I’ve been able to do two short basal tests. One this morning which lets me know that the correction we set up for dawntime phenomemom
One the other evening that let me know that the new basal rate (.05 less every hour during the day), is okay. I still don’t have enough courage to completely change that time period without talking with the CDE. I see her in two weeks.
I think it was because I hurt from sitting in one place, but I really wanted to know my TDD (Total Daily Dosage). 38.135 which puts me at 11:1 for the 14 day average and puts my correct at 38, which I think is more reasonable than the 7 day average (11:1 / 41).
So I test a lot tomorrow.
And it makes me feel like there is a light at the end of the tunnel …
… probably a train though.
Before the “Saturday binge” of Saturday a week ago, I was just experimenting with carb ratio of 11:1 (means I take the number of carbs in food and divide by 11) and it was working for most meals.
I went back to 10:1 because my insulin usage was up, and the 11:1 wasn’t working and I was chasing highs.
Now I’m chasing lows… (I write this stuff so if I screw it up, I can go back and look at it, even print it out and show the CDE or Dr.)
All weekend, two hours after I ate, I was in range of 120-130. If I am that “low” — the goal is 140, I tend to go low within two hours. I really don’t want to eat every two hours, it aggravates the GERD (the more often you eat with GERD, the more often you experience heart burn). In fact, in a perfect world, like tonight, I eat about 5:00 and don’t eat again until morning, and I sleep better. I ate enough slow carbs and protein to keep me going tonight, so far. Though I’m keeping a close eye.
SO, I think I’m going to try the 11:1 ratio again, though I hate that math (10:1 is the easiest, you just move the decimal point). If I do a 7 day average, the 500 rule works out, it’s just that nasty 70 unit day that is causing problems.
Besides, I’ll just be chasing highs rather than lows, and it takes less calories to chase a high — but more insulin.
I really hate making two adjustments at once, but that’s the way it goes — when you reduce insulin usage, you reduce it all the way around, basal AND bolus.
Fun stuff isn’t it?
And I decided to look this stuff up in Pumping Insulin. Interesting facts: According to Pumping Insulin, I should be taking 72.5 units a day, based on my weight. So at an average of 44 units over the past 7 days, I’m doing REALLY REALLY good. My exercising is paying off.
The book says decrease or increase by 5% and recalcuate everything, but I honestly am afraid that’s too much too fast.
And according to the book, I’ve done two things that cause my TDD to go down: changed my activity level (more weights, more time on the treadmill), and changed my weight — lost weight.
Anyway my goal is to make gradual changes without screwing up control. I really hate chasing highs.
I ended up running a bit of a basal test on the new basal rate, since I was able to go all evening without eating.
It’s good.
And this morning ate breakfast, and the new bolus rate looked good. At least so far, I’m not chasing a high
Glad I changed that basal rate — woke up at 3:00 am with a blood sugar of 108 and again at 5:00 am with a blood sugar of 103.
I’ve decided to go ahead and add the 1/2 hour decrease (by .05 units) in basal tonight, as it looks like I am right where I want to be.
Still seeing some weight loss too.
Since I’ve woken up with fairly low blood sugar three mornings in a row, I’ve decided to drop my midnight to 4:00 am basal rate by 0.05 unit. I’m reduced my basal by a whole .20 units 🙂 Actually every little bit helps reduce the total.
I’ve also been slowly, from midnight back, decreasing my biggest and longest basal rate during the day. I’ve been dropping by .05 unit every half hour, and am now dropping from 9:00 pm on.
It works out pretty well, the basal rates are now
12:00 – 4:00 0.85
4:00 – 8:00 1.10 — this will be the next place I change
and I half it on cardio in the morning days
8:00 – 9:00 1.00 — this is the rate I’ve been decreasing by half
9:00 – 12:00 0.95
So things are going well.
Here’s the really good news, my daily total insulin usage has dropped to 38 – 45 units a day with an occasional excursion to 78. That’s a whole lot better than it was before I started working out regularly.
And I know I’ve lost at least 20 pounds since I discovered my scale wasn’t working.
It isn’t easy, but I know of a Type 2 diabetic who has cut her insulin usage dramatically and has lost lots of weight. I met her on iShape and she’s an insulin pumper too.
Here’s what is working for me:
Regular cardio and resistance training.
I have a treadmill and weights here at the house. I belonged to a gym, but I will say I’ve been more regular since I set up at home.
I also have iShape as a support system. I track my workouts, track my food, and my other progress. I also have people to work with. Right now, we’re doing a two week challenge with partners (that’s a first).
I really think you need a good regular schedule — which iShape provides, and a tracking system — which iShape also provides.
I will say that it is a long hard progress. I’ve got about 4 weeks without any weight changes. At the same time though, I was tracking everything else — during that period I saw a change in insulin usage.
See that, kept me sane.
All of a sudden I’ve seen a drop in weight (about 3 pounds), though I admit to making a change in my definition of “clean eating”. That’s a challenge term. I was making sure I was 600 calories under what the program said I burned, but right now, I’m using their calorie level. Some days it’s 500, some days it 700 under what I burned.
And I’m not feeling deprived. Yesterday I had a Subway sandwich with a small bag of chips. I’ve had gummy bears, and other “treats” through the week.
Oh, and I really think you need to be on a pump. Or at least really really understand what you are doing if you are on insulin. Thursday, and Friday morning, I was fighting low for about 12 hours. If I had been on my own regimen, I would have had to have added even MORE calories than I did with the pump, defeating the whole purpose.
You need to be able to cut your insulin usage to match your decreased needs, or you ARE going to have a hypoglymic episode.
I woke up clammy and feeling funny, and with a blood sugar of 89. I did sleep in a bit and did use my “non-exercise basal”.
I’m going to start changing my evening basal again, since I’m “back” to where I was.
And yesterday insulin use was actually under 40 units.
I’m really documenting this because I don’t want a repeat. I screwed up on Saturday and I’ve been paying since yesterday!
Sometimes yesterday, probably after I changed my set, though it was working fine, I believe, my blood sugar started going back to what it was before Saturday’s screwup. This morning clinched it, blood sugar fasting was in the 110-120 range even though I haven’t hit the treadmill yet and I’m on morning exercise basal.
I did notice that this site was more irritated than those in the past which follows my theory that only a certain amount of insulin can go through a site.