Ah, if that’s the case, probably no worries then! I hope you’re able to find something that works for you.
You spiked all the way to 175 this morning from the oatmeal. You need more insulin for it, without a doubt.
Also today you needed more insulin because it is Monday and you haven’t been swimming for a few days. After a couple of days of swimming, you won’t need as much insulin for your breakfast.
What you need changes depending on recent activity. So keep in mind that Monday is a spike day. Friday less so!
Each progressive day of swimming means you need less insulin for the same amount of carbs.
what i was trying to say was that with OTHER foods, i dont spike. with the oatmeal i DO spike. the point i was trying to explain was that my I:C ratios are fine, just NOT for the oatmeal.
would you add another 1 unit onto my bolus for the oatmeal and see how that works?
also, i dont spike in the first 2.5 hours; i spike AFTERWARDS in the 3rd and 4th hour. its as if i need a dual bolus to cover those later BG highs. i dont get it at all. is it just b/c its just plain SLOW digesting carbs?
As you know, I don’t use IC ratios because all carbs are not created equal. A bowl of rice and a bowl of oatmeal don’t look the same, they don’t taste the same, why would we expect them to get digested the same!
So your dosing for oatmeal just needs a bit of an adjustment. If you take more insulin you may drop and then level out a few hours later, instead of rising.
Also, make note of how many days you have been swimming, and adjust for that. Monday versus Friday, etc.
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i think that this is the best approach. i will add 1 extra unit on wednesday (tomorrow is another MD appt in the city). but i will be swimming wed, thur, and friday, so i will be very sharp- eyed monitoring it.
one thing that i did do today that might have kept my BGs from elevating even more was that i gave myself a little higher bolus when i turned off my pump. instead of the usual .5 units, i gave myself .7 units. who knows.
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Sounds good!
ICs for many people are different in the morning and evening. They can be different for different kinds of carbs, and different depending on your activity level. Many variations!
This morning how many grams did you eat? 1 serving, 30 grams?
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28 gms of carbs in 1C oatmeal (maybe a wee bit more 
) no decaf or milk this morning. (usually i will have 1.5 Cups milk, too, which is another 20 gms carbs)
Take a little more insulin next time. Don’t panic if you drop a bit, just hang on and keep an eye on it. Wait it out (unless you drop down through the floor).
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the reason that i came up with adding an extra unit was b/c it would cover the amount i spike by. if i go up to 175 BG, 1 unit would bring me down 50 points. so its kind of like doing a preemptive correction 
(of course i could be completely wrong; it was just the best guess i could come up with )
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It’s helpful to adjust only one thing at a time instead of several things, so that you can know what the change is doing. So trying a little extra insulin for breakfast and leaving everything else the same would give you a good comparison with today. 1 unit sounds like a good start.
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tomorrow is a swim day so i will try the extra 1 unit of insulin at breakfast. i take my insulin at 7am and eat at 7:30. this way, by the time i begin to prep for the pool, all bolus is out of my system (i begin prep at 11:30am ) if i am crashing, i’ll fix it and move forward.
i tweaked my overnight basals and checked them throughout the night. all went well and i landed at a perfect 81 before breakfast. i am just waiting to see the effect of the new basal after i test at 10am. hopefully the day will go well too. these were very minor tweaks ( .025 )changes, but with the overnight, i had been waking up consistantly at 130ish compared to this mornings BG which was obviously much better.
today is not a swim day b/c of MD appts in the City. but tomorrow through friday i plan to be in the pool, and hope to do a hard 2 hour swim on friday.
yesterdays swim was very hard and i paid the price for it last night. serious pain. an “ADVIL NIGHT” for certain. but i woke up this morning feeling wonderful. no pain whatsoever.
is it weird that i dont need any overnight lowered TBs? i ask b/c the one time i lowered my basal overnight, i woke up at around 150. if i dont use the TB, i wake up like this morning (81).
eric, just tested my 2.5 hour post bfast BG. landed at a nice 98. no crash, no spike, and i ate a very hearty bfast, too.
(off topic : originally my I:C ratio in the morning was 1:10. now it is 1:6 and problems like spiking have disappeared with the exception of the oatmeal. i did the change incrementally lowering it by .5 at a time until i saw the result i was looking for.)
After one day of swimming that seems right. After 2 or more straight days you will need to drop your overnight basal.
Another thing we can look at is this. I made a spreadsheet that shows my IOB at any given time, including from turning off basal. We can plug in your numbers and see exactly what insulin is in your body when you get into the pool. That will tell you how much you have for the drop you get in the first hour.
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that sounds awesome. i’m eager to see something like that.
We’ve been over your basal rates and everyting before, but just to make sure I have all your updated numbers, just send me:
- your basal rates
- insulin duration
- insulin peak activity time (best guess of how long after a bolus the insulin is most active)
- what time you are taking your breakfast bolus, and the amount
- what time you are disconnecting
- any other boluses you take in the morning
- when you plan to start your swim
I’ll plug those in and tell you how much IOB you have (total of both basal and bolus (IOB).
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basal rate is still in flux, but almost set 
basal:
12am .6
9am .575 (this may be lowered but not certain yet. waiting to see if a pattern emerges)
10am .525
(i may have to add a 10pm basal of .6 depending on my 1am BG, but the rest of the night is perfect)
insulin duration is appx 4 hours (Novolog)
peak activity 2.5 hours
breakfast bolus at 7am, approximately 4 units to cover the 28 gms of oatmeal (which hasnt been enough insulin) (1:6 carb ratio )
disconnecting at 11:30am, bolus .5 units at time of disconnect
plan to start every swim at 2pm
(crashing from 2:30 to 3pm)
Are you fairly confident it peaks at 2.5 hours? I know it’s different for everyone, but that seems kind of long.
it may be 2 hours, but the way that my pump is set, an alarm goes off at 2.5 hours for testing BG post meal. i could easily be wrong about it. how would i know?
Let’s think through it.
How does this graph look to you for your insulin activity?
Tell me what time you think insulin starts to hit really strongly after a bolus. What would you change on this graph? Would you move it to the left (earlier)? Would you make a sharper peak and a faster drop off?
I have absolutely no idea. i dont use a cgm, so this is very difficult for me. i’m not that in touch with the FORCE when it comes to this. no one has taught me anything about it, nor have i ever thought about it before. 
i think that my insulin starts to peak at about 1.5 hours. i do know that it doesnt start working until about 15+ minutes, and i know that by 2 to 2.5 hours it starts drizzling out. still in my system, but not as potent. these are just guesses.
eager to learn about this from you. i know that the more i learn, the better i will be about managing my D, and that is always very freeing and fabulous. 