@Eric I’m not sure, but for those reading these posts there may be some confusion between selecting the type insulin (Afrezza to NPH, which changes the DIA curve by/of it self) and modifying the curve for a specific type of insulin. The section indicated seems to regard the insulin type (Novolog/Humalog [supposedly fast acting] vs FIASP [supposedly even faster]) vice changing the DIA for the selected insulin, but I might not understand the code and it may do both! I know @Eric knows what he has/is doing, so I say this for the benefit of others; for those folks, please understand both things (insulin choice and DIA settings) change the impact of the code and resulting treatment, so be careful if you’re modifying your own code and know what the intent and impact of any changes, particularly if you’re treating children. I think we’d all agree being able to make changes is a good thing, and its best if single/minimal # of changes are made, monitored for impact for a couple of days, then other change/minimal # are made, and tested again. The logic being with multiple changes we don’t “know” which change made any perceived impact.
Which of your approaches to nutrition or sugar control gave the most noticeable result and why?
@CarterAva - The most notable blood glucose result, for me, was when I employed a therapeutic carbohydrate limited way of eating. I started testing the idea in 2012 when I limited my daily consumption of carbs to 100 grams/day. The results were dramatic for me. I lost weight with little willpower expended, reduced total daily insulin with an overall BG improvement, reduced both hypos and hypers, improved glycemic variability, and noticed a marked improvement in quality of life.
The improvements were so quick and dramatic, I soon limited my daily carb intake to 75 grams, then 50 and finally 30 per day. That was all 13 years ago and I haven’t looked back. I easily sustained this way of eating to today. (This is my experience and I realize that others can deal with a variety of issues!)
In recent years I have added an emphasis on protein, particularly animal-based foods such as meat and seafoods like sardines. I still eat berries, kimchi, seeds, eggs, cheese, and some nut-butters. I treat myself daily to a small serving of dark chocolate. Coffee is still in my diet and I drink one 16-ounce cup each day.
I recognize that some diabetics can successfully employ other ways of eating (such as low fat high carb plant-based) that works for them.
I assess that my way of eating combined with AID diabetes technology has given me a quality of life I previously never imagined possible! In fact, my success with the diabetes tech would likely be totally undermined without the eating style I’ve adopted.
I realize that my long-winded answer failed to address the “why” portion of your question. Carb limiting reduces the amount of injected insulin required while improving overall control. I’m a firm believer in Bernstein’s law of small numbers: fewer carbs leads to less insulin and smaller mistakes. It doesn’t eliminate dosing mistakes yet it does make them smaller and safer.
We are at the other end of the spectrum with @Liam-M. He eats any and all foods with no limitations except the self imposed (I don’t like x) foods. We decided at the beginning that we wouldn’t tell him he can’t have this or that, because it’s too difficult to manage. I work day and night at learning how to Bolus for everything, so that he’s able to enjoy it all. We test over and over until we learn the right method of bolusing for each food he eats. He has 5 brothers and I didn’t want to treat him any differently than the others (where that possibility exists of course).
I respect the choice anyone makes for the low carb lifestyle but I was afraid doing so in such a young person would give him a bad relationship with food, and eating, and lead to possible long term issues. Whether that’s true or not, I don’t know…but I just felt strongly that doing this would make us/him “limited”. Being “unlimited” is our goal for him. Do, eat, be anything he wants, without limits, except those he imposes on himself. We just have to put in a bit of extra work to learn how to do it correctly.
The biggest help for us of course was the CGM and then the DIY loop system we use (Omniloop). When he was first diagnosed at 2yo, we didn’t have a CGM for the first few months, and because I learned early on what hypos could lead too, I didn’t sleep much at all during those months. The CGM fixed that and led to a better quality of life for the both of us.
Then I learned about Omniloop and moved to that and haven’t looked back. 85% TIR (give or take 3% either way each 90 days), 5.7 - 6.2 A1C and 1% low/severe low.
As @Liam-M is entering puberty now, things are getting more challenging, but I enjoy a good challenge. My method is to observe patterns and tweak settings to try and remedy them (usually basal and ISF, but Bolus amount also as he grows).
I totally understand and respect what I see as a rational decision on your part. You, as a parent, have been dealing with a young and growing child whose developmental issues materially differ from the adult population. I thankfully avoided those factors as I was diagnosed at age 30.
Each and every one of us must decide where the balance point that separates pyscho-social and physical parameters against long-term overall health. And that balance point may change as time goes by. In fact holding on to a certain point of balance after factors have changed and doing so is primarily accepted because “I’ve always done it that way” is not a good tactic.
I have zero experience as the parent of a young T1D. The responsibility that a parent feels in the sacred duty of seeking to deliver their T1D child successfully to adulthood unburdened by unnecessary physical or psychological diabetic burdens is one I can only imagine. I do know the usual perspective of a parent; my only child is an adult daughter.
@ClaudnDaye, thanks for tempering this discussion with your perspective as the parent of a young T1D!
As a Canadian, I like my blood sugar to be at 6.0 which is around 125. Just feel healthiest at that level!