@Jess, I think the concern is that while it’s mostly not different, that’s assuming the insulin works 100% the same way every time, which for most people, it doesn’t, and especially not in a newly diagnosed kid who likely still produces some of his own insulin, adding even more variability to the mix. So you may think you know what the insulin on board is going to still do, what the current blood sugar is, and calculate what remaining insulin is still needed, but it’s possible (and all of us who have had this disease a long time can attest to it) that at least one of the factors you are considering will not behave how you expect. Granted, this also means you could risk continuing to be hyper, if you underestimate the correction, but again, endos are more concerned generally about the immediate risk from hypos than the cumulative risk from hypers. Diabetes is fun like that!
So basically, the difference is because you’re testing later on and insulin absorbtion/use can be one more wonky variable (so you can’t be sure exactly how much the blood sugar will continue to drop), you’re adding an extra bit of error to your model. Most of us on here I suspect are comfortable with that and do it anyway most of the time. You may want to consider that potential for increased error in making dosing decisions—round down on dosing to avoid hypo risk, but maybe even round up if you know food is coming soonish anyway. It’s something you’ll get a feel for (and learn by trial and error) as you go.
Your first post described a typical day for me.
I recently changed Endocrinologists. My new one is more proactive about treating my diabetes, and even reads my Dexcom Clarity reports remotely. I once forgot my evening long-term dose, and she contacted me the next day to chat.
Anyway- your endo was being cautious. Maybe trained before CGM technology was available and you wouldn’t typically check again until the next meal? My (new) endocrinologist has no problem with stacking my short-term insulin if the calculated dose doesn’t cover meals correctly. She even gave me a chart of coverage doses to use.
Mine too (though she’s a PA in the endo dept, in addition to my non-endo PCP)! CGM changed and prob saved my life. But I meant the chart of coverage doses to use for stacking insulin if original dose didn’t do it. I’d be super interested to see an endo’s recc’s on that if they are at all generalizable. Thanks for replying!
before Loop I used some rules with my daughter (G6/Omnipod) that you could make a chart or table from. These were my high level observations
0.6U drops her by 100 points (ISF=167) from breakfast until 11pm (23:00)
0.4U drops her by 100 points (ISF=250) from 11pm until breakfast.
so between breakfast and 11pm I would
give 0.1u insulin for every 16 points over 140.
to keep the example simple lets assume she has 0.6u on board and remains at 240 for 3 hours then I will keep topping up her insulin so that she always has 0.6u extra. if she goes from 240 to 256 then I will add 0.1.
Whats sort of chart do you think would be useful?
This is a chart with my daughters corrections/IoB
