Have been fighting rollercoaster last week. I am on 530g with elinte. Been bolusing for carbs before eating using dual wave. After I eat will go low, usually real low, within 1;30 -2:00 hours then shoot up after a couple hours then have to bolus to get back down. Fasting and after I get back down I pretty much strait line. I know I have gastroprohesis and have been stretching out my dual wave boluses trying to compensate. Debating on flipping boluses to take small amount up front with larger after or just waiting until I start to rise and then bolus. My pump is going off again I am in low suspend again. Oops now it’s that wonderfully I am diabetic require imedeint assistance please call 911 so I have to go eat and make it harder to get down later. Got to love it (diabetes)
@T1john, what a pain, so sorry to read this!
We sometimes eat very low Glycenic Index foods, and my son then has the same problem, in particular in the morning. Normally, we prebolus by 45 minutes a single bolus. But, for these meals, we prebolus only 40% bolus 45 minutes ahead, the follow up by an extended bolus for the rest over an hour.
Can’t you do something similar, where you use a much smaller bolus ahead, then give and extended bolus for however long you need for your gastroparesis?
I know, for us, every time we think we have something down, it changes! It keeps us on our toes 
Sounds like you need to bolus for your meal later, and that should do it. Some meals just don’t require pre-bolusing whatsoever in my experience (for example, if I eat only an omelet with cheese, veggies, and meat, I don’t prebolus at all, and take my insulin after eating, and the timing works great). Also people’s need to prebolus (or not) may shift over time and potentially lessen, due to gastroparesis (a very common complication of diabetes that will make food take longer to digest).
Yea that’s along the line I have been thinking, I am good at carb counting but never use the glycemic index. Last night after my post I climbed to around 170 around 11:00pm a good 5 hours after hearing boluses again came back down a nd stayed around 100 all night. I try and keep my bg 90 - 110 with pretty good sucess. It would just be nice to get dialed in to stop the rise before it starts. I am a proactive type person vs reactive. But it is what it is with t1d.
Yes the gastroprohesis has always been issue as long as I have known about it. And of course it is inconsistent, makes it hard to control rises. My try flipping my boluses to like 30% before remainder 1 1/2 hours later and doing a temp basal rasing my rate for a couple hours.
Same—I stopped pursuing Afrezza after not getting anywhere easily re: procuring it awhile back, but I’m thinking of trying it again, because it seems like the most viable way of handling unpredictable timing—wait until it shows up on the CGM and then take insulin.
T1john, consider increasing your overall basal a little bit and see if that helps.
Just went back and reviewed my gmc from last night, went out of range at 11:30pm took bolus came back in range at 3:30am. May not help that my basal rate drops at midnight for overnight to prevent lows. And I ate dinner at 7:00pm, did drink a root beer around 10:00 because I was going low. I sure fixed that. I guess I may have to start using the glycemic index as well as carb counting, dinner is really only time I have problems, breakfast and lunch I barely have blip.
@T1john, if you’re treating alongside a pump suspend, it can kick you into some crazy highs in the hours to follow. I can’t speak to gastroparesis or its effects, but the suspends alone can cause big rebounds. How long are the suspends? And are you doing any kind of bolus to cover the longer ones?
This might not have anything to do with what you’re seeing. I’m a one trick pony.
Hate to say I don’t really know how long the suspends are. I am on the 530, only shows bg, guess I could tell by analyzing #'s, and I am not set up with carelink yet. Coulbnt get to work years ago and now can’t remember password, have not called them yet.
I don’t normally like to eat if I am low or high, low makes my bolus a little unpredictable to me, not like I am having that problem anyways. When low I treat with treats and bring up to normal then do my standard dual wave for what I am going to eat then go for it. Treating my lows that way let’s me get my fix in. Like treats, ice cream etc. But I am careful with what I eat for meals, kind of anal about how many carbs serving size etc. But don’t take glycemic ended into account. Have never really found good resource for that.
There’s no graph screen?? It doesn’t have a screen that shows the last however many hours with a shaded area for suspends??
@T1john
Sorry, I did not realize your pump was doing automatic basal suspends.
I change my recommendation on higher basal to just instead say, turn off the suspend feature. That can cause all sorts of problems.
If I remember correctly I think the 530G graph screen only shows shaded regions to designate nighttime, which is like, super useless.
Threshold suspsends should be 2 hours unless you resume it before that
Nope, 530 only has graph showing bg’s, others are avaible on care link I guess?
I would also suggest turning off the threshold suspend unless you find it is actually helping you. I found the thresholds are too high to not be obnoxious (don’t call 911 if I’m at 60 please, I’m fine) and they aren’t predictive which limits their value (once I’m already low basal suspension is pretty slow to respond). Plus the sound of that freaking siren, yikes.
Mine does predictive lows, let’s me know when I am droping before the suspend kicks in. Usually I just let it ride and do it’s thing while keeping an eye on it, also to fingerstick to verify. Can’t at I have a lot of bad rebounds like I said in earlier post I like to work it up slowly and won’t eat meal unroll it’s in range and stable again. And must add my wife loves sirens in the middle of night. But adjusting my basal for overnight hours has pretty much stopped them, I still get in day though probably because I like to be in range before I eat, then with bolusing slow stomach and higher basal rates with activity on and on, this really is a fun ailment isn’t it.
And it also shows when I do boluses, but yes old school, but at least don’t have to worry about am and only requires to collaborations a day. But I still fingerstick many more.
But hay you got to make most of what you got right. My warranty is out in August mabey then I will upgrade. Thinking the tslim x2. Am going to the freestyle libra next month so that will help with some more info.
Do you override your suspends, @T1john? If not, it sounds like you can assume you’re getting the full suspend, and that could be making things trickier. I didn’t mean to overwhelm your post with this idea, but I would be seeing spikes with those suspends. Could you consider overriding one once you start treating it? Or maybe giving yourself a small bolus to cover the missed insulin?
Here’s graph from last 12hrs
The gap is where I was late on my calibration, I know two a day is allot huh.
That’s a great looking line, no??