What technique is working for handling your post meal excursion, or in the case above, lack of excursion.
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Showers can be tiring.
Main things are:
- I started out in range before dinner (being in range at all has been a struggle since everything has slid off the wagon without me connecting the dots for the last…too long)
- I pre-bolused by 20 minutes
- My meal had a higher fat/protein to carb ratio than normal (Taco Tuesday!). I have notoriously under-bolused for what tacos required bc I was only ever counting the 19 grams of carbs in three shells. I doubled my dose and spread it over an hour and that seemed to work perfectly. Gaucamole, cheese and 80/20 ground beef bring a lot more fat/protein that I ever paid attention to before, so I imagine that helped draw out the burn.
I’m tinkering with my “work day” bolusing strategy. I’m making the day a graze session since desk work is so sedentary. My pre-bolus times have increased as my confidence has increased. I’m getting more aggressive with my bolusing as trial and error dictates. I do extend my bolus so that I don’t blow out my site with too much insulin at one time, which seems to be something my skin is prone to. I’ve never used another pump than Omnipod so I don’t know if my sites would do better with different cannula choices or not…but it’s a moot point since I have no intention to switch. My graph today looked the best it has in well over two years.
I’m getting back to the point where I don’t use a carb ratio…I just use what experience dictates will work. I eat a lot of repetitive things…and I live a lot of repetitive days…so it’s nice to get to a point to just know what works. But it is also unsettling to me that I have 1:10 ratio drilled in my head and some things are 1:4 and some things are 1:6 and some things are just whatever. I would love to have the security of an equation that works and can be applied to a dynamic lifestyle…but I just haven’t found that sort of flexibility PLUS control in 12.5 years of this disease. Spontaneity has always come at a price of looser numbers for me. I am a try, try again person…but that is data collecting, not spontaneity in my book.
ANYWAY…sorry for the long, rambling answer!
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Yep, I got 2 rolls on Amazon 6 months ago. Each roll was 11 yards long -the 2 inch wide roll was $18 and the 4 inch roll was $30. They’ve lasted longer than expected and work well for what I need.
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I don’t consider that a long rambling answer, but rather a very thorough one.
So what is interesting to me, is that you have found an approach that appears to be working for you. And this is fantastic.
Your desire for a fixed ratio that doesn’t change is desirable, but I think in the long term unworkable.
My son thinks of his carb ratio as a starting place, then adjusts based on other factors such as activity in last two hours, activity anticipated in next two hours, amount of carbs in meal, amount of fat in meal, with a tendency to over treat and then eat his way out of the insulin. This often gives him a track similar to yours, although being a teenager and not living a very regimented life leads him to more highs.
it seems that you have broken out of the most confining thought, i.e. steady ratio that doesn’t change, and are well on your way to long term success. This is great!
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Thank you, @Chris! Your son’s strategy seems a perfect parallel of what I somehow forgot to do once I switched to pumping. 
I’m working my way to fixing that steadily.
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YouguysYouguysYouguys…I actually FELT a low today. I haven’t FELT a low in forever. It’s amazing. I’m coming back!
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So happy for you 
- not feeling lows must be crappy
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So since I’ve had some BG breakthroughs and mental rebooting these last two weeks, I’ve become incredibly hungry. In a good way so far.
When I was diagnosed at 21 years old, I stopped thinking about food in terms of hunger. It was either time to eat or not. And numbers determined it all.
I have not felt actual Hunger with a Capital H since diagnosis. And now I do. Is this all mental? Like I finally feel free enough with my self-care that I can allow myself to feel hungry rather than eating to accommodate MDI scheduling before and Dexcom graphs more recently?
All theories are welcome. This is all very novel to me. My vote is it is a sign of new mental freedom but I’ve read that taking more insulin makes you more hungry. With being more aggressive on bolusing, I’m definitely taking more insulin. My basals seem to have been fine this whole time.
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Chow down on stuff that doesn’t have carbs. That’s what we have Liam do. Cheeses, deli meets, vegetables, etc.,
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I would suspect that the mental aspects are a big part of it. Congrats on having Unlimited hunger. Just kidding. It is really nice to see another diabetic move in a more “free-wheeling” way. That is awesome.
On the analytical front, rarely do I think that the complicated diabetic things are completely the medication or completely mental, humans are quite the complicated beast.
I will await those who have had T1 for a long time to weigh in on the hunger issue.
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I’m one of those long term diabetics. I’ve found that the lower my Bg the hungrier I am. If it’s low, if my wife didn’t put a lock on the refrigerator we’d run out of food. After 48 years of living with this beast I can judge when low or getting that way by how hungry I feel
So, nothing kills an appetite like being high, and nothing simulates it like being low. Ain’t the human body wonderful?
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Certainly could be something to do with feeling / having things more ‘in-line’… am sure at times we have all had the food-fight. My BG’S a _what?_Eat, and be dam$ed…don’t eat, and be dam$ed. It can be a stressor indeed!!! It’s hard to enjoy food if it’s being looked at as an antagonist.
That being said, lows for me are always a fight or flight reaction. I can feel the cortisol and adrenaline surge… FOOD. Now. Finally learned to keep the food consumption to a reasonable amount to treat the low, be patient, re-test. Rare to have a rebound high later… sad for my stomach 
I have also been told by both a dietitian and an endo that once one’s body is working with a metabolic balance that it begins working better, attempting to build back any lost stores of fat / muscle / energy yadda yadda yadda.
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I should add that I take this advice with a slight grain of salt…erm…BLOCK of salt, at times 
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I just bought “Sugar Surfing” for my Kindle and love it already.
“The concept of Sugar Surfing is based on the acceptance of chaos in biological systems combined with the desire to make adjustments proactively and react to unexpected BG changes before things get out of hand.”
Yup. I need this. And I used to live this way…and then I mistakenly thought I wouldn’t have to keep up like that on a pump. Thank goodness I know I was wrong about that now. 
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This really is the key.
We can never fully duplicate a fully functional pancreas and immune system but we can try to begin “thinking like them” and doing what we believe they would do if they were 100%.
This is why we make so many changes throughout the day with Liam. You must remain proactive and be unafraid of experimentation.
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Yes, we sugar surf. My son makes 3-8 mini corrections a day. We are currently trying to back off his aggressive treatment decisions to try and reduce the yo-yo effect. But as you have found, having a pump doesn’t reduce the number of decisions it just makes implementing them easier.
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I think the key is to be proactive instead of reactive. Get ahead of it.
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Last night, I kept myself from over-reacting to a downward trend before bedtime. I treated w milk instead of cookies 
and had a nearly flat line from 130 down to 90 all night long. It was glorious. But the urge to over-react is still really hard for me to fight.
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My general approach is to be aggressive with a high, but conservative with a low.
It takes practice to know exactly how aggressive and how conservative in each case, but this serves me well.
Much better than doing it the opposite way.
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