FUDiabetes

One day in a life of puberty peaks

I read @Chris’ email on the rollercoaster :frowning:

Here is yesterday and this morning’s for us. It does not include 2 basal shots. Total shots in 24 hours = 13. Not exceptionally high either these days.

Yellow = 120
Red = 70

@Chris, I think that a big part of the problem for us is being able to adjust faster to the basal changes. We are off 8 U from a week ago, but probably still 4-5 off from where it should be.

And next week it could swing back 15 again . We need to learn to adjust faster/ better on basal.

I agree with you Michel, we adjust our basal weekly, and his needs are changing more rapidly than that. Also, with the pump we use 6 different bolus rates. It is amazing how different our bolus amounts are from time period to time period. It gets even weirder when you adjust and adjust and two basal rates diverge then they end up back at matching amounts…Hopefully your appeal goes well.

1 Like

Same here:

  • Correction factor 3 weeks ago: 1:50

  • Correction factor last week: 1:12

  • Correction factor during the day today: 1:25

  • Correction factor during the night today: 1:10

  • Next week: who knows?

We have to be comfortable with uncertainty and change:-) I know that, for us, we have to figure out how we can adjust to change faster and how we can recalculate ratios faster.

I can see why you would think this looking at the graph. Another way to think of it might be that if you’re taking 13 shots of bolus/ day you’re effectively managing a large amount of the basal needs with bolus insulins. The tendency to over adjust basal doses can be counter productive… if this were my trace I’d interpret it to mean not enough basal throughout the entire period, and not necessarily the need to be able to more finely adjust it— it appears his trends are always upwards, except from when knocked down by bolus.

I think when his basal dose is optimized you may find more stability in his bolus ratios too, but that’s just based on my own experience…

Might consider trying the tresiba, it’s a really really good basal and by providing an effective 1x daily dose it’ll really help make the picture clearer instead of trying to decipher 2 or more daily basal doses to determine what’s doing what

1 Like

yes, I agree with you on this trace. I think I mentioned somewhere that he was probably 4-5 basal units short right there. He is 2 units up right now, and will be two more units up tonight.

What happens, @Sam, is that his basal needs change fast – and we always try to change his basal somewhat progressively, say, no moe than 2-3 units per day. But I think we need to change faster than that. The concern, of course, is to have him run low at night for a whole night, which has happened before, when the pendulum swing back (several nights on a row) :frowning:

If we had stability on basal needs, things would be a lot easier.

Yes it does help, but sometimes it can be as elusive as a unicorn and the closest we might ever get is a flat and consistent basal dose… … there will always be the perception of having it “not quite right” and there will always be indications that maybe it’s a little too much one day, and then not quite enough the next— but if we act on those inputs too frequently we end up in a tail-chasing pattern which isn’t what we want either… ive learned myself that the tendency to overadjust basal or adjust too frequently is counterproductive in my own case…

It was also an eye opener when I went to my doctor telling them I needed more basal adjustability (painting a very similar picture to what you are saying here) and his response was essentially “that’s all BS-- use tresiba instead” and it’s been a huge improvement… I was actually somewhat irritated that he didn’t seem to be listening to me say “I need adjustability” but it turned out his advice was perfect

1 Like