This is how I use my calibration factor… so a steady 5.5 means stable. A higher calibration factor often means I’m rising. (It CAN mean other things, but I don’t want to confuse you ). At 7:30 I was a 63 with a calibration factor of a 4.68. By 8:30, I was a 217 with a calibration factor of 7.38. That’s a big movement, and that’s a rising BG. So I was rising and would (almost) stake my life on it.
I now use my [quote=“Eric, post:39, topic:4259”]
When you were at 220, was your pump also pushing up your basal to bring you down?
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Oh, I no longer use auto other than to have a good time. I’m in manual mode 100% of the time. Manual mode doesn’t mess with nasals, but it does have suspends… and, I’m looking now… no suspends this morning or over night. The only suspend got by me afterwards. And by the way, I had some kind of leak… had to change my set. So that at LEAST explains the post-exercise crappy numbers.
Look at you with your fancy math skills. Yes, it’s about spot on. (I was smiling at “fancy math skills”, too— don’t go taking me seriously ). I think the recommended bolus was a 2.4… I was mistaken… either way, close enough, and maybe 40% is too much.
I’ll definitely try 20%… of what?? Of the recommended correction? Even if I know I’ve got mother push coming up behind it??
I would like very much to show you a pic of my logs, but if you make so much as ONE joke about the amount of numbers in there… well, them’s fightin words . If the temptation is too great, I’ll just describe things. I’m really, painfully long and boring posts…
You can post a pic, hopefully I will understand your stuff. But really, there are some other things to think about first.
So you are sure that was a legit spike to 217 at 8:30am?
A 150 point jump in one hour - from 7:30am to 8:30 - and that was with no food, just your 50% basal suspension and coffee?
And then when running, no other IOB or any other insulin beside the 0.8 units you took?
Where was your infusion site? Was it in a leg muscle?
I think you were going down before you left. A crash like that after 15 minutes seems like it is something beside that 0.8 units plus 15 minutes of exercise.
It would be good to get you on a flat BG with no IOB and doing some moderate intensity runs to get a good baseline.
Trying to baseline numbers when you go from 60 to 210 to 60 within 75 minutes (or something close to that) is not really ideal for trying to come out with exercise adjustments.
If you can start a run when flat with no meal or correction IOB, it will be easier to come up with some number adjustments for you.
So in reality, you’re not even going to be able to read any of it… but if you can, there’s one VERY important thing to keep in mind… I do not pay attention to all numbers. I track a certain set and just log others for my records…
Mostly just the coffee. I was less than 30 minutes into my temp.
Zip. Only the .8.
In my flabdominal area. My flabs.
I was also surprised by it, but not terribly so. This is how I do. I’ve plummeted from a 500 to a 50 during a 40 minute walk. I am not making this up, and I would almost, but not really cuz how stupid, be willing to bet my life on that not only was that NOT a falling number, but that number was on a big rise. I would’ve been at a 240 within 10 or 15 minutes, and with that temp coming up behind, I would’ve easily hit 300. Probably higher. This is not necessary to add, but I’m going to anyway, I had to jump 5 times (10 minutes each), put 3 temp basals of a one hour 120%, one hour at 130%, and 2 correction boluses to bring down my blood sugar after exercise today. And dancing! Lots of dancing. Not a single carb all day. I finally got myself to a 60… FINALLY… i finished my dinner 20 minutes ago, chicken, green beans, and 1/3 of a sweet potato, which I PRE-bolused for, and I’m already at a 172. I’ve done all my insulin and am too tired to jump. I can feel the rise in my skin, and I’m guessing I’m in for a big rebound. But I know you didn’t ask for all of that… sorry.
The REST of what you said is where the treasure is… in some kind of a plan. Maybe even a solution. If you have ideas, I’ll try them. Everything you’ve come up with so far, I’ve already put into place and with some success. And the Tresiba can’t happen till I see the doc, but I’m up for that, too.
I knew you were going to say that… because, yes, I do. However, it was the absolute truth when I told you I only track certain numbers. The rest I just keep for when I need them for… something… which is not helping my case.
Ok, shoot. Say whatever you would like to say, and I will do my best to not take it personally and all the wrong way…
Daily carb intake… changes by the day. According to my pump, it looks like a 30 day average of 115. And that’s been with lots of bingey eating… I think I’m usually closer to 85-90??
Insulin duration: 3.5 hours
And, yes, if you don’t mind spending the time it takes to come up with something to try, I certainly can try it. I really, really appreciate it.
On the BG numbers, it looks like maybe - this is a guess - Relion, Relion Prime, Contour?
How about for a couple of weeks, just going with the Contour. I know it’s fun and useful and informative to compare. But maybe just a focus on simplification would help you out for a couple of weeks. Same for the Libre and SG and all the other stuff which is possibly just clouding a pattern that might be very easy to see if all the other background noise is removed.
Can you try just Contour and insulin and your CGM for 2 weeks? And don’t use data from the CGM, because I think the Medtronic CGM’s are crappy. Just use it to wake you up if you are low or high.
Your short insulin duration - 3.5 hours - are you fairly certain of that? If so, you are going to see more rapid drops and climbs than someone with a 4.5 or 5 hour duration. That’s just the nature of it. Not good or bad, just how it is. If so, we need to be more conservative with dosing before exercise.
How about a baseline to see where you need to go from here. This is just a starting point:
Can you try a run before lunch, after it has been 4 hours since a meal? We want 0 units of IOB, and a flat BG.
Do a 30 minute zero basal before you run. And stay at zero basal until you are done.
Right before you start:
If you are 100-120, take 25 grams.
If you are 120-130, take 20 grams.
If you are 130-140, take 10 grams.
If you are 140-150, take 5 grams.
After you are finished, replace half of all missed basal, and take 40% of your IC for carbs right when you finish. Have at least 20 grams of carbs right when you are done.
Like I said, just a starting point. Let’s see what that looks like.
Ok, we can still be friends. You’ve got a nice delivery and an easy letdown.
Yes to all of it. And to the part about putting the stuff away (had to think about that a second longer).
I can.
They are.
I have NO idea why I have that. I was at the factory setting of 4 for years, and my most recent endo decided to shorten it. That’s as far as the loyalty to it goes. I’d be happy to try to change that… I test enough to catch it if it’s a problem.
I can, and I will. How long can I run? Does length make a difference?? It might take me up to a week to get this done though as those are like “when stars align” kind of conditions… but I’ll get it.
When I am speaking of insulin duration, I am talking about how long it actually lasts for you. Changing the value in the pump only changes the numbers your pump shows you for IOB and for bolus suggestions. It doesn’t do a thing for how long insulin actually lasts.
Do you have a guess on how long insulin lasts for you? If your endo changed it to 3.5 hours, I suspect that was simply to help you get more insulin for meals or corrections or to remove you IOB faster, or some other idea he had. I am betting he didn’t actually calculate or test how long it lasts.
Would love to figure that out. Sorry. I passed out last night, but I’m back at it this morning, using JUST my contour and pump (and calibration factor because we didn’t specify, and because you’d have to pry that from my cold, dead hands).
And that’s pretty upbeat. I’m shooting for a late evening run but doubt I’ll be able to do what you mentioned last night. I’ve got a sick baby so it’ll be a seize the moment kind of thing. I will try to plan ahead as much as is possible and will keep to 20% if I need to do any kind of insulin…
Just try to look for some trends on your runs, depending on what your BG is doing. Start with big brush strokes and then work down to smaller ones.
Before run:
BG - high, medium, or low? BG - flat, rising slowly, dropping slowly, spiking, or plummeting? (this is an important one)
And no IOB if possible.
It takes time to get it ironed out.
Ask @daisymae. She used to always start her swims at 200 because of fear of drops, and now she gets in the pool at 80. But she didn’t get there overnight. It takes time to get it figured out.
@Nickyghaleb, I think this is a GREAT thread and I’m super proud of you for running repeatedly even with these swings and crashes and everything. True bravery.
One suggestion, and you won’t hurt my feelings if you don’t think it’s worth trying, but have you tracked your blood sugar with a monthly vision in mind? The reason I point that out is that assuming you experience cyclical insulin resistance and cyclical insulin sensitivity, the more acute tweaks for exercise MIGHT not address your exercise needs on a consistent basis. When I engage in high activity, if I don’t have my hormonally-induced insulin sensitivity or resistance ball-parked for the day, it’s going to be nothing but crashes or lingering highs for the whole activity and the whole day.
The biggest thing I’ve learned for my brand of diabetes is that if my basal is not correct +/- 5-10%, nothing else I do that day will get close to accounting for the incorrect basal. It’s amazing how much correction you need for a stuck flat-line of 210 or 220 that is progesterone-induced, when just an extra 5-10% basal an hour could manage it. The math on it is confounding and astounding, I promise.
Let me know if you have questions. Either way, I’m rooting for you!
I have two ways of tracking insulin resistance/sensitivity.
(1) I eat the same breakfast everyday. How the bolus performs day after day gives a good indication of when insulin resistance starts to ramp up and by how much.
(2) My overnight bg patterning. When it starts to consistently drift up and level somewhere overnight, it’s time to start cranking up temporary basals to deal with the hormone-induced resistance. When it starts drifting up to 160 and staying there overnight, that’s when I start adding it in 5-10% at a time. If it drifts up and levels at 190 like it did last night, I know I’m getting into the most resistant 4 days of the cycle with more rises to come.
I track my percentages of extra basal needed by day of cycle and compare notes to previous months for patterns. I’m lucky that it’s so consistent for me.
Anyway, if this is a factor for you like it is for me, it will help make the rest of your corrections for exercise/highs/etc start from a more level playing field.
And an impressive 2 cents it is… you are to hormones what Eric is to whatever he pretends to know everything about. Seriously… you’ve got numbers, and numbers are something I can roll with. (And I will take a moment to say something very serious about Eric, which is that he’s awesome and knows some stuff, too, and I say that because I might be one joke away from dealing with it all on my own).
I’m not exaggerating when I say I’ve never paid attention. And I’m not SURE any of it will apply, but you’ve got my attention now. I have something going on, and I don’t understand what it is. I have been really having a tough time for going on 4 days now?? 5?? And that was following a couple of days that things were too easy to be true. Last night my blood sugar went up and down all night… Literally, I’d clear an alarm letting me know I was dropping (now it would take me an hour to clear it, sure), and the next alarm would be to let me know I was on the rise at a fast rate. I even went back and looked at some of what you had to say, and although it would not fit my timing this month, it’s as good a possibility as anything I’ve got (which includes inflammation, recent change to high carb diet, or alien abduction).
So I’m on it. Please don’t hesitate running ideas by me if you’ve got any… and I would never offend you by telling you I don’t want to try, I’d just not try them and never admit it.
I’m waiting for an evening run and half-expecting a disaster. So far I’ve got way too much insulin on board because my son didn’t finish his nasty BURNED gluten free buns… so I did.
I’ve got an hour and a half to go though, so hopefully some of it will disappear. I’ll probably crash just in time to have to jack everything up again and screw up my night… which is MORE positive thinking. Dripping with that today.
If time permits, i will try to slap a little organization into the hormone department and see if I can’t turn it all into something to track. I hope they have a meter for that. I could use another meter.
). At 7:30 I was a 63 with a calibration factor of a 4.68. By 8:30, I was a 217 with a calibration factor of 7.38. That’s a big movement, and that’s a rising BG. So I was rising and would (almost) stake my life on it. 
. If the temptation is too great, I’ll just describe things. I’m really, painfully long and boring posts…
Seriously… you’ve got numbers, and numbers are something I can roll with. (And I will take a moment to say something very serious about Eric, which is that he’s awesome and knows some stuff, too, and I say that because I might be one joke away from dealing with it all on my own). 
️