FUDiabetes

Time For Some Bragging

ahhhh congrats! Pump life is the best life. :grinning_face_with_smiling_eyes:

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My boluses are typically low in comparison, which is why it’s so frustrating to me. I’ve read on here a lot that anything over 5u is better in a split dose or manual injection dose, but the highest bolus I’ve taken so far with my pods is 3.95u

I’ll take a 1u bolus for my 25g meal and notice an hour later my dexcom rising to 200, I finger stick and it’s accurate. Doesn’t make sense - I waited the 20 mins after my bolus, I double-checked the cannula and it’s in my skin in the window, etc etc.

I have noticed with 2 pods in particular that when I removed them, there was blood mixed with condensation in the cannula window that wasn’t visible when the pod was on me. This last pod I had on though, I had these same issues with - and no blood when I removed the pod - in fact, there was still a droplet of insulin at the edge of my cannula after I removed it lol. I’m chocking this up to my hormones ramping up because I’m approximately 7 days away from my womanly troubles :roll_eyes: If these past few days have been any inkling of the insulin resistance and hormonal swings I’ll be going through soon, then I’m really in for it lol.

That’s the problem with pump life and podding and sites though, there’s so many determining factors as to why a bolus may fail.

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That sounds super convenient, but as with my dexcom supplies OptumRX gave me a big nope when my dash rep tried to go through them. Thankfully I got them via DME because I met my OOP for the rest of the year between that starter kit and my Dexcom supplies. So I just received a 3 month supply from Dexcom, and in about 12 more days I’ll get an order set up for free pods lol.

Thanks! I honestly didn’t think my a1c was going to get any better than 6.5, and being I had a lot of highs - yeah I brought them down but still - when transitioning to the pods I was really happy with that result.

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It is SO MUCH BETTER than stabbing myself multiple times a day and not feeling like I have good control.

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If that happened to me a couple times I’d change the insulin:carb ratio in the pump to give a larger meal bolus. Little increases after each meal where I’m still going high, until I reach the point where I start going low 3 hours after eating, then I’d go back one step. That’s all presuming I think the cause wasn’t a shortage of basal.

If the insulin:carb ratio needs to be stronger for the pump than is required when using a syringe/pen, it doesn’t matter that it seems wrong, the only goal is to figure out how to work with the pump to get a good result.

I expect to change my insulin:carb ratio a few times per year “with the seasons,” and of course my insulin requirement roughly tripled over my first few years of LADA as the remaining pancreatic insulin production went to 0.

With experience I learned just 4 basic strategies for tuning the insulin dosing, all pretty easy.

If repeated manual corrections through the pump don’t bring down the BG, I change the site. (And probably take insulin with a syringe to guarantee a fix to the immediate problem.)

If I’m ending up high after meals I strengthen the insulin:carb ratio.

If my BG tends to drift higher all by itself for no reason, I increase the basal.

If corrections don’t tend bring the BG back down to a good range, I change the insulin sensitivity to give bigger doses.

And a 5th one when LOOPing; if the BG tends toward wide swings / oscillation, I change the insulin sensitivity to give smaller doses.

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With me, I’m sure these past 3-4 days have been due to this. When I’m 9-10 days away from the start of my lady time - it could be one of 2 outcomes:

-I have perfect numbers, and then insulin makes me drop low when I take it (I like this scenario, but it’s rare and doesn’t happen as often as the latter)
-My basal rate is completely useless, and I have to go straight from 8.4 all the way up to 12u/day… at which point I have to monitor my dexcom… because at a certain point my morning insulin resistance wears off and the insulin starts to smack me around right before lunch - so I put it down to the 8.4 to avoid an urgent low.

I’m typically steady at 95-100 when lunchtime hits. I still pre-bolus… I take 1 unit for 25g carbs (whole-grain) and I wait 20 minutes before I take my first bite. I did this on Monday and noticed a rise that my meal bolus wasn’t going to cover, so instead of taking a correction bolus I ramped up my basal rate again to .5/hr instead of .35/hr. by 2pm my BG was stabilizing, by 4pm I was getting low and unaware - I finger sticked when I got home and I was at like 67, so I set the basal back down to .35/hr, snacked it back up to 107 and it stayed there steady. Having typed that all out I’m starting to feel like you’re right and I may need to reassess my I:C ratio.

Of course, indeed. I completely failed to remember this about my diagnosis! DUHHHH :roll_eyes: :sweat_smile:

I’ll definitely make this a talking point at my appointment with my Endo on the 26th to see if it needs tweaking.

I had mentioned this in the other thread that touched upon temperature and insulin sensitivity, I had it in my mind - being I was only given the Humalog back in May/June. So I’ve only really had “Summer” experience with I:c, and find it a little odd that I’ll seemingly need more insulin as Autumn is coming in to play. However, it could just be my pancreas making itself more and more useless lol.

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If that’s a typical pattern, I have to ask if you tried a basal schedule that is set up to give more insulin 'til 10am, and then less insulin from that point until later in the day. My basal schedule is strongest overnight, then at 11am drops to its low for the day, then creeps up in steps during the afternoon and evening, and back to the strong rate at midnight. Everyone’s basal pattern is different, and some are the complete opposite of mine, but if you have the same basal rate through breakfast and lunch, there’s another knob you can adjust. And that may or may not be reflected in all 3 of your basal schedules because the hormone changes may vary the times of day that you need more basal.

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:raised_hands:
Never heard that quote :laughing: Gonna have to remember that one!

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This is definitely something I can look into for weekdays. I’ve noticed on days I work the dawn phenomenon has set in, and naturally on days off when I sleep in I don’t have an issue - and sometimes have to do a temp basal drop of -5% until I eat.

I’ve been pumping since August, it might be time to level up and see where I can edit my basal rates more.

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I try to live by that one! I have trouble putting down the hammer most days :laughing:

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That’s a nice concise summary of the big picture, great guidelines for fine tuning, thanks!

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Sameeeee :laughing:

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