Nice !!! Maybe you hit the right dose and it just needed some time for everything to adjust and balance?
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I’m hoping so! This is definitely the longest I’ve spent in range in three days. lol
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So just as I started eating lunch (bacon and eggs) my BG went from 5.2 mmol/L to 7.9 mmol/L. I took insulin, so it’s coming down, but maybe the dose isn’t quite right after all. I’ll probably do two extra units this afternoon and go from there.
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Yesterday I took 40 units.
I spent the afternoon and most of the evening running high. Then last night I went low. Then I spent five hours low overnight (my own fault for sleeping through my CGM alarms). Then low again this morning.
I’ll try 38 units today, I think.
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40u actually reversed the rising trends on its own without bolus corrections? If so you’re right you really must have a very fine balancing point
Well, overnight yes, I dropped all night. But then this morning I’ve risen back up out of range. So I don’t know what to do now. I’ll correct and see what happens.
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High all day today, then crashed low tonight. May be headed low a second time (I treated the previous low, rose to 7.3 mmol/L, am now back down to 5.2 mmol/L with a down arrow…but that may level out).
I think I’ll stick with my plan of 38 units tonight.
My pump had a lower basal rate at night compared to the rest of the day. So this may be one limitation of Tresiba. But I’ll see if I can find a balance.
I’m headed over to my parents’ place for a few days tomorrow, and I’m so tempted to connect my pump just so I can do boluses without always having to get everything together to take a shot.
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Any downside to using the pump?
It would not have any impact on the Tresiba - correct?
Or would there be an issue with a minimum basal required? If you set the basal to absolute minimum would that be low enough to effectively have no impact?
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This is what I’m wondering about.
I could actually set the basal to zero, but then I’m not sure if I’d have issues with insulin crystalizing in the tubing.
If I set it to 0.025 units an hour, that would only be 0.6 units extra throughout the entire day, so I doubt that would make any difference.
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I would do the 0.025. From a pump/tubing/insulin perspective you know that has to work or else Animas would not have it as an option. Almost the same as zero from an impact perspective.
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Want to break it down in terms of what and when you’re eating in comparison to yours bg trends? It wouldn’t surprise me that as one goes to mdi from pumping there might be a lot to revisit in terms of bolus as well since before it was the same insulin and the two realms had a ton of overlap and now they don’t…
Seems to me that your evening / overnight trends have been by and large more cut and dry than daytime… not to say that they’ve been optimal, just easier to identify, going high vs going low
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I’m bolusing 1:1.5 mmol/L for corrections and 1:8 for foods. A few days ago I was using 1:2.0 for corrections and 1:10 for food. On the pump, my bolus settings ranged from 1:1.5 to 1:3 mmol/L for corrections and 1:8 to 1:14 for food, depending on where in my cycle I was. I’m currently at the point where 1:1.5 and 1:8 are expected. I’m definitely spiking much higher when I eat high-carb meals versus low-carb ones, but overall during the day I’ve just been running high non-stop and rarely getting into my target range, even after corrections.
My overnight trends do go up and down quite a bit, although in general they are high or low rather than being within my target range. It’ll be interesting once I can stay in range whether they will actually stay flat or not.
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I’m thinking at this point the overnight trends deserve the most merit… I think once those are optimized it might start becoming more evident how to manage the daytime ups and downs
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I agree. I’m going to take 38 units tonight and see how things go.
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I’m also hoping to get the basal dose set right before I try exercising or anything like that. (I mean aside from my usual amount of walking or other things I do every day.)
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So interestinlgy, after eating dinner (cauliflower rice, a few peas, tomato sauce, chicken, and low-carb tumeric “bread” with DF margarine - I bolused two units) - I’ve gone up to about 8.5 mmol/L (from 5.2 mmol/L before eating). That’s a big rise for me for such a low-carb meal. I think I’ll probably come down, but this is typical of what’s been happening all throughout the day, either after meals or just spontaneous rises. With the spontaneous crashes, I think I’ve been in range for all of three hours for the past four days. Hopefully I find some balance soon.
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I think the pump is fabulous in lots of ways, but I agree there are downsides. For instance disconnecting the pump from our son is a pain in the butt. Pulling out a pump on someone else IS disruptive to them. And it does scare me that insulin delivery can somehow stop and poof, in three hours we’re on the road to DKA.
I also think that, while shots would be a huge bummer for our kid (we did it for 3 months and it was bad), the pump really feels physically intrusive to him. He often complains when his site hurts, it snags on things, the actual pump is bigger on his little body than on an adult, etc…
Ultimately the benefits of pumping outweigh shots for us, but not by that much.
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I never wore a pump as a kid, so I can agree that the advantages/disadvantages for kids may be quite different than for adults. I think a large part of whether a pump works or not depends on lifestyle and personal preference. For example, if I have a site that hurts (as an adult) I’ll just change it out early, I can manage disconnections easily by replacing basal that I missed, and I think in 11 years of pumping my tubing has been ripped out only once or twice. For me, the three-hours-until-the-road-to-DKA thing is really the only disadvantage. But I can definitely see those being larger problems for a young child.
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Last night I went low around midnight (I was still up), probably overtreated (15 grams carbs) and rose to 10 mmol/L, stayed there flat for the next six hours, and then between 6:00 and 8:30 (when I got up) gradually dropped to 6 mmol/L (with no bolus).
I think I’ll leave 38 units for now and see what happens tonight.
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Today so far was low all morning and then high all afternoon.
I’m sticking with the same 38 units.
I’m perhaps cheating somewhat, because I connected my pump for the purposes of bolusing while I’m visiting with family. One thing with shots that I’m really missing is IOB calculations and I also suspect I’ll miss the ability to do extended boluses or temporary basals (higher) over the next few days.
I’m keeping the basal on the pump programmed to a flat 0.025 units per hour, though, which is only 0.6 units per day. So I don’t think basal-wise it’ll make much difference.
So far, aside from the wonky control of trying to find the dose that’s best, I’d say I definitely prefer the pump lifestyle-wise to shots. But I do plan on giving Tresiba the full six or eight weeks trial (unless I’m still trying to find the correct dose in another two weeks, in which case I’ll go back to the pump early).
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