A post was merged into an existing topic: Is there such as thing as mild gastroparesis?
Nice in-range night overnight! I did brush the tops and bottoms of my target range (rose gradually the first part of the night and then fell gradually the second part of the night), so still a bit too much of a spread, but I didn’t actually go high or low. 
It seems to me that changes I make to my Tresiba dose kick in essentially right away. I reduced my dose by two units yesterday, and my overnight readings tonight were much better (I went to bed in range and woke up in range, no highs or lows). Does anyone else find this to be the case? The information on Tresiba does say it has an onset of about two hours. Is it possible that for me it acts faster than for most people (maybe that’s why I find the split-dosing so successful)?
Anyway, plan today is as usual: bacon and eggs for breakfast, cabbing it to work (I really need to break that habit next week!), and a quiet office day today.
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Yes but the weather is pretty crappy… I would be ok if it was just cold or if it was just wet but this cold and wet thing stops all my outdoor exercise and since I only exercise outdoors it pretty much stops all exercise.
Next week does not look much better.
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Yeah. You can also add dark to that list, at least at 7:15 when I have to leave. I basically have zero motivation to spend an hour out there, half of which is walking.
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Update: I took 9 units of Tresiba this morning and my BG literally stayed between 5.6 and 6.1 all morning. 
No eating or insulin required.
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Nice flatline overnight tonight! I was out of range, though, but it was flat. I did a correction before bed, but it appeared to do nothing (except maybe prevent me from rising further).
It seems 9/9 may be a perfect dose for me.
Today I’m going to a party and am going to stick to very low-carb eating (bringing all my own food). I think that’s had no small role to play in how stable I’ve been.
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Hmmm. Now I’m wondering if 9/9 is too low. It’s noon and despite a correction I haven’t come down at all (just like last night), but I have held very steady, just high. Maybe this is the start of hormones kicking in…
This morning I took 10 units of Tresiba. I’m not sure if I’ll stick with that, though, I may still use 9 units. Yesterday and the night before I’ve been running at the upper edge of my target range even with corrections and an extremely low-carb day (maybe 10 grams of carbs total, mostly because I only ate breakfast and two snacks and that’s it). However, yesterday afternoon I did come down and stayed in my target range for hours. So I’m thinking I may just have to double the corrections I’ve been using, as that’s what I did yesterday. I did the same this morning and we’ll see how it goes.
How often do those of you using Tresiba change doses? I feel like I’m changing doses just as often as I did while pumping, even though people say not to… I also feel like I’m using and changing bolus doses far more than I did on the pump. It seems to me that both equal out to the same in terms of the constant adjustments that have to be done in order to stay in range.
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I only change doses when I change activity levels or drink a lot or if I think I need to make a more long term change; however, I think that sometimes I have days (1-3 or so at a time) I am running a little off, with hormones likely part of that, but by the time I adjust for it, it would be over. I also think I would probably need to fine-tune more to get ≤ 6.0 A1c, but to be perfectly honest, I’ve decided I’m alright with not hitting that right now.
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Yeah, this is what I’m aiming for with eating very low-carb. I’m OK with an A1c in the 6s, but my last two (eating low-carb and pumping) were 6.0 and 6.3, which are really close to the 5s. So at the moment I’m very motivated to try and see if I can hit the 5s for the first time ever.
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Well you’re still kind of zeroing in on your dose… so it’s a little different. I only change mine a little as needed maybe once a month or so if I start seeing generally upward trends or generally downward trends over a number of consecutive days
Using bolus a lot more than when on the pump makes sense…
I think I’ve pretty much narrowed it down. Either 9 or 10 units holds me steady overnight or when I’m not eating. Aside from variations that I’m not sure I could address with a flat basal (such as rising and then falling again overnight), I think it’s probably as good as it’s going to get.
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I decided to stick with 9u Tresiba last night.
I went to bed at 10 pm with a BG of about 5.5 mmol/L (dinner at 6 pm). At around 11 pm my BG started rising until it was at 14 mmol/L by 3 am, after which it just flatlined there until morning.
I’ll do 10 units Tresiba this morning and if I seem to be running high all day, I’ll probably start ramping the dose up. It’s definitely the right timing for my BGs to skyrocket.
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Weirdly, I did a correction using the same ratio I’ve been using lately, and within an hour plummeted from 14 to 2.8 mmol/L. Ugh. Feeling awful. No idea what causes that. Maybe the high was from protein? Going to need to figure out a way of dealing with protein, if that’s the case.
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Yesterday was pretty chaotic, BG wise. As detailed in previous posts I spent the entire night running around 14 mmol/L, but then after a correction in the morning dropped to 2.8 mmol/L within an hour. After that low, I spent the rest of the day running high. I stayed mostly around 8.5-10.5 mmol/L (with multiple corrections), except for around dinner when I rose to 15 mmol/L. I corrected that and gradually came back down during the next six hours, except then I just continued down. Just after going to bed I got down to 2.3 mmol/L and treated. I rose back up to around 6.5 mmol/L but then again dropped low. I spent the rest of the night running low until about 5:00 AM, when I rose slightly and woke up at 4.2 mmol/L.
I took 10 units Tresiba last night and will stick with 10 units this morning. I have no idea what caused yesterday’s blood sugars, but it’s one of those days where <10% of readings were in range. There was no unusual activity or food or anything like that.
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So sorry you had such a rough day yesterday, Jen. Hope today is way better!
Thanks! I hope so, too! I’m having trouble telling what dose of Tresiba I should stick with. I’m not sure if 10/10, 10/9, or 9/9 is right. Tomorrow I have a day out in schools working with teachers and kids, so that will be a day where I won’t necessarily be able to stop and take a correction or treat a low every hour. Makes me nervous of what my BGs will be like. 
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Do you think you might stick with Tresiba long term? Did you have concerns about lows/highs as frequently when you were on the insulin pump as well?
At this point, nope. I plan on using up this box of Tresiba pens and then trying the OmniPod. My main reasons for trying Tresiba were that I’d heard it was dramatically better than Lantus (which I used for several years over ten years ago), I wanted to explore all my options before choosing a new pump, and since I have issues with infusion set allergies I was curious whether some of my crazy days were caused by absorption issues. I think days like yesterday demonstrate that those days just happen regardless of the regimen I’m on, for whatever reason.
I’ve always had quite a bit of variation in my blood sugars. Taking this past month alone, it’s been much worse control than I have with a pump. But since I’m new to Tresiba, it’s not really a fair comparison on average.
The main difference is that on the pump, when I had totally random days like yesterday, I could make many more in-the-moment adjustments that would reduce the length and severity of BG excursions. I’m feeling quite limited with Tresiba in that regard.
My control on the pump, on average, is very much like my control was during the one week I had relatively stable BGs with Tresiba (from when I began splitting the dose until two days ago). I’ve not yet seen a Tresiba day that matches my best pump day, but I’ve seen many days that match my worst pump days.
So yeah, as of now I’ll be going back to the pump when this experiment ends. But I still have three and a half pens to go, which is a whole other month or six weeks at the rate I’m using Tresiba right now.
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