Changing DIA?

TiaG
Sun, 23 Apr 2017 20:16:55 +0000
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So, my son has been having some pretty bad lows the past day – 3 below 55 in the last 24 hours alone!! What’s weird is that his lows seem to come towards the end of what should be the DIA, and then they seem to really accelerate in a way we’re not used to.

If it happens 2 or 3 hours after a meal I usually assume the carbF is too strong. If it seems to happen within an hour or two of a basal change I tend to assume it’s an overly high basal rate. I also tend to assume it’s an overly high basal rate if he’s going low when he technically has negative IOB or no IOB…to me that’s an indication that the baseline (what’s assumed to be 0 basal) is too low.

But as a sanity check i usually look at the TDD – if his overall need for insulin went down then I assume it stands to reason that his basal insulin needs have decreased.

But this time his TDD is actually on the higher end – 8.5 units to 10 units, as opposed to his typical 6.5 to 8. Obviously some of that TDD is to deal with some of the lows, but not that much of it.

To me the logical conclusion is that maybe the insulin is just acting in his body longer than we typically assume. We have his DIA set to 4 hours and am tempted to try switching it to 5. But is that weird? Do people’s DIAs typically change a lot over time, or is that a fairly stable variable.

Also, if I change his DIA, I assume I’d also need to change his ISF – are there formulas that can relate DIA and ISF so that he is net getting almost the same amount of insulin, but with a stronger ISF and a longer DIA?

Thanks!

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