Seems like I should know this by now-- if you check two hours after meal you've bolus dosed for and find you are above your target range-- say, 180 for example-- do you administer a correction dose at that time? Or just learn from it for future reference? I haven't really figured out this concept yet.
I have met with two different CDEs. I've only met with the one where I live once, the first one was several meetings immediately after initial diagnosis (I was away from home). So far I haven't been to an Endo yet, as I live in Homer, AK and the only place in AK with Endos is Anchorage-- and I haven't made it up there yet (it's about 250 miles away) But my family doctor's daughter is a T1 so I think he probably knows a lot more about it than most. My goal is to check two hours after I start eating-- but in reality with these classes / conferences I'm at all month its hard to be precise, at least during the week. Often anywhere from 1:30 to 2:10.
I just filled out the pre-auth request for dexcom cgm. I really think that would help a lot. Hope I don't get too much of a runaround with the insurance. I can just see them forcing me to collapse a few times before they agree to cover it...
IDK, Sam...i just did a trial CGM last week for 7 days..and it was all over the place, told me i was low, like dropping to 40's when I wasn't..sometimes it was close..but it might just mess you up a bit right now? One's not supposed to correct or go off what the CGM says (it's used to show 'trends')..but it's hard not to when you see arrows going down, down, down and alarms going off. I'm still relatively new at this, just coming out of my honeymoon, really..and things have been more stable. It took at least a year and I am still very insulin sensitive.
It matters too where you're starting at at the meal. Check at the one hour mark..see what's happening. Again, if you're coming down then that's good. Your basal ties into this too. As this disease progresses and our beta cells die off totally, where I'm at now, if I don't match my carbs with insulin, I don't come back down..that's when we do the corrections and with time and experience, we learn to know how and 'when' to do those corrections.
That's great that your doc has experience, hands on, with Type 1, that's invaluable..great for you.
How do you feel? Do you feel those spikes...I guess that matters too?
Yes, I think many of us have learned to eat less carbs and bolus less to avoid spikes. Also there is something called the "law of small numbers" that means that the less carbs you eat and the less insulin you take the less chance of making mistakes and if you do make mistakes, the result is less severe. Many people have excellent results longterm on true low carb, following Dr. Bernstein's "Diabetes Solution". Others of us eat a more moderate version, like myself - I try and keep it under 100 a day.
I just sent a note to my doctor asking about going to zero basal. I think that might not be a bad idea for me too at this point...
I think there are a number of honeymooners who just are using bolus w/meals if their fasting numbers are good. It sounds like they (you) caught this very early. I was DKA, put on both..then honeymooned and I too was so insulin sensitive, everything was lowered. I decided to just do basal, my fasting numbers, (the second phase of this) were really high too. I did small amounts of basal and just basically no carbs because I didn't want to bolus..didn't last too long, eventually everything effects blood sugars and I was too skinny anyway.
Maybe that would be a good thing...just bolus if your fasting numbers are still good????
Starting tomorrow will be on zero basal. Hopefully it works out. Have a question-- my current Lantus pen is almost full. I know they say not to refrigerate after using-- but it would be a shame to wait for the 28 days to pass and throw away this much insulin. Anyone have any experience good or bad breaking the rules and putting a used pen back in the fridge?
I always refrigerated my Lantus, the current pen as well as my supply. But I think once it's open then it's still only good for 28 days.
If it doesn't extend its life after its open, why do you do it then?
You got me. I assume it just protects it to keep it refrigerated, keep it from being exposed to hot temps and to potential contaminants. I just always kept mine there because it's as good a place as any.
I do the same thing, just put it back in the frig, toss after 28 days. I take my insulin out about 10 minutes before I inject as I've heard room temp insulin doesn't burn so much, IDK, then just put it back in frig.
good luck, sam, with no basal.