Replies to This Discussion

Permalink Reply by hfw on January 27, 2013 at 6:51pm

Are you on a pump? I think it would be MUCH easier. I've been able to tweak the settings and am pretty much between 80 and 180, with a nice flat line hovering around 100-115 between the hills. I don't think my numbers would be anything like that on MDI.

Permalink Reply by MegaMinxX on January 27, 2013 at 8:44pm

The key is all in the timing of your insulin and food/carb counting/portion size. Many people need to take insulin and wait 15-45 min, depending on what type of insulin, and other factors.

If you are reacting to the spike going up, you may also be 'stacking' insulin if you take more insulin to 'correct', when it really is a matter of waiting for insulin that you already took. Are you familiar with 'insulin on board' ?

Or maybe your bolus insulin for your meals is too high, and you drop 2-3 hours after the meal, and then over correct with food to raise your BG.

Can you provide some details on your typical meals, and if you are using carb counting / IC ratios, pump vs injections, etc ?

Permalink Reply by lisa c on January 28, 2013 at 2:57am

agree with all great advice below. It would help all of us give you advice if we knew more regrding your regimine. Normal food choices, pump or not, T1 or T2, injection sites, etc.

Thanks.

Permalink Reply by Phishery on January 28, 2013 at 8:42am

I am a big fan of dr, bernstein's Diabetes Solution approach. I use a much higher number of carbs then he recommends, but I started there and it helped to get my lines very flat. My a1c went from 8 to 5.0 in 4 months using Mdi (my last one in dec was 5.2 on a pump). My last cgms download showed an average bg of 98 with with with a standard deviation of 27. It is built specifally to help with what you are describing by really fine tuning your ratios and limiting carbs. Limiting carbs helps keep the error to a minimum. For example, insulin absorption can vary by I think +\- 20%. If you eat a large amount of carbs, that requires a lot of insulin, and that percentage can have a pretty big impact. Lowering the carbs helps to reduce that particular variability. This is just one example of how his approach tries to make things more predictable and less variable.

Permalink Reply by Mom 2 Kyle on January 28, 2013 at 2:03pm

Funny, but we didn't realize that my son was having those crazy highs and lows either until he started wearing his CGM. He has 3 highs per day (250-260) and then comes crashing down 3-4 hours later. If we don't catch them with 10-15 carb snacks he just bottom outs in the low 60's and then we're over-treating/eating.

SO, his endo. saw this and said that the only way to make this better is to go on the pump. We are doing as good as we can with MDI (and to me this just isn't good enough). BTW his A1c are 6.1-6-8 and has been T1 for 2 years.

** Adding some fiber to your meals, we were told, can help too.

Permalink Reply by icuski2 on January 29, 2013 at 11:04am

Thanks for the ideas!
I am a T1 and on the Minimed pump, which works great (usually!). But now that I am on the Dexcom, I can see what happens in between my meter testings - and it is alarming!

I do need to double check basal rates as well as my I:C ratio. I hope to refine those a bit to help smoothe out some of these swings. I also can try limiting my carb intake, at least until I get my I:C ratio right.

Just trying to get ideas as I feel like I am chasing my tail and it is phyically and mentally exhausting! Thanks for your suggestions and support!

Permalink Reply by lisa c on January 29, 2013 at 12:51pm

what are you seeing. please be more difinitive.