Don't Jack with My Basals

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Comment by PattiM on October 5, 2009 at 7:14am

Hi Melissa:

Thanks for the welcome. When I was pregnant with my son 14 years ago (unexpectedly, with a GH of 11.7-- I call it Glycosolated Hemoglobin and we use the mml method of counting blood sugars and GHs in Canada), my insulin needs changed completely. I was lower than usual most of the time and could eat more on the same doses-- just went on the pump a month and a half ago, so multi-injections were the name of the game. I went to a high-risk unit for check-ups and adjustments on a regular basis and had what was considered good control during pregnancy. (I think that nowadays, I wouldn't be considered to have had good control. Times change.)

My son was born healthy, although his BS was a little low and they had to give him glucose from forumula. Still, not bad for an unplanned pregnancy in the "olden" days.

I've been diabetic for 36 years. Started with one injection a day, mixing Toronto and Lente insulin. Over the years, progressed to 4 shots a day with Lantus and Humalog. Now on the pump with Humalog and thinking I was better off with Lantus. My blood sugars are more erratic now and I can't always figure out why. At least on the injections I almost always knew why I was high or low. Often don't have a clue with the pump. My pump instructor has made changes to ratios and sensitivity factors, but basal hasn't changed. I'd like to experiment with that myself, but don't know enough about it to do it. I'm on the Animas 2020. I like it, but the infusion sets can be a problem. The insets 1 and 2 are both annoying-- hit and miss-- but no one has ever shown me how the self-administered ones work.

Anyway, back to you. I think your person changed too many of your settings and . . . well, for no good reason that I can see. Were you having lows all the time from too high boluses? What was the reasoning behind it?

Comment by elaine peterson on September 25, 2009 at 8:04am

Don't tell me your mother forgot to pack dessert!! Sorry you're going through a rough patch....It is so frustrating. growl away......

Comment by Rebecca M. Rodick on September 25, 2009 at 1:55am

Wow, Oh, my gosh and What the Friggin' is going on? My DOCTOR would even tell your CDE to have patience!!! He only changed one thing at time---always!! And I'm skeptical about trusting a CDE to make changes like that---isn't a doctor only supposed to do that? Course, I've only been pregnant once, for eight weeks, so I've never had to have these things talked about.... I'm sure none of the B.G.'s are good for your baby, but I don't want you to worry about that---just get yourself back onto a more even B.G. trail... for you both!!!!! Actually makes me pissed off and crying at the same time.... Rebecca :-(

P.S. Australia is where Simon Baker is from, you know? He's that gorgeous and talented actor on the only new show that made it in the top ten last year----hey, if he can look and act that good and be from there, why not move there? ... or at least vacation there?????!!!!! (and come back looking and acting as cool as he is, right? ) LOL!!!! {;-0

Comment by nel peach on September 24, 2009 at 6:57pm

Another thought : I changed to using the Sure-T's ( MM ) 3 months ago and my overall numbers are much better, consequently I will need to adjust : basal , bolus, ratio's , corrections ...and you are right : one thing at the time . Our Team are our CONSULTANTS .

Comment by Karen Doering on September 24, 2009 at 5:39pm

Any time I make changes suggested by my endo, or even fellow diabetics, things don't work out. I am my own best doctor. I just made a lot of changes to my settings on my pump after years of many lows and things are going fairly well but I also know it won't last ;-)............

I changed my target setting from 100 to 120 and I changed my correction factor from 1 unit per 70 to 1 unit to 100, and I am experiencing less lows. I also changed my carb ratio at dinner time, but sometimes I have a hard time believing my settings and over zap, grrrr!!!

I also really watch the insulin on board and try to take that into account and trust my settings, that is the hard part as I want immediate back to normal when high, I am not patient. :)

Congrats on the baby news I am so excited for you!!!! :)

Comment by Heidi Bruggink on September 24, 2009 at 4:50pm

Congrats on the baby, Melissa! How exciting!

I agree with everyone else - there's no way to even determine what's causing the differences this way. I'd go back to my old settings and tweak one factor at a time to see what works and what doesn't, and then choose whether or not you want to follow her recommendations. Because ultimately, that's all they are... we're the ones who make the treatment choices day in and day out.

(Luckily, my current CDE feels okay about my ratio - I'm at 46/54, and she hasn't pushed me to change that.)

Comment by Tracy Malloy on September 24, 2009 at 2:59pm

POOR BABY! She must be wondering what you are doing to her!
I have only been on the pump a few months, so I am no expert...But I imagine that your needs are different throughout the day with the hormone changes and everything, I just adjusted my basal's (I have 4 different basal's) to reflect my menstrual cycle, and will prob have to change it back in a few days. If I notice a pattern for a few days I will try something else, I am sure you are used to doing that but are being extra careful about it now. I have different I:C ratios throughout the day too. Personally, I don't care to much for trying to adjust something that may need a little tweaking with drastic changes. It's your body and you have to live with feeling like poo, not the doctors or trainers. Like everyone else says, YOU know what is best. My trainer gives me SUGGESTIONS, it's up to me if I feel good about it.
luck to you and wishing you feel better!

Comment by Mark Russell on September 24, 2009 at 12:29pm

I agree with Kristin, hon.... You know what to do... so do it! Do your own tweaking to your basals. I am VERY fortunate to have a doctor that also has Type 1 Diabetes and is on a pump as well. He has taught me alot over the years, and not long ago... a year maybe, CDE, or CDMI, or what ever they call themselves, jacked up my basals and really had me screwed up. High all day, bottoming out during the night... Long story short, I went back to what I knew worked, about a month later, she moved back to California!! hahaha Good luck!

Comment by KiwiRox on September 24, 2009 at 12:12pm

My CDE still wants me to shoot for 50/50, eventhough I clearly work better at 40 (bolus)/60 (basal). We are all different. At least my CDE doesn't do so many drastic changes at once! Good luck and watch those lows.

Comment by John Smith on September 24, 2009 at 8:56am

I use my doctors as prescription writers...stopped trusting them to tell me how to adjust my doses long ago. And with the pump and CGM, I feel I'm the best judge of how to adjust my basals and stuff.

Too bad that you CDE made you change so many parameters all at once. I would reset everything back to how it was and tweak my settings one at a time to see if it helps.

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