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Anyone fancy some number analysis?

Discussion in 'Parents of Children with Type 1' started by emm142, Jan 23, 2012.

  1. emm142

    emm142 Approved members

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    As if you don't all have enough to do. I'm basically struggling a bit with things in my life right now and I'm trying to do diabetes but it just doesn't seem to be working like it used to. I'm usually good with the number crunching and adjustments, but my brain just feels fried. I'm embarrassed at the fact that I've been over 300 every day this week, and it's always in the evening and yet for some reason I haven't just raised my I:C ratio. I guess maybe this is what burnout is like for me - I'm still doing all the testing/bolusing but I just don't feel competent to make changes on my own that I would normally make in a heartbeat. :confused: So my BGs are basically a mess, and I think that typing them out here and getting verification for the changes I intend to make would make me a bit more accountable for it, and hopefully make me actually do something.

    20 Jan:

    1AM: BG 293, 1.5U bolus
    9.30AM: BG 133, bolused correction
    10AM: 40g carbs with prebolus
    12PM: BG 322, when I tried to correct got "NO DELIVERY", site change and correction
    2.30PM: BG 184, 20g carbs, bolused correction and for carbs
    4PM: BG 117
    7PM: BG 135, 45g carbs, correction and bolus
    9PM: BG 200, bolused an extra 1U because BG was going up fast
    12AM: BG 279, correction bolus

    21 Jan:

    2AM: BG 260, correction bolus
    7AM: BG 260, correction bolus
    11AM: BG 130
    2PM: BG 121, 35g carbs and bolus
    6PM: BG 125
    8PM: BG 160, 40g carbs and bolus
    10PM: BG 308, correction

    22 Jan:

    12AM: BG 245, correction
    2AM: BG 140
    BG flat between 100 and 140 all night and over the morning
    2PM: BG 97, 35g carbs and bolus
    6PM: BG 240, 15g carbs, correction and bolus for carbs
    8PM: BG 240, correction
    9PM: BG 200, 70g carbs and bolus
    12PM: BG 305


    Okay so I only wrote in the actual BG checks. I'm wearing the CGM full time so I do have information from inbetween, but it's all very predictable. No surprise lows in there or anything like that. It seems like things are okay when I don't eat, which make me think I:C should be increased to 1:9. But I wonder if there's a basal issue in the evening as well, because corrections don't really seem to work. Any thoughts?

    Currently:

    I:C is 1:10
    ISF is 1:110
    BCR is around 1:10

    (Yes, I'm very insulin sensitive and very carb sensitive. I think I have the ISF and BCR of someone younger than myself, and I'm not really sure why.)

    Basals are
    12AM-6AM - 0.5
    6AM-8AM - 0.55
    8AM-10.30AM - 0.70
    10.30AM-9PM - 0.85
    9PM-12AM - 0.80
     
  2. JaxDad

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    I think that if this is burnout for you then you're doing great. Even though you didn't feel like doing the analysis, you're taking the time to post and looking to improve it. That's a far better attitude than "$crew - it"; so kudos to start.

    Jan 20 looks pretty good to me if you throw out the am stuff and chalk that up to the set.

    You mentioned that things look pretty good when you don't eat? Does that include the late evening/overnight? I'm thinking that you are probably right about the I:C butI also have two other possible hypotheses.

    First, did your diet change to fattier "more pleasant" foods around dinner time? I'm thinking you would be well aware of this being so familiar with D but figured I'd mention it as I know my food choices get less healthy with stress.

    Which leads to this other thought; that it maybe the life struggles you mentioned are catching up with you in the evening/night and the stress is raising your BG. It may not be as prevalent during the day because there are more distractions.

    Good luck, I'm sure you'll be feeling better soon.
     
  3. MomofSweetOne

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    Emma, I am so glad that my daughter looks up to you as someone she hopes to be like someday! Earlier this week we had a discussion that I don't expect that her A1C will always be the way that I'm trying hard to keep it, that I know burn-out will happen as she lives with this for life and that I hope rather than hiding burn-out or less than happy A1Cs, she'll ask for help if she needs it.

    While reading this forum, I'm realizing how much I rely on gut & intuition along with the numbers when I make a decision. But, as an outsider, I'm wondering whether it would be worth fasting for a night just to double check whether your basal is accurate before changing carb ratios. If you get a nice flat line, then I would definitely start moving the ratio one carb at a time.

    It's interesting to me to see your ratios. My daughter is currently on 1:15 for breakfast, 1:20 for supper, and 1:17 for supper, yet her correction factor is 1:70 now.

    Also, the adrenals pump out adrenalin with highs that make BG corrections harder to get down until the adrenaline in the system is gone.
     
    Last edited: Jan 23, 2012
  4. Connor's Mom

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    My gut is pointing me to the ISF before the I:C ratio. That being said, if you tweaked the I:C ratio and you have the results you are looking for great! It just looks to me like the corrections are not quite enough.

    Then again you have been at this longer than me and you know your sensitivity better than anyone:p

    I think you are doing pretty good if this is your burn out. You are still testing even with your CGM and you are seeking advice for your correction even though you've been doing this for awhile. I think we all need a second pair of eyes on the numbers sometimes and a nudge letting us know we are still doing things correctly.

    I hope my little guy stays as responsible as you and the other young adults I've seen on here.
     
  5. JackyH

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    Just curious - Were you using the Sure-Ts during this time? It's just that they would always appear to be working when he wasn't eating but then when we bolused for food he would go high and stay high.
     
  6. emm142

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    I haven't eaten anything particularly fatty, but you're right - these numbers certainly look like high-fat numbers would for me. And yeah, you may also be right re. stress. Thank you - I hope it will get better soon as well.

    I think you're right. I do need to do a fasting basal test at night. I just really don't want to. :p But now somebody else has suggested it, I feel accountable and I will try to do it tomorrow. :) Thank you.

    I know what you mean about the ISF. Sometimes it seems like corrections really don't work. However, when they do work, they seem to work perfectly, which is why I think maybe the problem they don't work in the first place is because without them my BG would be going up, so they just help me to tread water. But whether or not my ISF is wrong, there's something else off which is making me go so high in the first place, so I'm going to try and deal with the other issues and bear in mind that I might need to tackle the ISF after. Thank you. :cwds:

    I was using a sure-T on the day I had a set failure, and after that I have been using a Silhouette. :)
     
  7. Sarah Maddie's Mom

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    Hi Emma, I'm sorry your having a rough time of it right now. :(

    At a glance I think that if you increase your basal starting about 9 but maybe earlier in the evening that you could head off those midnight highs, and corrections and just get your day off to a better start.

    I imagine that increasing basal at night when you are on your own is frightening. Can you call in some support? someone to call you at midnight and make sure that you get up to check?

    I admire you so very much.:cwds:
     
  8. TheFormerLantusFiend

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    Two thoughts:

    1. How low do you correct for? You're correcting for things like 133?

    2. How far ahead are you prebolusing?

    3. You have no lows whatsoever- why not bolus more?
     
  9. Helenmomofsporty13yearold

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    It does seem that you are not getting enough insulin around your supper. Perhaps if you just get more aggressive with this number and end up with a number you do not have to correct when you go to bed, the rest will be better, too. I think you are right to play it safe overnight with your sensitivities.
     
  10. mmgirls

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    so when are you going to bed?

    are you going to bed later? staying up later to study?

    going to bed early and exhausted?

    With my DD changes in the time she goes to sleep or restless sleep create basal isssues.

    I am very inclinded to say that the ISF should come down. What is your target theat you are correct to and what is your IOB?

    I also think that you have a basal issue around 7pm. But just guessing not knowing the other infor.
     
  11. Heather(CA)

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    The first thing I would do is up your dinner insulin. Once you correct your staying pretty flat. So, whether you use your I:C ratio or basal, you need more starting at dinner. I would try a 1:8 or 9 for dinner. Then post some more numbers....Everyone needs a break sometimes, let us help :)
     
  12. wilf

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    Looks like supper carb ratio and evening basals (maybe also early overnight basals) both could use some tweaking. Overall you're needing more insulin in the evening and maybe also in the early overnight period. Good luck. :cwds:
     
  13. emm142

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    Thanks, Sarah. I'm not generally asleep by that time (partly just because I hate to go to bed on a high BG and hefty correction), so it should be okay. And I do have a friend I can ask to call me, so yeah. I think you're right. I reckon that basal and I:C both need to be raised.

    1. I correct to 105. So corrections for a 133 are pretty small, given that and my ISF, but they do still make a difference, particularly if I correct 30 mins before a meal. It helps if my BG is below 120 going into a meal.

    2. I usually prebolus the correction by 30 mins or so, and the food dose by around 5 minutes. For breakfast I do a 15 minute prebolus. That was working before, but perhaps I need to re-evaluate.

    3. I think you're right. This morning after breakfast I went up to 275, so I've changed my I:C to 1:9. Going to eat lunch once I've managed to get this high down, and then I'll see how the new ratio works.

    Thanks - I have now changed my I:C to 1:9. I will update on how dinner goes tonight. If things are still bad, I will do a fasting basal test.. tomorrow. :p (Yeah.. I don't put these things off. Ever. :eek:)

    I'm generally staying up later to study (until 1ish). Honestly I'm not getting enough sleep and that could be part of the problem - I think that my BG tends to be a bit more volatile when I'm under-rested.

    I correct to 110, and DIA is 3 hours. I'm thinking possible basal issue as well, but on the day that I didn't eat until later my BG didn't rise THAT much, although it did rise a little. I don't know. I'm going to see what this I:C change does. If it doesn't work out, I'm going to do a basal test tomorrow. Thank you. :cwds:

    Thank you, Heather. This is exactly what I'm going to do. Changing my ratio to 1:9 for all meals as of today (because my post-breakfast and post-lunch BGs are high too, albeit not as bad) and if that doesn't work out I will test basals. I hate testing basals. :p

    Thanks, Wilf. This is pretty much my thinking too, now I just need to deal with it. ;)
     
  14. Heather(CA)

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    Keep us posted :) You may need to go to 1:8 for dinner but I'm glad your taking it slow because it's before bed :cwds:
     
  15. emm142

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    Yeah, you might be right. I usually end up around 300, and it would take 1.5U correction from there to 120. With the normal carb amounts I have for dinner, getting 1.5 extra units for dinner would require a ICR more like 1:8 than 1:9, but I figured that I would take it slow because sometimes if you catch the BG before the insulin resistance from the high has kicked in you need less insulin. But yeah, I had dinner on a 1:9 ratio about an hour ago and I'm now 200, so we'll see whether I go up from here. :cwds: If so, I guess I'm basal testing tomorrow (ugh!!).
     
  16. emm142

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    And now I'm 297. Ugh!!! That extra 0.5U at dinner didn't do much good.

    So guys, what's the next step? Should I basal test tomorrow night, or should I change my I:C to 1:8? It has NEVER been that high a ratio before at this time of day. That makes me iffy about it.
     
  17. Style mom

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    Personally, I'd probably basal test. Or in reality, I'd just increase basal and see if that helped. ;)
     
  18. Heather(CA)

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    What was your 3 hour number and did you go up from there?
     
  19. emm142

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    I did a mega correction (2U, despite IOB) at 2 hours, so it's hard to tell. But even then I only went down to 200. I should have gone down a lot further, so I'm thinking basal as well as I:C. But it's hard to tell with so many other factors (i.e. insulin resistance from the high).
     
  20. emm142

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    Okay, definitely a basal issue going on. I'm going up now and it's 5 hours since I ate.
     

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