So, after a fortnight of basal and bolus issues things seem to have finally started coming together. This has come at a cost I hasted to add. I have been going barking mad thanks to the frustration that having things go wrong on you and trying to find a solution to the problems. Well, going mad is something of a misnomer. I have been mad ever since diagnosis! There's only one way to live with the D.
So what've I done to crack the nut? I have changed my basals overnight to counteract waking up high. I can now go to bed on a reasonable level of say a six or seven and stand a decent chance of waking up on much the same number. I know there will be some fine tuning to be done but, the hard part has been done. The next thing that I've done is change my insulin to carb ratio. That's because I found my BG rocketing up to the high teens or so after each and every meal, no matter how much or how little carbohydrate I had. I now use one unit for every seven and a half grammes of carbohydrate. That's quite a change from my old one unit for every ten grammes. It also means that for the first time ever, I am actually using the bolus wizard gadget on my pump. It's a necessary evil as I can't damn well do the maths to work out my doses in my head. One unit to ten grammes was nice and simple. Here it gets sticky. Here there be dragons. That said, I shouldn't moan too much. It works and I'm not about to bugger about and change it.
After all this tinkering I am a bit fed up with the D although I am now rather less stressed because it's all going well at last. Now to see how long this thing lasts before I have to make more changes. That and the fine tuning of my overnight basal. Did I say something about being less stressed? Oh bugger...
Monday 30 May 2011
Thursday 26 May 2011
So I said I'd basal test...
Well, I have done it. However, it's not what I quite wanted it to be as I managed to get my BG shooting up to sixteen at twenty to ten last night. Not quite something I wanted. So what did I do? Changed my cannula and corrected. That was a good thing. What it did mean was that I wasn't able to start my basal test until three in the morning as I'd have had active insulin at midnight when I really wanted to start the ball rolling.
Here be the results:
03:00 8.1
04:00 5.5
05:00 5.6
06:00 7.2
07:00 6.2
So, what might I draw from this? Well, the drop from 03:00 to 04:00 is quite worrying. This could go some way to explaining why I have been waking up high every morning. What I believe has happened is that I have gone to sleep on reasonable levels of about six - seven millimoles per litre and then because of too much basal I have ended up dropping into a hypo. My body has then flooded my system with glucose from my liver which was released by the hormone glucagon. That would cause my BG's to rise uncontrollably because my non functioning pancreas can't compensate for the glucose as it doesn't produce insulin! So changes are afoot.
On another point, I have also sussed why I am rocketing up to the late teens post meal. This seems to be because my insulin to carbohydrate ratio is out at all times. This was reinforced by my two and a half hour post breakfast reading being eighteen millimoles per litre. So what have I done? I've changed my ratio for the entire day from one unit to ten grammes of carbohydrate to one unit for every seven and a half grammes fo carbohydrate.
Now this does get to me a little bit. This is because I loved the times when I had a nice and easy ratio of one unit to ten grammes. That made life very easy in terms of bolusing. I could do it nice and easily. I didn't have to think over much nor did I have to use my bolus wizard. Now that's all changed. I have to use the bolus wizard as I can't work out the doses from that ratio in my head. It's irritating but I have to get on with it. I'm sure I'll get used to this but for the moment it's really doing my nut in.
Tom
Here be the results:
03:00 8.1
04:00 5.5
05:00 5.6
06:00 7.2
07:00 6.2
So, what might I draw from this? Well, the drop from 03:00 to 04:00 is quite worrying. This could go some way to explaining why I have been waking up high every morning. What I believe has happened is that I have gone to sleep on reasonable levels of about six - seven millimoles per litre and then because of too much basal I have ended up dropping into a hypo. My body has then flooded my system with glucose from my liver which was released by the hormone glucagon. That would cause my BG's to rise uncontrollably because my non functioning pancreas can't compensate for the glucose as it doesn't produce insulin! So changes are afoot.
On another point, I have also sussed why I am rocketing up to the late teens post meal. This seems to be because my insulin to carbohydrate ratio is out at all times. This was reinforced by my two and a half hour post breakfast reading being eighteen millimoles per litre. So what have I done? I've changed my ratio for the entire day from one unit to ten grammes of carbohydrate to one unit for every seven and a half grammes fo carbohydrate.
Now this does get to me a little bit. This is because I loved the times when I had a nice and easy ratio of one unit to ten grammes. That made life very easy in terms of bolusing. I could do it nice and easily. I didn't have to think over much nor did I have to use my bolus wizard. Now that's all changed. I have to use the bolus wizard as I can't work out the doses from that ratio in my head. It's irritating but I have to get on with it. I'm sure I'll get used to this but for the moment it's really doing my nut in.
Tom
Wednesday 25 May 2011
Frustration
So, a little while ago I did some basal testing which showed that my overnight basal was fine. Over the past few days I've been waking up on levels of at least eleven.
What's hard to accept is that only a week or so ago I was waking to pretty damn good numbers. Now I'm waking up high again it's hugely irritating. What really gets me is that although I may have cracked my basals one day, the next day things will change totally thus ruining a good work. All that I can liken things to is an artist in the midst of creating a master piece then being obliged to wipe down the canvas because a bird has shat on it.
I suppose that after nearly fifteen years of diabetes I should be well used to this fact. I believe that I am. Now that I pump the changes that can be brought about at a moment's notice things seem to be somewhat more palpable and they seem to make a greater splash.
So what's the result of all this you might ask? Once again I will be basal testing from midnight until I give in to the desire for a massive cup of sweet tea tomorrow at some stage. Ideally I'd like to go from midnight tonight to midday tomorrow and have a massive basal test. Now people who pump themselves know that a basal test is simply not as easy at it sounds. Laying off carbs of all sorts for any period of time isn't the only thing you have to do. That's the easy part. The hard part is timing any carb intake (aka a meal to those without D) prior to the basal test so that your insulin that you took for the carbs has left your system before you get cracking. So for me, any bolus that I take for carbs has to be taken at least five hours before the test is due to start. That is because the insulin I take in my pump (Novorapid) stays in your system for five hours or so. At least that's the idea.
So, by the time the eighty minute whistle blows (yes I do like my rugby) it's not just a simple question of forgoing any carbohydrate for a period of time. The bad thing is the logistics of preparing for the test. It's not fun. Then you have to take into account that if it's a night basal test you'll be waking up every hour, on the hour for the duration of the test. Fuck this for fun. I'll post the results when I re surface after the test tomorrow.
What's hard to accept is that only a week or so ago I was waking to pretty damn good numbers. Now I'm waking up high again it's hugely irritating. What really gets me is that although I may have cracked my basals one day, the next day things will change totally thus ruining a good work. All that I can liken things to is an artist in the midst of creating a master piece then being obliged to wipe down the canvas because a bird has shat on it.
I suppose that after nearly fifteen years of diabetes I should be well used to this fact. I believe that I am. Now that I pump the changes that can be brought about at a moment's notice things seem to be somewhat more palpable and they seem to make a greater splash.
So what's the result of all this you might ask? Once again I will be basal testing from midnight until I give in to the desire for a massive cup of sweet tea tomorrow at some stage. Ideally I'd like to go from midnight tonight to midday tomorrow and have a massive basal test. Now people who pump themselves know that a basal test is simply not as easy at it sounds. Laying off carbs of all sorts for any period of time isn't the only thing you have to do. That's the easy part. The hard part is timing any carb intake (aka a meal to those without D) prior to the basal test so that your insulin that you took for the carbs has left your system before you get cracking. So for me, any bolus that I take for carbs has to be taken at least five hours before the test is due to start. That is because the insulin I take in my pump (Novorapid) stays in your system for five hours or so. At least that's the idea.
So, by the time the eighty minute whistle blows (yes I do like my rugby) it's not just a simple question of forgoing any carbohydrate for a period of time. The bad thing is the logistics of preparing for the test. It's not fun. Then you have to take into account that if it's a night basal test you'll be waking up every hour, on the hour for the duration of the test. Fuck this for fun. I'll post the results when I re surface after the test tomorrow.
Sunday 15 May 2011
Not quite what I thought was going to show up...
So, over the past few weeks I've been spotting rising BG's in the morning around eight to eleven. I guessed that I mightbe hypoing in the small hours thus causing a gradual rise. I did a basal test today. Three in the morning to nine in the morning. Here are the results:
03:00 - 7.8
04:00 - 7.8
05:00 - 6.3
06:00 - 6.9
07:00 - 6.7
08:00 - 7.3
09:00 - 5.8
Now I like those results quite alot. I don't think I'll be making any changes based on that. It'd be daft to trash a good set of numbers like that. All I need to do now is basal test the evening. That's the plan at least.
I have made some changes to my basal in the evenings. That's because for two or three days I was getting hypos between about half eight to ten where I would hypo quite nicely, well, what's nice about a hypo? Anyway, I was dropping down to about two millimoles per litre and not coming back up for about an hour despite all the treatment that I threw at the hypos. If I recall rightly I've slashed a good quarter of a unit of my basal rate prior to nine o'clock. Quite a dramatic change if ever there were any. It seemed to knock it on the head last night. I'll be basal testing this evening as I mentioned earlier so I can do some fine tuning. Seems that I need to get this right. That and I can have a stab and getting a half decent basal pattern sorted for my work.
I'll post the results from the evening's basal test when I've done it.
03:00 - 7.8
04:00 - 7.8
05:00 - 6.3
06:00 - 6.9
07:00 - 6.7
08:00 - 7.3
09:00 - 5.8
Now I like those results quite alot. I don't think I'll be making any changes based on that. It'd be daft to trash a good set of numbers like that. All I need to do now is basal test the evening. That's the plan at least.
I have made some changes to my basal in the evenings. That's because for two or three days I was getting hypos between about half eight to ten where I would hypo quite nicely, well, what's nice about a hypo? Anyway, I was dropping down to about two millimoles per litre and not coming back up for about an hour despite all the treatment that I threw at the hypos. If I recall rightly I've slashed a good quarter of a unit of my basal rate prior to nine o'clock. Quite a dramatic change if ever there were any. It seemed to knock it on the head last night. I'll be basal testing this evening as I mentioned earlier so I can do some fine tuning. Seems that I need to get this right. That and I can have a stab and getting a half decent basal pattern sorted for my work.
I'll post the results from the evening's basal test when I've done it.
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