Greg how long do you delay before eating once you have bolused?
[quote user="Greg Borkman"]
My last two A1Cs have been 5.4 and 5.5 and I have lows probably 2-3 times a week but thats not bad at all. The key I think is going to bed with good numbers and waiting an appropriate amount of time before eating to let your insulin get a head start. I am on a pump.
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I've been playing around with this a bit myself. I would like to hear your general rules for how much in advance you bolus before eating.
well in the morning i have that rising dawn effect which is annoying as hell so i sometimes wait up to an hour before eating. Usually i wait about 45mins in the morning, i check every 15mins after i give insulin to monitor it and it usually goes up before it goes down so thats why it ends up being that long of a wait.
During other times of the day 5mins.
Scott,
Over the past many years my a1c's have always been below 7, usually hovering around 6.3. I found out that for me though I was experiencing many, hypos. This was when I was doing MDI. Since transitioning to the pump with CGM, I have been able to lower my a1c to 5.7 or so. I have been more aware of my hypo's though and them have been a lot less frequent. This also stems from my ability to keep better track of things and take care of myself. I am happy with my numbers and hope to keep them this way. And again have managed to avoid the big lows that I was having pre-cgm and pump. That was bad.
I've had it for 32 years. My a1cs hover between 7.0 and 7.5. Like CrochetNut, when I try to get more aggressive insulin-wise and testing/dosing more I end with more lows. Like you I don't know that I have the attention span and diligence to go after like some do. I do test 4 or 5 times a day. I believe that with my a1c I'm definitely in diminishing returns land. I could probably put in more effort and get lower, But I also wonder what real benefit there is, if any of being 6.8 as opposed to 7.2? I know there are benefits to a lower a1c, but I think we've become a slave to that number and see it as a end all be all. The DCCT said that a huge benefit occurs at below 8.5 and then risk of complications goes down even further from there. So the lower you get, the less benefit you get from getting even lower. I don't know. Not sure what to think about all of this.
I've only had it for 5 years, so feel free to disregard my comment, but I've never had an A1C above 6.8. I go hypo sometimes, but I can feel it coming easily and I will eat/drink something and be ready to rock n roll.
My doctor and i have agreed that for me the best A1C target is 6.5, i have found if i am any lower I am suffering too many lows.
im coming up on 11 years and i went in on tuesday of this week and mine was a 6.2 and i am hypo a little frequently but other wise
[quote user="Greg Borkman"]
My last two A1Cs have been 5.4 and 5.5 and I have lows probably 2-3 times a week but thats not bad at all. The key I think is going to bed with good numbers and waiting an appropriate amount of time before eating to let your insulin get a head start. I am on a pump.
[/quote]
I do the same thing with bolusing before meals, but bed time still trips me up. I have difficulty avoiding going too high or dropping too low due to too little snack or too much basal.
What exactly is your bedtime routine to keep good numbers while you're sleeping? Do you eat a bedtime snack at all, or just rely on lower basals?
Hmm Interesting Greg, I thought for sure you would say like half an hour. I find if I don't bolus about 25 mins before eating any time of the day I shoot up as soon as I eat. That being said, I've had D for 17 years so it probably has something to do with amylin production
[quote user="Ideen"]
[quote user="Greg Borkman"]
My last two A1Cs have been 5.4 and 5.5 and I have lows probably 2-3 times a week but thats not bad at all. The key I think is going to bed with good numbers and waiting an appropriate amount of time before eating to let your insulin get a head start. I am on a pump.
[/quote]
I do the same thing with bolusing before meals, but bed time still trips me up. I have difficulty avoiding going too high or dropping too low due to too little snack or too much basal.
What exactly is your bedtime routine to keep good numbers while you're sleeping? Do you eat a bedtime snack at all, or just rely on lower basals?
[/quote]
here are my basal rates for various times of the day:
12am .4
4am .7
6am .8
7am .85
10:30am .65
3pm .45
7pm .4
total 24hrs 13.50units
Hello!
Thanks for so many answers and thoughts. I needed a kick in the BUTT! Like I said in the earlier post I'm going to try. But like some of you said, this is NOT my first time around this block. I find when I keep tight control I'm having HYPOS 3 times a day and I just can't take that much time dealing with that - vs trying to stay at 140 and not find myself driving and starting to get a reaction while I'm getting ready to give a presentation -- it really is not a good time to be chugging down sugar packets while your standing on stage - or being at 300 and feeling weird.
Anyway, I know it make a difference - The DCCT trials only ANSWERED a question that for the most part was self evident. People left untreated die. One could apply the same test to breast cancer. Do women and men with BC live longer with treatment or not. That DCCT was a waste of money - just to prove and make people feel more anxious over their diabetes. Maybe it wasn't planned, but it does add a level of anxiety to be so perfect all the time. Sometimes the shoe falls off.
No excuses - I just need to know that people are doing it and find a way in my life to prioritize it. Not an easy trick -- we all know that.
I'll let you know in 3 months. My last on was 7.3% - which I think is good for me -- I'm gonna shoot for anything UNDER 7%.
Happy New Year!!
Scott, you gotta start somewhere. Even a 6.9 would be a great first step without having to deal with constant lows.
[quote user="Greg Borkman"]
here are my basal rates for various times of the day:
12am .4
4am .7
6am .8
7am .85
10:30am .65
3pm .45
7pm .4
total 24hrs 13.50units
[/quote]
So you don't change anything for when you're sleeping other than a slight right a few hours before waking to offset the dawn phenomenon. Do you eat anything before you go to bed? Or are your blood sugars just fine during sleep without a snack?
I just find that if I do a routine like yours basal wise then I go low during sleep. I envy your rates and control...it seems rather uncomplicated.
[quote user="Ideen"]
Scott, you gotta start somewhere. Even a 6.9 would be a great first step without having to deal with constant lows.
[quote user="Greg Borkman"]
here are my basal rates for various times of the day:
12am .4
4am .7
6am .8
7am .85
10:30am .65
3pm .45
7pm .4
total 24hrs 13.50units
[/quote]
So you don't change anything for when you're sleeping other than a slight right a few hours before waking to offset the dawn phenomenon. Do you eat anything before you go to bed? Or are your blood sugars just fine during sleep without a snack?
I just find that if I do a routine like yours basal wise then I go low during sleep. I envy your rates and control...it seems rather uncomplicated.
[/quote]
Sugars are just fine when I go to bed, I can have a snack or no snack and my blood sugar remains in control...just no snacks after midnight thats when it gets complicated.
What are your basal rates?
wow this has def been an informative post. I never ever thought of low blood sugar being as bad for you as high blood sugar. I def want to check with my docter on the effects low blood sugar has on your body.
I certainly find I have the same issue as many, I try so hard not to go high i wind up running low a lot.
like i said earlier my a1c has been below 7 for years but now i feel like its just cause i have lows
I really admire the people who have replied to this post and have said they keep almost perfect control. my hat goes off to you, i wish i could be like that. I feel like im always readjusting etc.
Eva, I felt the same as you for a long time before I learnt properly how to use the pump (although I am still definitely learning - things have improved though) - I highly recommend reading 'Pumping Insulin' by John Walsh
[quote user="Evamarie"]
wow this has def been an informative post. I never ever thought of low blood sugar being as bad for you as high blood sugar. I def want to check with my docter on the effects low blood sugar has on your body.
I certainly find I have the same issue as many, I try so hard not to go high i wind up running low a lot.
like i said earlier my a1c has been below 7 for years but now i feel like its just cause i have lows
I really admire the people who have replied to this post and have said they keep almost perfect control. my hat goes off to you, i wish i could be like that. I feel like im always readjusting etc.
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I'm sorry! I feel like an @ss for having close to perfect control now.
Thanks Dylan I do not use the pump but if I decide to I will be sure to read it :)
Greg, In no way was my previos post ment to be any kind of guilt trip so please dont take it that way, My last A1C was 5.8 ..im not complaining.. But I will just never be one of these people who is always in that magic 80-120 range... I always have to readjust my insulan, for example I eat almost the same thing for lunch every day and after a few days I will have to give myself more or less insulan just cause my body changed... and so on. Thats all I meant, Congratulations on your close to perfects control and keep doing your thing, thats awesome!