Insulin dosage question

So I'm trying to get a very strict regiment. Today I have tested every 2 hours to see where my blood sugars are at. (I keep forgetting to reattach my CGM, but as we know, it is more accurate to test) So I before lunch I was 146 and I corrected to get me down below 100 as well as giving 3 units for lunch. Two hours after lunch I was160. I was going to correct to get me back down below 100 but my pump said I had IOB and suggested not to correct.

What would you have done? Would you have corrected or just tested again in another 2 hours or so?

Nikki, for me, below 100 is too low -- I can easily drop to 50 quickly!  You may have missed the mark in the 3 units ...

I usually like to go for a 10 minute walk after I eat and take my bolus.  I usually give myself 3 hours before injecting more.   I travel a LOT - so I do prefer to not be suffering from lows all day - for me 120-160 is great and in the AM a 120 would be superb - but alas, not always the case as I keep a rather unstructured schedule.

Scott

I agree with Scott. I have a very active and unstructured life and need to keep with a BS of 120 - 150. My morning BS is usually 80 - 115. My A1C goal is 7 and I am slowly working there. My last 3 A1Cs have been below 8 (7.8, 7.5, and 7.3).

I'm working as well to lower my A1C, especially afte seeing that an average of 120 bg's can be I think it was a 7.0, I thought well that seems easy enough. Ha. That is such a joke for me right now. I will be trying to get pregnant towards the end of the year so it is crucial for me to lower my A1C. And I HATE lows so it scares me to have a low average of 80-100, but I have to do it.

For someone who has never really taken this good care of themselves, this process of "learning how to take good care of myself" is so incredibly hard! I feel like I need to go take a class like I did when first diagnosed. Blah.

Nikki,

Unfortunately, nothing comes easy and for those that are not use to having to watch their carb and caloric intake, it is even harder. Having family and friend support is very important. Remember why you are doing this and knowing that it is an achievable goal will help you get to good control. I learned over many, many years and have finally gotten self control to keep checking my BS and maintaining good numbers.

Good luck to you and don't get discouraged. I was diagnosed a the age of 6 (1968) when there was not as much known or available for juvenile diabetes.

You have to make sure your pump settings are right.  Have you fasted and tested your basal rate to make sure it's accurate.  Do you have a good feel for when the insulin is out of your system and have the pump setting accurate?  If this stuff is set correctly on your pump you can always trust it to calculate insulin on board correctly.  

If you need help with any of these settings, get John Walsh's book "Pumping Insulin" or Gary Scheiner's book "Think Like a Pancreas".  Your pregnancy will go a lot smoother if you understand your insulin needs and have pump set up for your specific settings.  

Wow. Thank you so much. I have heard about the fasting basal test but have yet to give it a try. I think I'll try that tomorrow. And no I am still brushing up on the effects of having insulin in me all the time. (stupid me) I wish my Endo would educate me more. And I will be trying to find those books this weekend! Thank you again for all the wonderful input.

I love the 'think like a pancreas' book!

Hi Nikki. I was diagnosed back in 2007 with Type 1. Just recently, I was diagnosed with Type 2! My family and I thought it was a joke, but it's true! I can tell you how I did it, but I don't want to offend anyone here who believes no cure is possible. You can email me directly and I will answer you: info@thehealthfoodguru.com

Hi Scott. I was diagnosed back in 2007 with Type 1. Just recently, I was diagnosed with Type 2! My family and I thought it was a joke, but it's true! I can tell you how I did it, but I don't want to offend anyone here who believes no cure is possible. You can email me directly and I will answer you: info@thehealthfoodguru.com

One thing I learned in my pre-pregnancy prep is to take my insulin 10 to 20 minutes before I ate. I was told countless times by my CDE to do so, but until I saw the numbers on my CGM, I didn't realize I was spiking to at least 200 every time I ate! Now I can gently roll to 130 and back down to 80 after eating. The other major thing I learned is it is easier to correct a slight low (60 to 70) with glucose tabs or Starbursts than it is to try and get highs back to normal. Of course, your pump settings should be excellent before aiming for lower numbers -- it's scary to get so low if you don't trust your settings! Good luck with the pre-prego!

I like to leave my blood sugar in the 140-160 range. I feel better, and don't fear a sudden, sypmtom free drop that I am known to have. I know I am probably one of the few, but I get too nervous when I am near 100. If that had happened to me, I would have definately waited an hour, tested again, then maybe corrected. I don't really trust my cgm, i find it has reports that can be 40 points off. I use it more as a guide to whats happening, going up or down.

I have to disagree with most of the previous posters -- I think 100 is an excellent goal. Esp, with a CGM to warn you if you're going low. My endo also recommends correcting to 100.

However, I think you did the right thing by not correcting 2 hours after with IOB. 160 isn't terrible for 2 hours after. I wouldn't have waited another hour, and I probably would have been back around 120 with that IOB (at least for me).

I agree about maybe looking into bolusing a little earlier before you eat if your just slightly high after a meal but not enough to up your ratio.

I think you're doing great!

[quote user="Sarah"]

I wouldn't have waited another hour,

[/quote]

 

Sorry -- *would have

I have always shot for numbers around 100, and I found out not too long ago my parents used to try to keep me between 60 and 120 when I was little, mostly before I went to school and on summer breaks until I went on the pump when I was 10, I was 1 when I was diagnosed. Now I don't leave anything below 70 go without eating since I have to drive and my parents aren't there to make sure they catch a low I don't. The lows suck, but like Christa said, if you catch it at 60 or so and eat, its a lot easier than 400 and insulin. I was really surprised when I was on the CGM at how high my blood sugars went after eating even with insulin, I'm always being told to take it 10 minutes before eating, and I'm working at it. I think the biggest thing would be to figure out how long your insulin stays active. I'm on novolog and for me it is only 2 hours, but that's different for everybody, you could ask your endo, or CDE how to figure your number out better if you think it's off. My pump will figure out how much active insulin I have left and subtract that from the correction and give me enough insulin to correct after all of the previous bolus is gone (i'm on the minimed paradigm). Good luck with everything =)

My nurse practitioner has told me not to correct if it's 160 two hours after a meal. Depending on your basal settings, your sugar might drop by itself in an hour. 100 is a good goal, not below.

Lucy

To me it depends on how good of control you want to be. My target is 100 - 110, if I'm over 150 I correct, because I know my body I will continue to go higher.

I agree