That’s really solid advice. I’ll start taking data and try making adjustments if needed. I’m also thinking my active iob might actually be 4 hours instead of 3 since I seem to level out after 4ish hours usually.
A few years ago a researcher pharmacist pulled 18 vials of insulin from different pharmacies and different manufacturers. I think he found in this very clever study that purity of these us Pharmacy insulin vials we’re on average about 50% pure. Rangers I think we’re somewhere around 30 or 40 per-cent to close to 90 but none was 100%. Canada has a more pure monitoring system and only three Distributors to track temperature compliance. I was told they check insulin quality at production. They even have ways to monitor temperature when distributed. Personally I’ve received warm insulin through mail order from us pharmacies and I was surprised to hear how careful they are up north. I did notice that when I open a new vial my dosages can shift. And one time I tried a new insulin and it was like water and I assumed it was the insulin. But then when I read that article I wondered if it was actually just poorly stored insulin as opposed to not working for my body because everyone has unique experiences with medicine. Another issue that makes my insulin more sensitive is exercise. If I exercise heavily the day before it can have a long tail. Sometimes. Not always. Another issue is injection site. I’m 42 years with this disease and I have a lot of scarring so I suspect that makes a difference. And also location on the body. The legs seems to take longer pretty insulin to start working but then if it is closer to the abdomen that can work quicker but burn out quicker. Lots of variables. Since I can notice differences from vial to vial I wonder if that’s usually the culprit. I hope this helps and then by the way sometimes our bodies Just Adjust and do strange things. Diabetes is an art more than I science in my opinion
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Hi @Elle123 the purity of insulin in the United States is, bar none, the best in the world. I looked everywhere for a study regarding the variability in insulin purity and I can find nothing. There is only about 3000 micrograms per milliliter of the API insulin in U-100 insulin, the rest of it being mostly pure water, and so I have no idea what the percentages referenced have to do with actual purity.
I am involved with pharmaceutical manufacturing and I can tell you first hand that the regulations involved before being allowed to label a vial “u-100 insulin” are serious and comprehensive. I’d hate to think otherwise and I have 100% confidence in US FDA regulations and US manufacturing.
If there is a study please link, it I could not possibly have checked everything. The only document even coming close to variability was written in the 1980’s and was in reference to U60 change to U100 beef pork derived insulin. I started taking insulin in the late 70’s and it was a big deal to make sure the syringes were for U-100.
Variability in absorption and in activity is where I observe differences.
Here’s a few articles on how actual insulin is tested using HPLC
https://www.hindawi.com/journals/ap/2014/749823/
Here’s another on general insulin
https://www.ncbi.nlm.nih.gov/books/NBK278938/
And more
https://www.hindawi.com/journals/jdr/2018/1205121/
And that bit regarding old insulin
https://care.diabetesjournals.org/content/4/4/504
Cheers and take care!
My body disagrees with you as well as other diabetics. Say what you will. I assume you are not diabetic yourself…
These articles did not horrify me because I was not surprised and it actually helped me make sense of the problems I’ve had with quality. I’ve been able to switch one insulin out for another, one new bottle out for another and do much better. Granted I’m a case study of one. Anyone else on here might be able to anecdotally make a contribution to know whether they notice differences from one bottle to another
Not to mention Canadian diabetics don’t have to go through a lot of Hassle and barriers that we do in the United States. The United States stands out as horrific to us. Go to Europe and the same report of easy access for many and it is more Affordable. We know when we’re getting but that’s besides the point. even if it was pure which the study below suggest is not the case and there was no large-scale effort as far as I know to replicate independently, it’s also not affordable for a lot of people. If you’re in manufacturing maybe you can put the word out that people would like to survive this pandemic and diabetes in general. It’s a really cool thing to do to our community to make it inaccessible. Furthermore a lot of studies are not independent but rely on drug manufacturers funding though I haven’t checked the nature of your studies posted. What I do know is that there are examples of medicine for diabetics type 1 and type 2 that have had supposedly good studies but they have ended up killing diabetics or creating serious harm so they were taken off the market. And I guess your regard for the FDA holds up when they are stalling approval of non-invasive glucose monitors for years and approving crap. I’ve had personal experience with some of those quote non-invasive monitors which are not in truth non-invasive and they were right maybe 30% of the time and work for normal people but not for people with swings. That’s your FDA that you are so fond of. In the meantime diabetics in Europe and elsewhere are starting to have access to truly non-invasive and affordable by comparison glucose monitors and we get screwed. Sorry but I just don’t have the same experience and if you are diabetic and you think this is good treatment, my lived experience and hope for diabetics is much different than yours and we’ll have to agree to disagree
Don’t be silly. I’m diabetic.
Taken directly from the API article and I quote
The study tested just 18 vials of insulin — far too few to be definitive
So it essentially says nothing. Other than click bait.
Any refrigerated materials may degrade over time. Think about milk.
Mishandling and storage outside the guidance of the documentation could lead to product loss. Cant argue anything there. That’s why the finished sterile liquid is refrigerated.
Anyway thanks for the link.
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Really nice reply, @joe. Factual, non-defensive, and de-escalating. Thank you, and well done.
The concern about degraded insulin is real. People should know it can happen, and certainly if it’s happening repeatedly, it’s a problem. To Joe’s example, I didn’t buy milk from this one store for a long time, because it went bad a lot — probably because they weren’t good about keeping it cold. (They’ve since fixed the problem, and I’ve bought lots of milk from them since. Yay!)
But, @Elle123, please refrain from ad hominem attacks. You can 100% share your concerns. Just please do it calmly and kindly. There’s too much unpleasantness in the world already.
Posts on this discussion board are consistently helpful and supportive, and those of us who read it really want it to stay that way.
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Well said. If I might add, we in the US are painfully aware of the prohibitive cost of insulin (and overall medical care) here. We are all in the same boat in the David v. Goliath of us against big pharma.
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Please listen to the message and read this study before you attack my style. And it would be nice if non-diabetics would appreciate and respect the irritation and anger that we who have been burdening this disease and mistreatment have suffered for years and perhaps put any irritation or upset into perspective. I think we have a right to be upset and it would be nice if there was empathy around it. It would be a really big deal. We’ve had parents die and siblings died and whole communities die and we see how we are treated compared to other countries. Many of us do. So instead of being upset with me or any other diabetic, we would appreciate empathy and acknowledgement of how unfair this is so we know you are allies to change it. Certainly it’s not correct that we should be suffering this way paying $325 a vial of insulin and delays in delivery with all of the barriers when Canadians can walk into a pharmacy and get the same for $30 Canadian. I’m sure you’ve read people cutting short their insulin because they can’t afford it here. So what I would appreciate from 9 diabetics is some empathy and acknowledgement that there’s a real reason we are upset. And if I’ve offended you because I live with this disease and have lost loved ones before their time, and I’m upset and you read it in my email, we’ll agree to disagree.
Diabetes sucks. The healthcare “system” in the US is horribly broken. And we could all use more empathy, compassion, and energy — to keep ourselves and our loved ones safe, to fight against the injustices that come with this disease, and to stay sane while doing it. Every person on this board is with you!
I carefully researched the information and studies I provided or referenced. I’ve been following this topic because my life and family members and diabetic community life depend on getting accurate and informed information. If there’s anything you saw that was not factual please bring it to my attention. I can easily research and locate articles supporting anything I have stated if you have concerns about the validity. If anything was shared from personal experience that is in a different category and I believe it’s valid to share on here because this board is a forum honoring personal anecdotal experience. Furthermore there are not enough quality studies on these topics, if there are even any , so obviously we have to draw from anecdotal experience Which is taken less seriously than actual good quality studies. If you are saying that my personal experience is not factual, I certainly hope it can still be useful to diabetics who may have similar personal experiences. We have to rely on each other since there is not enough study.
I attempted to bring fact-based information above to the best of my ability so again if you see anything not fact-based let me know. The last thing I want is bad information to go out to my fellow diabetics. We suffer enough without more bad products and bad information
Regarding lack of accessibility to insulin due to the pricing, an even bigger problem because if you get bad insulin and it is out of budget, it’s a double whammy. I’m still unclear what was not considered factual but if it was about insulin pricing here is another article. I thought it was interesting because of the mention of the effort to do the Caravan to Canada to get insulin. I believe that was because of pricing not quality, but they got the double benefit of very strict quality control. If you buy one vial that is double the potency you scored as long as you know how to redose as well as even to redose.
The absurdly high cost of insulin, explained - Vox
Any diabetic on here who uses an insulin pump. I don’t have that experience because I failed at two major manufacturers , the first manufacture because of inconsistent delivery and mechanical failures, where by the way I couldn’t even get a refund, and the other one because I got serious hives eliminating injection sites after 8 months of success. There I couldn’t get a refund either. It cost thousands . So I stopped even purchasing them or trying new ones. Maybe the situation is different now and they will refund you but I don’t know. I stay away from pumps. However you might want to look if there’s any recalls such as this one.
Medtronic recalls certain MiniMed insulin pumps tied to 1 death
I am not sure again what was considered non-factual. The comparison of bad milk and Insulin does not hold up in my personal opinion, with all due respect. First of all insulin is both life-saving and deadly and whereas you might buy milk at 1 market, this insulin is being distributed to millions of people. And he didn’t just test at one market or one Pharmacy or 1 insulin. He used multiple insulins by multiple manufacturers at mulitple pharmacies and found the same problem which was dismissed by manufacturers and never replicated on a larger scale. As a courtesy and ethic he brought it to the attention of Manufacturers who dismissed the concern. As far as fact-based, here is a small study. We need more information and it’s not being studied. We could get more facts if they decided to pay attention. In the meantime even though I can’t say it’s factual it’s anecdotal come out we’re only stack with anecdotal reports because there’s not a larger scale study to my knowledge. If you happen to find one please bring it to our attention. The insult of buying bad insulin at high cost goes without saying to any of us suffering it directly. If I sound irritated I hope these examples explain why and that if non-diabetics do not consider what I am saying supportive, that they respect that many diabetics may find this fact-based information useful and tolerate my inner curmudgeon. We don’t get this too far in life with diabetes without keeping ahead of the information as much as we can. To the poster, I hope you get peace and safety and improved control. If I’ve said anything to offend you I deeply apologize. You are the most important person not to upset
Oh and I was trying to think of other topics that you thought I did not provide factual information or support for. Here is another example regarding manufacturer influence on studies.
https://ethics.harvard.edu/event/drug-companies-and-medicine-what-money-can-buy
Interesting article on issues impacting quality control evaluation and Insulin going to the market. One example is the FDA budget cuts for instance. It is hard for them to collect data because of the nature of the subject but the open discussion certainly raises concern and that could be followed up with factual study is if there is a will to do them.
Very interesting exploration on issues around quality control
Quality Control of Insulins and Biosimilar Insulins - PMC Any non-diabetics on here. Please have a heart. We are a small group and we need your help to advocate. Maybe you could call your legislator. We know as Pharmacy calls the shots and it’s unlikely for this to happen, but in 2017 they almost passed a law to allow purchase of drugs across borders. I have seen too much to be hopeful this can never come into law but you can call your Congress people and hope politicians with pharmaceutical companies and their districts won’t block this again. It almost passed
Most of the individuals on the forum are living with diabetes - in some case for several decades; others are parents, siblings, spouses or friends of people who have it, and are trying to learn so they can support their loved ones. Few if any are unaware of the frustration, irritation and anger that you specified, and that they (we) too live with it 24/7. There have been discussions on that topic or or it’s been included in some of the posted responses.
We are not the enemy. We are here to encourage and support one another, including helping to find resources and suggestions that might help one another get what we need. Yes, our system is flawed. As I said before we are all in the same boat. If you are new to the forum search the discussions for resources, or click the Resources link - you might find some there.
As for the articles you shared in your first post (one was duplicated a couple of times and I have not had a chance to read the ones you shared later), I was unaware of an issue so thank you. I’ve had diabetes from nearly 60 years and been in a pump nearly half that time. It may be that a difference in concentration lies behind some of your unexpected readings. You sounded quite positive that yours were due to different bottles and I am curious - sincerely so - to ask how you determined that was the issue. There are so many variables - as you stated, inserton site, scar tissue, exercise, stress - that you were able to make that determinarion is admirable. The way I look at it - for me - I manage what I can and adjust for the unexpected. In all my years with diabetes I have had only one nesr-DKA episode; I’ve only had one pump go bad (not related to the near DKA); and the only faulty bottle of insulin I’ve received in 57 years came from my local pharmacy - it didn’t look right when I opened the bottle so they exchanged it. The replacement was fine.
You referred to losses, and if you’ve experienced one I am very sorry. I hope you are able to channel your passion into something constructive.
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Perhaps my bluntness is offensive to some people. I was responding to being accused of providing false information which is unfortunate and I found insulting. You can say something nicely that is quite harmful and I don’t see that as being useful. And then I don’t think I was upset until I was told that my information was problematic by the last poster. If my communication is offensive I apologize to anyone on here. I’m East Coast blunt and I think that comes off differently to different cultures. I chalk it up to a cultural issue. And to be clear I am not saying it’s an insulin if you I’m saying it could be an insulin issue and it might be something that people take into consideration if they are having different readings. I can say I’ve certainly had issues with different insulins and I change bottles and it was better. It’s also possible that people with different types of liability will have different responses and sensitivity. There are many factors but I’m not saying I’m confident and I never said I was confident it was quality but that this is a legitimate consideration. And once I learned it it helped me understand that perhaps I gave up on an insulin that could have been useful too soon. Maybe I should have tried it from a different Pharmacy. It was apidra. I will also say that I lost use of a very helpful long-term insulin that was discontinued because they didn’t make enough money off of it. And this is legitimate and I can’t even remember the name maybe it was Humulin ultralente. It was a long time ago. Once I switched my management was much worse and I haven’t found a better long-term insulin. So I’ve had various issues with type as well as quality. I’m not on a pump in the fact that you are 60 years with type 1 diabetes is the most hopeful thing I’ve read in a long time. Cuz I live with the memory of my mom dying quite brutally at age 44 after having diabetes for 40 years so I like to hear hope. And as far as pumps I had irregular release from one pump and then a Medtronic pump that resulted in hives months later. It was great while it worked and then it stopped working and they can’t figure out if it was the plastic or the cannula or what but in any case I had to give that up and now I’m on 10 injections a day trying to mimic the pump pattern of minut amounts. In my opinion would have shared his very useful experience to people who have interest in it even if they take offense for my tone and I particularly am not fund of non-diabetics criticizing my tone. And criticize my information without evidence. I would hope that people who are not diabetic or diabetic would be careful to read what I say and if they explicitly think I’m giving this information to say that directly as well as to anyone else they respond to for a fruitful conversation. Good for you for 60 years. I can’t even imagine it but I hope to
Furthermore I don’t know that people can understand my tone online. However if the moderator things when I’m providing is not useful to the community or that my concerns about responses to my comments are inappropriate please remove me. This is obviously not a supportive community that I’m looking for to be attacked for providing actual research
additionally the whole point of providing this information is to be constructed. I’m sorry it appears that you don’t think the information is constructive although I’m glad that some of it was new to you and perhaps useful. I worked in public health so I’m sensitive about providing useful information and if it’s considered to be false information I certainly want to know. This is repeated but I’m making sure you hear it directly from me. Additionally I have other faults with the idea of comparing insulin to milk and this idea puts into contacts to response that you’ve had rare concerns about insulin quality.
Milk is maybe $2 or $5 if you go high quality so it’s not going to cut your budget too badly. Additionally if you get spoiled milk consistently you have the freedom to go to a competitive and better quality store with a better refrigerator. It’s much easier then perhaps finding new health care coverage even to get insulin that works better for you in terms of quality, quantity or type. Every diabetic has a different experience with access. Your experience is different than my experience is different than anyone else on here. Even locations we live might impact the quality of the pharmacies or mail delivery. Some states cap the cost of insulin and some don’t. It seems like chain of custody varies from state-to-state although you would think there would be Universal quality control. It would be useful for you to look at the postings I wrote that shows some of the complexity if you want to debate the matter. And I only escalated it because I was told what I provided was false information and I want to be sore people know it is a real concern. And other countries manage it better. I’m glad you had good experiences but others have not
Thanks for your responses. I would just encourage you to tenderness your target audience.While the info was new to me (thanks again) you expressed frustration with people who do not have diabetes, and their lack of empathy and understanding. If I had to hazard a guess I would say 95+ or more of people on the forum - including the first person you had an exchange with - have Type 1 (the rest being caring friends and family and the occasional person doing research).
I’m sorry to hear about your mom. While she is no longer with you I hope her experience has helped the progression of tools and treatments that can help us in our day to day lives. Your experience with your pump is unfortunate. May I ask how long ago this was? There are people in the forum who have issues with the adhesive for their infusion set or CGM, and have found sometimes creative ways to minimize contact with their skin, using prep solutuons or barrier methods. Depending on the nature of the issue some people find a particular set works better than another - I was having issues inserting the 90 degree set myself and found the 30 to be a better choice. Some people may need the steel cannula while others find it ordinal and unusable. I topped or at 4 injections/day when I was on MDI and can’t imagine taking 10. Some people prefer shots but if you’re the slightest but interested in going back on a pump I encourage you to check out Tandem’s TSLIM. If you read the forum you will find lots of experiences from people who have used one or both, and can give insights and comparisons. From what I’ve read - please check for yourself - many prefer Tandem, and its loop with Dexcom’s CGM. The loop works to prevent and correct lows and/or highs depending on whether you use Basal or Control IQ, and feedback on accuracy of Tandem’s combined system gets much more positive feedback on the forum than Medtronic’s.
I may not be telling you anything you don’t already know. If that’s the case I apologize. If you think you might be interested I encourage you to check out Tandem’s TSimulator which gives you a virtual feel for the functions; or you could try the actual pump. I’m told users can take a trial run before they commit and you may be able to get sample infusion sets to see if they work and if you have a preference.
I recently got my 50 year Joslin awards - they start at 25 so you qualify. There are people on the forum who have lived with diabetes longer than I have so don’t lose hope.
Thank you for the redirection. I realize the reference to the righteously irritable diabetic group was with good intention. But I’m okay. When they make it livable little go away and nothing else can really help it. This diabetic anger is kind of like the Lewis Black of anger, lovingly made up of 42 years surviving diabetic policing, price gouging and invalidation. I thought it was appropriate to call out the invalidation because how right is that on a support group site for bringing up unfair and unsafe situations. Furthermore I promise on the scale of diabetic irritable, I was pretty tame when you consider the continuum. Fun fact, wasn’t the Romanian dictator ceausescu a type 1 diabetic . I would say JDRF Forum got off pretty easy 
seriously, all just escaped in administration that earlier said we don’t even deserve pre-existing condition protection because we deserve our disease. they were on the cusp of simple rule change predicted to disenroll millions of disabled people from safety net income in health insurance. I think he upset is just fine. However I will trade the anger in for a handsome Scandinavian support group for a handsome Scandinavian husband if you might send anyone my way…
I’ve digress. In any case I have some great news. First and this needs to be fact-checked it looks like Vermont Florida and another state, possibly Colorado? Passed a law to buy abroad. That is amazing. As long as they are careful to buy from legitimate sites, that’s golden . I live in the state that has charged one of the highest prices for insulin for years. They keep promising to fix it and don’t . This would influence my move when it’s safe . Additionally my friends said that they did a search on the insulin quality and found a later reference that said the results were good off good. So that’s the good news. The bad news is she said it’s contradictory to patient reports she has seen. also it was on older insulin.
Thank you for the reference for the tandem. My insurance would be too expensive to cover now but when it’s a better situation maybe it would be worth looking into again. I had really terrible trouble both with red and almost burnt skin with the insertion sets for both the CGM and insulin insertion set. The Second Skin didn’t work well and I tried other interventions. The skin fell in like lip atrophy as well. Various areas of skin we’re getting affected pretty quickly over 8 months before the hives happened. I could only keep the insertion sets in a day or a day and a instead of two or three. irritation or problems progressed and the sites became painful. expensive to go through a lot of equipment. And various harm to the skin. It was a no-brainer to quit when the hives happens. I went to multiple doctors and not cost a few thousand because I didn’t know what cause the hives . And then I had a pump break cuz I ran out of supply and they went away . I heard about the steel but it sounded absolutely painful… My skin still shows the history and impact but a lot of it repaired. As I recall there were 2 or three different manufacturers, insulin sets and cgm’s. The first time I did a trial CGM at an exercise camp for diabetics, it was on for 3 days and left a red Raw almost burn mark so severe and sore that it took about 3 months to disappear. Now I’m very aware I am allergic to materials. that was in 2007 and 8 but in 2010 my foot swelled for a year with prolonged healing after a bunion surgery when the surgeon mistakenly used plastic instead of cat cut in the suture. later I was given a Fitbit watch but it also burnt my hand and I don’t know if it was from the metal nickel or the plastic but it only took a few weeks before I couldn’t wear it anymore. There’s something with materials. Another type 1 diabetic had similar allergies to me and diabetes the same length of time. She has used pumps for years but is now out of real estate on her body and has to go back to shots. She had stents put in and it’s been much harder for her to manage. But at least she did pretty well on the pump for a decade or more. In any case enough time has passed and I’ll poke around about the tandem. I have heard positive things that I just gave up on technology after all this. I am really happy to see that you’re up and Asia have come up with a non-invasive glucose monitor. I think it’s for type one but I’m not entirely sure. I also heard there is a sports watch and I wonder if that will be helpful for diabetics. Anyway I’m glad there is some exciting things to look forward to. In the meantime I thank you in advance for sending my Scandinavian husband. Canadian is okay as well. New Zealand.? I’m not picky
It sounds like you have a lot of skin sensitivity issues going on. Not that this compares to your situation, but several years ago I developed very itchy skin. I don’t remember now if I got rashes or hives but the itching was driving me crazy! I probably to benadryl for relief but at to visits with both an allergist and a dermatologist as I wasn’t sure which issue I had. The allergist determined I was allergic to scented products and while I hoped to find “the one” that was the culprit the doctor said it was unlikely it was just one - the simplest and best thing would be to use unscented products - soap, lotion, detergents, fabric softener… On my way home I stopped at the store and got new detergent, deodorant, you name it - and spent the rest of that day and the next washing everything I could think of. Thankfully it worked.
Have you worked with an allergist to see about treatment? I have seasonal allergies and am getting shots which are helping greatly. I don’t know if skin allergies can be treated similarly but it sounds worth looking into if you haven’t already.
You mentored possibly taking a look at Tandem. If it were me I would work first to see about getting the skin under control to increase likelihood of success - I probably sint need to tell you that. Don’t forget to do a search for “allergies” on the forum to see what people have done to minimize contact irritation.
There’s something about Fitbit bands that is problematic for lots of people, myself included. I don’t know if my skin can’t breathe, or it chafes against my arm, but i always have to change our the original one. You would think they were forcing us to buy accessories😉 - you’re not alone there.
Location, location, location… Yes, over time real estate gets tight. I was on 1 shot//day until my early 20s or so when I guess MDI began (at least that’s when it began with me) and I went to 2, then eventually 4 shots a day. I did that until about my md 30s when I got my first pump. For a while I changed my inserton site once a week and now I’m on a 3 day cycle. The more you can rotate the better, but I don’t need to tell you that. Abdomen is the most likely and practical choice but people use the thigh, your arm, waist, and butt with varying success. Some locations are more practical than others - I decided to use my upper arm for a site change yesterday and wasn’t able to remove the tape on my own🤪. Sometimes you gotta have help.
When I got my first pump someone suggested that I try different angle sets as a way of helping with scar tissue. I don’t know if it’s scientifically proven but it did make some kind of sense. That said, I do have an angle I prefer because the inserton is easier for me. I’m right handed so I invariably - 100% of the time - insert from right to left. I might open up some new real estate if I try the other direction. I don’t know, it’s just a theory but it could be worth a shot (no pun intended - okay, yes intended).
Here’s a link to an article from last year about states that choose to cap insulin prices. https://www.diabetes.org/blog/insulin-copay-caps-approved-five-more-states
I haven’t kept up on any changes - needless to say I’m hoping the current administration does something to help us all out. Banting and Best would turn over in they’re graves if they saw what had happened to their discovery.
Hi! My endo wants more data before tweaking anything else but I have a couple of opinion questions and want to try fixing more on my own since they want two weeks of data on my new basal setting first.
I woke up this morning at 8am and was 113. I waited an hour to eat (have hypothroidism and wanted to give my thyroid meds a chance to do their job) and when I looked an hour later I was at 82. Since this is more than a 30 point drop and I have noticed a trend of dropping like this after I wake up would the last few days would you suggest tweaking basal a bit there? Example right now I take 1.65 at 3am to fight the dawn phenomen and my sugars are perfect and stay within a 30 point range, but starting around 6am I notice that my sugar starts to decline but not rapidly.
Fast forward to breakfast. Had a bowl of oatmeal spiked fairly quickly, spike tappered off at 191 about an hour and 20 after eating and was down to 154 2 hours after eating and going down. At the 3 hour mark I was at 70 and corrected a low since my low threshold is at 69 or under and I still had a little insulin on board. If you were me, would you look at tweaking the basal a little bit first (from 1.65 to 1.6) to see it that helps, or would you suggest doing a higher IC ratio. Right now my insulin to carb ratio is fairly high (1:5) so I’m not sure if that’s the area to try first or not.
Taylor @Tee25 , I’m thinking that all three instances you describe are inter related, and may be tied to your basal rates. Yes, just my guess right now as I do not know all your basal rates - especially the rate(s) late evening and from midnight until 3:00 AM. Keep in mind that insulin dosing can be cumulative, and that “stacking insulin” applies to basal as well as bolus infusion.
To answer your questions at the very end of your postings, if I was experiencing what you currently are experiencing, I’d keep the bolus as is, for now, and reduce basal rates.
Between 4 AM and 5 AM you infused 1,65 units - some of this was still “on board” at 8 AM. Between 5 & ^ AM you took another 1.65 units, etc., etc. with some still on-board. Active insulin in your body when you got your 113 mg/dl measurement at 8 AM could have been a full unit, and depending on your insulin sensitivity would easily cause a drop of 30 mg. You didn’t mention when the 1.65 uph basal later will change, but if I was in your shoes, I’d reduce the 1.65 to 1.5, or even lower for a few days. Without knowing your full day basal rates, my suggestion to drop your rate initially to 1.5 is pure conjecture.