Good morning! I’m in a good rut and looking for ideas. I would love to hear some examples of what people that have successfully achieved an A1C in the 6’s and low 7’s. For the last year my A1C has creeped up to 8.2. I haven’t changed my diet and I don’t eat an over abundance of carbs. Breakfast is pretty easy. I’ll have a protein shake, Greek yogurt with less than 10g carbs, or eggs, sometimes on an English muffin sometimes not. I feel breakfast I have under control. Dinner is pretty easy to avoid excess carbs as I will have meat, salad or veggies, and rarely small portions of one roll, rice, or potato…no fries. I finally have given them up and when I do have them they just don’t taste that great anymore
Lunch is my downfall. I always run high in the afternoon and I can’t seem to bring it down. I’m looking for good lunch ideas. Something with more substance than a salad. Sometimes I do lunch meat and then cottage cheese, but sometimes I go the sandwich route and it ruins the day : / Maybe I need to square Wave or Dual wave bolus on my 670g pump?
Thanks for any suggestions for these meals! I feel like a few years ago I would be able to manage good control even while eating this, but now that I’m in my forties, I guess maybe that has something to do with it.
One of my favorite lunches is just a vegetable stirfry. I just use whatever vegetables we have, sometimes I use soysauce other times I use garlic. I normally also use some sort of protein (preferably tofu) but of course you could change that to your own preference
I’m new to the 670G and am learning myself, but, is it possible to increase the insulin/carb ratio? I sort of have the problem that you have with my dinner meal. Well sort of. I stay fine for a hours after my dinner, but, then go high around 2:00 a.m. Not sure if after meal high or DP.
I recently went to pump due to my numbers rising too, but, have been from 6.8 - 7.2 in previous years. And, I did MDIs. I wasn’t avoiding any foods, just doing ample bolusing for meals. Now, with pump I’m super focused though and for lunch normally combine lunch and breakfast as one meal and have one egg and one piece whole wheat toast or tuna salad with 3-4 crackers or cottage cheese with sliced fresh fruit or veggie/cheese omelet.
I found that I need at least 15 carbs in order to get my bolus going and BG down. If I don’t eat anything, my BG normally goes up for some reason. Also, I found it helped me to bolus for my coffee, due to the 2 tablespoons of unsweetened almond milk I put it it.
Can you do the Square Wave while in Auto mode? I have an upcoming followup with my CDE, so, I hope to figure out a lot more soon.
The reason, a very possible reason, that your BG is rising is because you have true autoimmune diabetes and your body is not producing any insulin to feed your muscles for the activity in which you engage. It is very simple to prove; assume that your BG is an acceptable 105 mg/dl at 8:00 AM and if you do not take insulin [and this includes recent basal and background insulin, and you refrain refrain from eating and then go for a morning brisk walk for three or four hours, what would you expect you BG to read?
My guess, would be about 300 mg/dl. Why? Because your body ‘saw’ and felt your energy burning up your muscles and did not detect any food intake so your liver responded to signals [probably from alpha cells] to feed your body with stored glucose / glucagon and without insulin your body could not utilize this feeding and the “sugar” remained in your blood.
Hi @RosiesAllStars, it may not be so much “what” you eat as long as the carb-load isn’t excessively concentrated, but rather how you balance the food intake with your activity and insulin. For example, for decades I maintained an HbA1c generally between 5.9 and 6.1% while working full time in a sedentary position and engaging in business travel and business luncheons and dinners. This included times utilizing MDI and later a pump, but the consistency was reasonable carb-counting guessing and effective and accurate insulin:carb ratios. My diet consisted of “All-American Boy”, averaging at least 250 grams of carbohydrate every day; my only “consistent” meal was breakfast when I’d eat at home.
I suggest that from time to time you evaluate the accuracy of your carb ratios and make appropriate adjustments - keep in mind that the ratios will differ at different times of day. Basal rates should be “fixed”, either manually or in auto-mode, before concentrating on your ratios.
@RosiesAllStars, since I’m still so new, I’ll tell you what I think the advantages of being in auto mode are. First of all, my CDE tells me it’s good. lol She’s a long time Type I herself, with over 50 years experience. So, if she suggest that I stay in auto mode, I think it’s a good thing. She did tell me that it’s not as easy for most people. I’m not sure why. I have stayed in auto mode over the last 30 days 98% of the time. I am in range 82% of the time, but, that’s not that good, I don’t think. A1C coming up soon, but, I think I am running too high in early a.m. hours and I’m not sure why the auto mode is not addressing it. Those hours are going to hurt me. Other times, I do pretty well, though, I would prefer to run between 75-100, as opposed to 115-130.
My understanding is that the auto mode would give me the insulin that I need based on how my body has responded before (I was in regular mode for over a month, before transferring) and adjust accordingly. I don’t think that is the case though. I’m not sure how to address it. From the reading that I have done, my problems are not unique. I sure hope that I can figure it out though, because, with the pump/CGM capability, there is no reason that I cannot have EXCELLENT control. I’m doing my job, now to get the pump to cooperate. lol
Wow! 86% I can only dream of, I’m at around 20-30%. I struggle in the afternoon, cannot figure out why. The only time my numbers are awesome are overnight and when I wake, but afternoons are the worst. I wonder if others need more insulin in the afternoon?
@RosiesAllStars, you and j seem to have the opposite situations. Lol
I’m not that familiar with it that much, but, to me, the only time I go out of auto mode is when I’m warming up. Is there a reason to switch out of it at other times?
I just got my 670 last week. I plan on going on auto mode this week and can’t wait to see how it works! So grateful for the people dedicated to improving our lives as Type 1’s by inventing this amazing technology. So glad you are having success, it’s very encouraging : )
With practice, you can eat just about anything and stay in range. Definitely learn how to check your basal first, then work on carb ratio, like @Dennis said.
I recommend listening to the Juicebox Podcast. Episode 210 starts his “pro tip series” that is pretty useful to start with. Juicebox Podcast — JUICEBOX PODCAST
You can get a lower a1c with manual mode, because the target Automode SG is 120mg/dL. But, it’s more work because you have to set your basals right.
Automode won’t work right until you get your Bolus Estimate Settings right or very close. And you need to get your basal rate set correctly before you can start fine tuning bolus estimate settings.
You also need to get in the habit of taking your insulin before you eat, usually 15 minutes. Otherwise, your SG and BG will spike for a few hours, which will mess up automode, time in range, and your a1c.
Thanks Edward. You have so much helpful information that has really helped me get started. One last question, is there a way in the reports or on the pump itself, to see what automode gives every hour for the basal? That would be good because then I could reprogram manual mode basals to match approximately what automode thinks I need. This would be good in case I need to go out of automode for some reason. I know I can scroll through the graph and see the ticks of basal pushes, but am wondering if it is displayed hourly somewhere. Thanks.
Another factor I have not seen mentioned is that the time of year can affect blood sugars. I do the same exercises year round, so it is not a matter of being more active. But I need about 1/3 to 1/2 less basal insulin in summer than I do in winter. Through each autumn and spring I have to continually adjust these basal rates.
You seem to have quite a great conversation going on here. I wanted to add a resource for you to look into - Have you ever heard of Sugar Surfing by Dr. Ponder? It allows you eat anything and still achieve excellent A1C levels. The only restrictions we have for my daughter are due to her celiac disease. Otherwise, we allow her to eat as we normally would. Keep in mind, we always have our protein, fruits and veggies. We offer her a balanced meal - but nothing is off limits. We still eat cereal, pizza, desserts on occasion etc. Her A1C is 6.1-6.3 depending on the season. She usually does better in the summer when we can be more flexible with the timing of her insulin/food intake compared to when she’s abiding by the rigid school schedules. You can find Dr. Ponder’s book online for about $30. Well worth the investment!
Awesome! Dr. Ponder also travels and hosts seminars from time to time. My husband and I saw him in DesMoines, IA His email newsletters are very helpful too. I have found a couple groups on Facebook that are also great support. I participate on the FB group called ‘SHIFT: Proactive CGM Management’, which is based on the Sugar Surfing foundation. Dr. Ponder even participates in some of the discussions, which is super cool. I truly hope this helps you. I’m not paid by the Sugar Surfing group - just a participant that have found it to be helpful.
