At the end of the day it’s YOUR diabetes, YOU are the one who has to deal with it day in, day out, so it’s up to you to decide what you are comfortable with.
How often are you testing and correcting? Just at mealtimes or in between as well? Are you doing loads of extra injections or just adding correction doses onto food boluses? Are you comfortable with the way you were doing things before? Did the DSN explain why she thought you were doing too many corrections?
We use a pump. The pump has a bolus wizard on it. So at mealtimes we input the BG level and the pump automatically adds or subtracts a correction amount if the BG is anywhere outside target range. Which means it would correct at levels as low as 7 or 8, the pump is capable of doing VERY tiny doses though! We also used to test at bedtime (first thing in the morning corresponds with breakfast anyway) and correct if necessary (I used to do it over 10 but that was my decision). We didn’t used to bother testing in between meals unless she was showing signs of being low or high. Nowadays we have sensors so always know what the blood sugars are doing, again corrections are always done automatically at mealtimes no matter how small, and then the sensor alerts are set to 14 so we correct then if necessary (don’t worry about how long ago was the last bolus because pump knows when it was and calculates the insulin on board and reduces the correction amount to allow for that). Daughter’s last hba1c was 51 a couple of weeks ago, apparently the best one they’d had that day in the clinic, and I’m beginning to think we can’t get it much lower than that without her being hypo half the time!
As I said somewhere else, if you try to get your numbers perfect all the time you probably won’t succeed and could end up getting a bit obsessive and never enjoying anything. But you also know that if you don’t take enough care then you could end up having nasty complications. Where you place yourself in between those extremes is entirely up to you, how much effort you put in/how fussy you are is entirely up to you, it’s your body and your life. So if you were happy correcting above 8, and weren’t doing loads of extra injections to achieve that, and didn’t think it was a massive inconvenience getting in the way of your daily life, and were getting good results, then carry on doing that. If only correcting above 12 makes things a bit easier and you don’t mind the wider variance of numbers then do that. However if you’re not comfortable only correcting above 12 then you don’t have to do what the DSN says, she’s only trying to help. How about meeting her in the middle and correct above 10? Your DSN shouldn’t just be telling you what to do, she should be able to explain why she thinks you should things a certain way, and she should listen to you if you aren’t happy with that, and you should be able to have a two-way discussion to decide how best to manage your diabetes. If my daughter’s DSN ever suggests anything which I’m not happy with I tell her why I’m not keen on the idea and she doesn’t push it, she’s not the one living with it every day!
