BG PATTERNS FOR TYPE 1 - HELP WITH

[JJay]

Hi @Inka - thank you for the suggestion of a half unit pen but.....I've always used 1 unit pens - after entering bg & carbs amount the mysugr app advises how much insulin to take so how would I go on with a half unit pen?

You can change the settings in MySugr to accommodate half-unit doses - go to Bolus Calculator Settings, and under Insulin click on Insulin precision, where you have a choice of 0.1. 0.5, 1.0 or 2.0

 

[helli]

@mum2westiesGill I thought you may also find this useful when considering patterns. As I mentioned, there is much more than just food which can affect our blood sugars.

 

[mum2westiesGill]

You can change the settings in MySugr to accommodate half-unit doses - go to Bolus Calculator Settings, and under Insulin click on Insulin precision, where you have a choice of 0.1. 0.5, 1.0 or 2.0

Hi @JJay - at the moment I've got MySugr Insulin precision on Full (1.0) - if I changed it to Half (0.5) what would happen then?

 

[mum2westiesGill]

It may be that the DSN has commented on occasions when your levels have been erratic (it happens to the best of us from time to time.... I have just had a shocking 3 month spell as a result of my Covid vaccines and things are just settling back down now) so lots of things beyond your control can cause problems. Or perhaps you are not getting the timing of your bolus insulin quite right and you are spiking badly after meals but then coming back down before the next meal. The Libre should show if that is happening and carefully adjusting how soon before meals you inject is key to sorting that problem. Do you have Freestyle Libre and if so, are you seeing large spikes on your Libre graph between meals? Maybe going up to mid teens? If you don't have Libre, try testing at one and 2 hour intervals after food to see if this is happening and then adjust your prebolus time by 5 mins longer next time and try again.

Hi @rebrascora - I do have the Freestyle Libre but don't really have a proper schedule of when to use it re what's going on between meals - could you or anyone suggest something for me ie how long after meals and how often to scan?

 

[mum2westiesGill]

19/5/2021 continued
14:05pm - 8.8 - 5.4 cp or 54g of carbs - 5u humalog - lunchtime
- wensleydale cheese sandwich 2 rounds of warburtons med white sliced 3.6 cp or 36g carbs
cadburys mini roll 1.6 cp or 16g carbs
- ate 1 malteser celebration chocolate just before leaving my in laws house - not sure how many carbs are in this and don't know how it will affect my bg at teatime

 

[JJay]

Hi @JJay - at the moment I've got MySugr Insulin precision on Full (1.0) - if I changed it to Half (0.5) what would happen then?

It would suggest more precise bolus doses, eg if you were having 35g carbs on a ratio of 1:10 it might suggest 3.5 units as opposed to 3 or 4 (depending on your BG and any insulin on board, of course). Sometimes that half-unit can make all the difference one way or the other! But you do need to have a half-unit pen in order to deliver.

 

[SB2015]

I can’t remember whether you have half unit pens @mum2westiesGill
They can make such a difference to the dosing of bolus and basal insulin.
if you add in the 0.5 unit facility on Mysugr you sill have the option of more precise dosing.

 

[mum2westiesGill]

It would suggest more precise bolus doses, eg if you were having 35g carbs on a ratio of 1:10 it might suggest 3.5 units as opposed to 3 or 4 (depending on your BG and any insulin on board, of course). Sometimes that half-unit can make all the difference one way or the other! But you do need to have a half-unit pen in order to deliver.

Thank you @JJay and my pen which I use for my humalog is a half unit pen - picture to follow....

 

[mum2westiesGill]

 

[mum2westiesGill]

I can’t remember whether you have half unit pens @mum2westiesGill
They can make such a difference to the dosing of bolus and basal insulin.
if you add in the 0.5 unit facility on Mysugr you sill have the option of more precise dosing.

Hi @SB2015 - thanks for your reply and I've just posted a photo of my half unit pen for my humalog

 

[mum2westiesGill]

I've set the 0.5 unit precision on MySugr - my tea is / was 3.6 cp or 36g carbs and bg was 8.7 - bolus advice came up as 3.5 units and also 0.5 correction - I've taken the advised correction doses off made the 3.5 units into 4 units - should I have left it as 3.5 units and 0.5 correction?

 

[rebrascora]

Hi @rebrascora - I do have the Freestyle Libre but don't really have a proper schedule of when to use it re what's going on between meals - could you or anyone suggest something for me ie how long after meals and how often to scan?

You can scan whenever you want to see what your BG levels are doing. There is no restriction on how many times you check your levels but the graph will show you how high your levels go even if you don't scan at hourly intervals after eating to see how high you spike.
It is also very useful to use the Time in Target function to see how much time you are spending in the 3.9-10 target range as this is a better indication of how you are managing your diabetes than HbA1c. You could hacve a great HbA1c result but be spiking high and then hypoing and the hypos could be cancelling out the hypos and make things look good but your time in range results would be less good because you were high and low too often. If you haven't checked out the time in range function, if you click on the review history on the reader (not sure if the app on phones shows data in the same format) then touch the arrow at the bottom of the page to go to the next page and Time in Target is the second option on that page under Daily Patterns. If you touch the Time in Target option it will open up a page which will show you your time in target as a percentage and how much you have been above target and how much below ie hypo. They like you to have a min 70% Time in Target and no more than 3% below ie Hypo. Obviously the more time in Target you can achieve, the better your management. I am currently 92% for the last 7 days which is great but 6% below (ie hypo) which is not so good so I need to work on not having quite so many hypos. I treat it a bit like a computer game and try to beat my previous best score! It is a really hand way of monitoring your BG management levels.
The daily graph is the second option on the first page of the "review history" option and will show you if you have been spiking too high after meals even if you didn't scan.

Apologies if you were already aware of these Libre facilities but it didn't sound like it when you were asking about when you should scan after meals to look for spikes. If you are unsure how to access them on the reader from my description I could possible take some photos of my reader to show you. I don't yet have a phone which is compatible so not sure if it is different to select the options on that. Hopefully someone else could illustrate that if you use your phone with Libre

 

[rebrascora]

I am not familiar with My Sugr... are you able to log it as 3.5+0.5 or is there only enough space to input 4.0. If you are talking about logging it on Libre I would just log it as 4.0

 

[mum2westiesGill]

@rebrascora or anyone what do you make of these?

 

[mum2westiesGill]

I am not familiar with My Sugr... are you able to log it as 3.5+0.5 or is there only enough space to input 4.0. If you are talking about logging it on Libre I would just log it as 4.0

MySugr has a bluetooth device connected to it so you can transfer from meter to phone or you can log in manually.
There is enough space for it to be logged in as 3.5+0.5 - the 3.5 came up as insulin food units and the 0.5 came up as insulin correction or what I did was delete the 0.5 and inputted the 3.5 as 4.0

 

[mum2westiesGill]

 

[mum2westiesGill]

19/5/2021 continued
18:48pm - 8.7 - 3.6 cp or 36g of carbs - 4u humalog - teatime
- tesco finest chicken parmigiana 0.8 cp or 8g carbs
- tesco cheddar mash 2.8 cp or 28g carbs
19:35pm - 3.5 cp or 35g carbs - 3.5 units humalog - pudding

- I don't know if the 1 malteser celebration chocolate which I ate just before leaving my in laws house - affected my bg at teatime - I didn't do humalog for this

 

[JJay]

View attachment 17057

Ah yes, same pen as mine!

 

[JJay]

I've set the 0.5 unit precision on MySugr - my tea is / was 3.6 cp or 36g carbs and bg was 8.7 - bolus advice came up as 3.5 units and also 0.5 correction - I've taken the advised correction doses off made the 3.5 units into 4 units - should I have left it as 3.5 units and 0.5 correction?

If you click the tick box to "accept" the suggested doses for food and correction they will automatically show separately in mySugr.

 

[pm133]

My dsn just keeps saying hmm they're so erratic & this is why I am worrying so much.

I don't understand this at all.

You are 88% in range and when you are not in range you don't spend much time there (high or low). What exact area of your day is your DSN worrying about?
When you are in range, your numbers seem to even out pretty well.
You want to maybe watch the hypos a bit more I'd suggest and aim at cutting those out.

Is it possible you are misinterpreting what your DSN is saying because I can't see anything worrying about your data at all? Certainly you need to ask her to be more specific with her advice because "it's erratic" is clearly not helpful.