Dear Mr Liver

[everydayupsanddowns]

Do pack it in!

Having settled back down for a week or two, Mr Liver has suddenly decided to wade in with a much bigger than usual 'feet hit the floor' liver-dump at breakfast time for the last couple of days. At least I am assuming that is what is going on. Same breakfast... same loaf of seedy bread... one slice of toast... same ratio... same raised basal pattern... same 20-25 minute wait to eat... but now my BG is peaking about 50% higher.

Yesterday


Last Monday / Wednesday / Friday with exactly the same breakfast.




I plan an emergency 'extra glug of insulin' SWAG bolus tomorrow to see if I can offset it, as a minor ratio tweak today hasn't worked.

Keeps us on our toes eh!

 

[helli]

Seems to be something going around. Since I returned from my holiday ... when I was walking every day and could have done with the extra glucose, if I didn't have Type 1 ... my liver has been chucking out the sugar in response to my usual brekkie dose.
I have upped my morning basal but, tomorrow, I will be prepared with the dextrose just in case my liver decides it will go back to normal.

 

[rebrascora]

I have been the other way the last few days. Normally I add 1.5-2 units of NR to my breakfast bolus as soon as I wake up and then need to wait 45+mins before I eat. Last few days. no extra "foot on the floor" bolus required (hypoed 3x yesterday morning after I still injected 1 unit for DP) and just 20-25mins pre bolus time. Thankfully with eating low carb (only 10g for breakfast) it's not like I can get it desperately wrong and hypos were all mild and caught early, but by the 3rd one I got frustrated and had more carbs than just 15 and promptly went up to mid 11s and stayed there most of the afternoon feeling like I was wading through treacle. I eventually gave in and did a correction (against DAFNE guidelines) and was back in range by 6pm but it washed me out. No DP bolus today and had some high meat content sausages for breakfast and things have been much more stable.... whilst I did my stable duties.

 

[pm133]

Do pack it in!

Having settled back down for a week or two, Mr Liver has suddenly decided to wade in with a much bigger than usual 'feet hit the floor' liver-dump at breakfast time for the last couple of days. At least I am assuming that is what is going on. Same breakfast... same loaf of seedy bread... one slice of toast... same ratio... same raised basal pattern... same 20-25 minute wait to eat... but now my BG is peaking about 50% higher.

Yesterday
View attachment 15300

Last Monday / Wednesday / Friday with exactly the same breakfast.
View attachment 15301
View attachment 15302
View attachment 15303

I plan an emergency 'extra glug of insulin' SWAG bolus tomorrow to see if I can offset it, as a minor ratio tweak today hasn't worked.

Keeps us on our toes eh!

I had to do a similar correction at lunch time when my BG was still at 11.0. Took 2 units of bolus and went for a walk. An hour later I was 6.6 again and allowed myself a bit of lunch (a lot smaller than usual) with my normal bolus. Slight risk of a hypo because of the overlap but I'm at home surrounded by glucose just in case. Like you, my peak of more than 11 came out of nowhere yesterday.

Good luck

 

[nonethewiser]

Do pack it in!

Having settled back down for a week or two, Mr Liver has suddenly decided to wade in with a much bigger than usual 'feet hit the floor' liver-dump at breakfast time for the last couple of days. At least I am assuming that is what is going on. Same breakfast... same loaf of seedy bread... one slice of toast... same ratio... same raised basal pattern... same 20-25 minute wait to eat... but now my BG is peaking about 50% higher.

Yesterday
View attachment 15300

Last Monday / Wednesday / Friday with exactly the same breakfast.
View attachment 15301
View attachment 15302
View attachment 15303

I plan an emergency 'extra glug of insulin' SWAG bolus tomorrow to see if I can offset it, as a minor ratio tweak today hasn't worked.

Keeps us on our toes eh!

Safe bet its basal, same issue 2 week back, upped morning rate been fine since.

Done few adjustments to basal rates past month, nowt new for this time of year.

 

[grainger]

I’ve found if my blood sugar is even slightly elevated before I eat breakfast (anything that would need even a 0.1 correction dose) that no matter what I’m eating I’ll spike afterwards.

no idea why and that’s probably not helpful but it could be something to do with starting point before you eat?

side note - your night levels look amazing!

 

[SB2015]

D really doesn’t like to let us have any rest!

No suggestions apart from the usual ideas of checking basal rates.
I have been amazed at how often I have had to change things recently.
Perhaps it has been the more unusual weather we have had.

I hope that things settle Mike.

 

[SB2015]

Ps are you running in automode in your T-slim with this?

 

[everydayupsanddowns]

side note - your night levels look amazing!

That has been a really tangible benefit of ’Control IQ’ that was almost immediately evident - much, much more stable - and reliably so - that I have ever had with any other pump (including MM640G with sensors)

Ps are you running in automode in your T-slim with this?

Yes! tSlim is raising basal and adding mini-boluses to no avail.

Basal has already been hiked upwards for the Autumn seasonal shift, so this feels like something more temporary and transient (I tend to tweak basal 3-4 times a month anyway)

Currently adding 1u to calculated breakfast dose, which seems to be working for the moment.

 

[SB2015]

Very timely. Good to know that others need such regular adjustments to basal. Mine has been ranging from 100% up to 150% (as this morning).

In automode do you have the facility to tell it to lift your basic basal rate or is that all set automatically based on the readings it is taken ? This will be clear evidence that I haven’t quite got my head round the auto system. I think that you will still have different basal profiles to use from which the auto does the adjustments and tiny corrections.

Good to see those overnight graphs.

 

[everydayupsanddowns]

In automode do you have the facility to tell it to lift your basic basal rate or is that all set automatically based on the readings it is taken ? This will be clear evidence that I haven’t quite got my head round the auto system. I think that you will still have different basal profiles to use from which the auto does the adjustments and tiny corrections.

It will be different on the MM780G, but Control IQ on the tSlim does base it’s calculations on your currently active profile. So I can adjust my basal profile to influence what adjustments Control IQ makes.

My understanding is that Automode on Medtronic pumps works differently, taking a couple if which it ‘learns’ what you need, and then adjusts and amends settings on an ongoing basis (so ignores your profile settings unless you get bounced back to manual mode).

@MrDaibetes may have a clearer idea of how it works on the 670?

 

[SB2015]

It will be different on the MM780G, but Control IQ on the tSlim does base it’s calculations on your currently active profile. So I can adjust my basal profile to influence what adjustments Control IQ makes.

My understanding is that Automode on Medtronic pumps works differently, taking a couple if which it ‘learns’ what you need, and then adjusts and amends settings on an ongoing basis (so ignores your profile settings unless you get bounced back to manual mode).

@MrDaibetes may have a clearer idea of how it works on the 670?

Thanks Mike. It sounds like TSlim is the next generation of these pumps. It will be interesting to see in what ways the 780 is different from the 670, apart from the introduction of Bluetooth. I shall look on the first time using auto as a learning process, and just make the most of what that pump offers.

It is amazing to think how far things have progressed in just the last four years.

780G also corrects your highs, the 670g learns you and only auto adjusts basal to your needs I believe and stops lows, it can't correct your high sugars but will give you the daily basal you need or it thinks you needs.