Good results but feeling down

[everydayupsanddowns]

Glad to hear you were pleased with your A1c.

Sorry to hear you feel down, though I completely understand why. Good luck with tweaking those settings. Take heart - You have the very best bit of kit currently available in the UK to avoid hypos without having to run silly-high. Just nudge things a little, watch and wait a couple of days for things to settle down then nudge them again. When I was trialling the 640G with sensors I found that when my basal needs changed the predictive suspend tended to leave me above range by the time it had cut out. SmartGuards into double figures were a sure sign I needed to tweak things a little so that I ended up mid-range instead (I only ever ran my 'low limit' as 4.0). So frustrating that we have to keep tweaking on an ongoing basis, but it is what it is.

I am sure you will find a new set of settings that gets rid of the 2's without meaning you have stacks of 15s 🙂

 

[everydayupsanddowns]

I was told to reduce all hourly basal rates by 0.1u so it is quite significant and has reduced my total basal by 2.4 units which should make a noticeable difference.

Make some wonder what your current total basal is? Adding a blanket 0.1 change (four clicks) might be all very well as a suggestion, but for my pattern that would change the shape a bit. If some bits are 0.8u/hr and other bits are 0.25u/hr then adding 0.1 is not the same proportion.

Try it and see how it goes... But copy your existing pattern to another slot first (I love the copy-edit option on the MM640G) so you can revert if you need to. You might consider making the change as a percentage (e.g. everything down by 10%) but that does involve a bit of calculator and paper faff. On the plus side though you can test that option first by setting a 90% TBR and seeing how it goes - as long as you don't need to set any short term TBRs on the same day/night, of course!

 

[Flower]

Thanks Mike. I have saved my original basal rate and then copied and edited basal rate 2. I agree that a 10% decrease in each rate would be less blunt an instrument and as you say a blanket 0.1 u reduction across all my varying rates will lead to a different profile. I am expecting some higher readings that I will then tweak again. It is somewhere to start and I will keep an eye on the results.

 

[AlisonM]

It's a valuable exercise for all of us and I suppose we should always review at some point to be sure we're still getting the best results we can for ourselves.

 

[KookyCat]

Ah the delightful aim higher instruction, I love that one, it's like they actually believe we have total control, like a switch we just flip. Bless their little cotton socks, they have no idea how incredibly clueless they are, so forgive them Flower they don't mean to be numpties. Let us know how you go on with your adjustments and if they help with the lows. My consultant's favourite phrase is "I'd rather see a 10 than a 2" to which I always answer "well I'd rather see a 5.2 but we can't always get what we want now can we". Don't get me wrong, I know they're trying to help, but I think they'd have a proper shock on their hands if they had to give it a go themselves. We need to invent a simulator or a game where they can try controlling blood sugar to give them a bit of experience with it. Have you noticed btw that if glucose readings are high they're all sympathetic and understanding, they don't do the switch flicking conversation, but if they're running lower they don't apply the same logic? They assume more willful action for low blood sugar. Sorry I'm off on a rant Flower! I hope you enjoyed that walnut whip and your blood sugar is behaving for you 🙂

 

[Flower]

Very true KookyC, it sounds a simple instruction to aim higher but in reality not so straightforward. I'll give it a go by meddling with a selection of variables and see which way the results go. I always think of Johnny Ball and his 'think of a number' show!

 

[Northerner]

We need to invent a simulator or a game where they can try controlling blood sugar to give them a bit of experience with it.

From August 2010 - still waiting for a manufacturer to take up the idea 😱


Diabetic tamagotchis...



One of the people on the diabetes forum suggested that it would be a good idea if trainee medics were made to carry around and care for a tamagotchi-type thing that was programmed with diabetes. They’d have to check its levels, feed it, ‘inject’ it, cope with activity and illness etc. Then, at the end of the training period the tamagotchi could be checked for its ‘HbA1c’ to see how well they had been looked after.

Of course, the device would be programmed with all the variables that make life as a diabetic so interesting and fun, plus a few random unknowns just to spice things up every now and again! At the review, the medics whose devices had fared badly would be castigated for their poor control – taking no heed of their protestations about inexplicable readings and assurances they had been working as hard as they could…

Welcome to the lecture! Now this may sound prophetic,
But by the time you leave this room , you’ll all be diabetic!
Don’t worry, we’re not going to tie your pancreatic duct,
But take part in some training that is often overlooked!

You’ve read all about diabetes - that’s all well and good,
But that is generalistic, so I think that you all should
Discover how much work’s involved to keep your levels steady,
So take your tamagotchis and start them when you’re ready!

I’m sure from all your reading you’ll know where you should begin?
For every gram of carb you eat, then you must type it in,
And if you’ve done some exercise, like gardening and such.
That might affect your levels, so estimate how much…

And if you get a virus, then your levels might climb high
And sometimes you’ll be really bad, but never find out why!
And maybe in the morning, as you watch the rising Sun,
You’ll be afflicted by the lovely dawn phenomenon!

Those of you on insulin, you’re all allowed to test,
If not, then we won’t let you as you might become obsessed!
I’d like to see you all back here when three months have gone by
Be warned – if you should fail we’ll want to know the reason why!

Three months pass...

Ah Jones! Your tamagotchi isn’t looking very good!
I can’t believe you’ve tried at all, I thought you understood?
Your A1c is dreadful, so can you please explain?
Or must I just repeat myself time and time again?

What’s that? This diabetes lark is harder than you thought?
But you said when you started it was nothing of the sort!
Perhaps you’ll have more empathy when patients come to you,
And acknowledge the complexities they speak about are true! 😱

 

[Barb]

Ah the delightful aim higher instruction, I love that one, it's like they actually believe we have total control, like a switch we just flip. Bless their little cotton socks, they have no idea how incredibly clueless they are, so forgive them Flower they don't mean to be numpties. Let us know how you go on with your adjustments and if they help with the lows. My consultant's favourite phrase is "I'd rather see a 10 than a 2" to which I always answer "well I'd rather see a 5.2 but we can't always get what we want now can we". Don't get me wrong, I know they're trying to help, but I think they'd have a proper shock on their hands if they had to give it a go themselves. We need to invent a simulator or a game where they can try controlling blood sugar to give them a bit of experience with it. Have you noticed btw that if glucose readings are high they're all sympathetic and understanding, they don't do the switch flicking conversation, but if they're running lower they don't apply the same logic? They assume more willful action for low blood sugar. Sorry I'm off on a rant Flower! I hope you enjoyed that walnut whip and your blood sugar is behaving for you 🙂

Can really empathise with you and Flower on this. It's so much easier to blame the person rather than the product.

 

[Lindarose]

What s brilliant idea and fab poem! Think it should be sent to all D medics to give them food for thought!

 

[AlisonM]

We need to invent a simulator or a game where they can try controlling blood sugar to give them a bit of experience with it.

What a great idea! Anyone game to have a go?

 

[KookyCat]

Well we've got the combined data of all of our experience so we've got brilliant capability for scenario modelling, all we need now is a budding game developer and we're golden. We could programme it with some of our favourite "motivational" phrases....like "just get your bedtime figure to say 7.5" which is my all time favourite so far 😉....just give me a moment whilst I quarter a jelly baby.....

 

[Flower]

I think it could be a chart topper, the motivational " watch out for night time lows" always amuses me, oh you mean the ones that happen when I'm asleep 😉