How high do you wait to be to correct?

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Lily123

Lily123

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Just a general wonder really for those on insulin

The advice when I was diagnosed was to wait until I was 14 and above to correct and that was understandable then but it is really annoying to be to be sat at say 12-13 and stable or rising and to not correct.

What level does everyone else correct at?
 
Provided I haven’t got any short acting insulin left on board, I correct anything in double figures, but conservatively. One unit of insulin lowers me by 3, so I've always considered it silly to wait until the next meal, or wait until I’ve got even higher. If, say, I’m around 10, and I’m not planning a meal in the next hour, and sticking a unit in now will bring me back to around 7, then I'd rather do that than sit in double figures until I next eat.

If I’ve still got bolus on board, I'd only correct if I was higher, and then I’d have a rethink about whether I'd made a mistake and underbolused at the last meal. If I decide I have, and I can’t see any reason for the insulin left on board to be able to deal with the high number I've reached, then I'd correct at that point.
 
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It depends on how much insulin on board I have. Normal for me though is correct if reached 10 for any reason.
 
I agree with both the answers, and am 'spoilt' really cos so far all my pumps have been Roche so their matching meter/remote control has always told me exactly how much I is still OB when I test my BG, then I press 'bolus' and it calculates the bolus to get my BG back down to 6.5 so then press 'deliver' and it does! I suppose other pumps which have the bolus wizard on the pump, you just test your BG on whatever meter and then manually tell that result to the pump and then ask it to 'correct' - but I don't know.

On MDI, always felt a lot more like guesswork .....
 
Same meter as you but without the pump add ons @trophywench . I used to rely on the insulin on board but kind of just guesswork from when I last injected as my DSN told me that the insulin on board isn’t too be trusted on it. I suppose it’s a different algorithm for the pump one
 
@trophywench my pumps have always kept track of IOB and calculated dose accordingly.
When they have CGMs attached (it was the Dexcom G4 with my Animas pump and a Medtrum CGM for my current one), the pump has used the current reading. Otherwise, I have had to enter my BG from the finger prick meter.
The level at which I correct depends. It depends on how much IOB and what I am going to do. I am likely to correct at lower levels if I am going to sleep or do some exercise if my levels are stable. But with a pump, I can bolus 0.05 units so a correction dose could be small.
 
Lily123 said:
Just a general wonder really for those on insulin

The advice when I was diagnosed was to wait until I was 14 and above to correct and that was understandable then but it is really annoying to be to be sat at say 12-13 and stable or rising and to not correct.

What level does everyone else correct at?
Click to expand...
So glad you asked this question, Lily-- and thanks very much especially to Robin!

I was diagnosed seven months ago, am still on MDI, and was starting to have the same sort of question-- especially because I've been ill recently, for the first time since diagnosis. I noticed that the 'sick day rules', at least the ones I was given, say to correct even with no ketones if 11 or more; but they didn't say when!

So I thought I'd try the following: if 4 hours or more after last injection and reading over 10, correct; if more than 2 but less than 4 hours after last injection and reading over 14, correct. And in both cases very conservatively! (Especially given that my correction factor seems to be about 4; on the bright side, I have a half-unit pen, so can be very careful.) It's been working well for me, but of course everybody's different. Let us know how you get on!
 
trophywench said:
I agree with both the answers, and am 'spoilt' really cos so far all my pumps have been Roche so their matching meter/remote control has always told me exactly how much I is still OB when I test my BG, then I press 'bolus' and it calculates the bolus to get my BG back down to 6.5 so then press 'deliver' and it does! I suppose other pumps which have the bolus wizard on the pump, you just test your BG on whatever meter and then manually tell that result to the pump and then ask it to 'correct' - but I don't know.

On MDI, always felt a lot more like guesswork .....
Click to expand...
The Omnipod works the same way. The PDM (handset) does all the calculations taking into consideration IOB. I'm so grateful for that. Much too hard to calculate IOB into any correction manually.
 
I am naughty and break all the rules, but it works for me with my diet and Fiasp. In fact, one of the reasons I correct much lower than I probably should is that Fiasp refuses to work unless I stack corrections once my levels get above 10, so my alarm is set at 9.2 and when that alarm goes off, I inject a correction, even if I am doing exercise. I should say that I don't eat enough carbs to spike above 10 with them generally, so the likelihood is that when my alarm goes off, it is protein releasing or a liver dump, so not a quick spike like you get from carbs but a slow releasing mound that could last hours. I will therefore correct anywhere from 8 upwards. Logically, if my correction factor is 3 then if I am at 8, 1 unit will bring me down to a maximum of 5 which is where I am happiest. In reality if I am correcting for protein or liver release, then it will not bring me down as far as 5 because some of it will be used to tackle the continuing release of glucose. Gradually I have learned to be more assertive with my Fiasp corrections in order to achieve good TIR and I know that I can eat a JB if my levels start dropping a little quicker or lower than I want them to. For me, lows are much quicker and easier to correct with one or at the most 2 JBs, than highs above 10, which might need 2 or 3 stacked corrections and several hours to bring down, so for me it pays to be preemptive and do a correction before I hit 10.
I log all my insulin on Libre, so I can check when my last injection was if I am unsure and calculate a rough estimate of IOB but using small doses due to my low carb way of eating and Fiasp having a shorter life span than NR, after 3 hours I can be pretty sure it is almost entirely spent, but if I am 8.5 and heading upwards after 1.5 hours I will still inject a correction but keep a close eye on Libre afterwards.
 
Usually anything over 10 I would correct if it has been 4 hours after bolus and I wouldn’t wait for my next meal to correct.

If there is no IOB then for me 4U would bring a BG of 10 down to mid to low 5s

I don’t always include IOB, but have a rough calculation on a spreadsheet on my phone that I sometimes use to calculate a correction which does include it. Then there are those times when it stubbornly stays high, so I would ignore IOB and hit it with some more insulin stacked on top.
 
@Eternal422 - OMG - 1u of Novo reduces my BG by 2.5 to 3, so with zero IOB were I at 10.0 and had 4u you'd be scraping me off the floor! At 10 anyway, I might have 1.3u ish were I calculating it manually, unless I was going to eat again PDQ, in which case I'd just roll it up into the bolus.
 
Theoretically 1U should reduce my BG by about 2, so 2U should drop a 10 down to 6 which I use as my target. But I guess when I’m at 10, I’m still digesting food so without the additional 2U it wouldn’t bring it down enough. My problem is snacking after meals, still can’t break that habit! So I’m loading more carbs on top of what I’ve just had!
 
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