Not correcting until meals

[rebrascora]

I think it is to be expected that we will be more likely to notice going low if we are physically active rather than sitting reading a book or sleeping, as our muscles will be sucking more glucose out of our blood and therefore the drop is likely to be a bit quicker and therefore easier to detect.

 

[PhoebeC]

I nearly feel over when I stood up out of bed so I definitely would have noticed it.

@SB2015 thank you sometimes it’s nice hearing others would do the same thing.

 

[Bruce Stephens]

I suspect that the DSN advice is based in the time before the Libre.

I'm sure that's part of it, but there's also the possibility of overcorrection. But really I think 15 is a bit too high, and I'd try to correct it. (It's certainly not a disaster, especially coming out of a hypo. I've had a few days going high in the evening which is definitely worse; I think I've just been distracted and not noticed in time to react soon enough.)

Also with Libre (or a CGM) it's practical to try aiming to stay in a range rather than trying to hit some target before each meal, but if you're trying to do that a certain amount of correcting between meals (with insulin, exercise, extra food) is going to be natural. (There's an approach for that (and a book): https://www.sugarsurfing.com )

 

[PhoebeC]

I'm sure that's part of it, but there's also the possibility of overcorrection. But really I think 15 is a bit too high, and I'd try to correct it. (It's certainly not a disaster, especially coming out of a hypo. I've had a few days going high in the evening which is definitely worse; I think I've just been distracted and not noticed in time to react soon enough.)

Also with Libre (or a CGM) it's practical to try aiming to stay in a range rather than trying to hit some target before each meal, but if you're trying to do that a certain amount of correcting between meals (with insulin, exercise, extra food) is going to be natural. (There's an approach for that (and a book): https://www.sugarsurfing.com )

Thanks for this. Will have a look tomorrow on my laptop

 

[leonS]

A few thoughts:
1. What is best for you is best for you. Let no one tell you otherwise.
2. SDNs and Dr.s tend to think
a. A hypo is a dredfull event and you will need to be rushed to A&E
b. Half your brain cells will die.
c. Hypos must be avoided at all costs.
None of this is true.
3. Any medical expert only advises. You do NOT have to follow that advice!

 

[everydayupsanddowns]

This is the DAFNE approach too I think... And it can understand it because it is cautious, and means that each dose more or less works in isolation, with none of the uncertainty and doublethinking that might be involved trying to assess carb absorption rates and insulin activity curves - which will be different from person to person, and sometimes from day to day!

So on the whole it’s not a bad approach. Often I can see that some of my dips below 4 are triggered by my overreaction to meal spikes. Just like I can also see that some of my dips below 4 result from slightly mis-timing a prebolus.

To me, this doesn’t mean that prebolusing is ‘bad’, or that I should never correct a high BG... but it does mean that I have to constantly sense-check what I am doing to see if my strategy is currently working, or if I have drifted into overreaction or need to tweak my approach in some way. It also helps to recognise how much dose is still chugging away... and that it may still be working 5 hours after the dose was delivered. Also that it may not really get going for an hour, where the food may leap into action seemingly instantly. Plus all these effects, timings, sensitivities, ratios and factors can all change over time.

That‘s the thing about T1 isn’t it... Constantly chasing the moving goalposts! 🙄

When in a cautious frame of mind, and if iob from the original dose is tending to roll in rather late to the party and cause a dip only once the correction is in full swing, I sometimes choose to correct but only down to 9 (because that was where my BG should have been at 2hours).

Hope you find a set of approaches that work for you 🙂

 

[freesia]

Hey @PhoebeC , how are your levels now? Any better?

 

[nonethewiser]

Such old school advice, really is.

Why stay high when you can correct & bring levels down, all it does is cause problems for when you next eat, meaning you would need to leave bigger gap between insulin & eating for insulin to work.

Makes no sense, especially for someone experienced & knows what they are doing.

 

[PhoebeC]

Just spoke to my nurse again.
So I decided to correct if it’s over 13 and I don’t think it’s coming down. But I haven’t even needed to.
I have gone 0 / low carbs most meals and it’s helped.
My ratio is 2/10 carbs for breakfast and that works fine and has for always, and it’s still the same I tried 1/10 Since last week and it doesn’t work.
Solved the 1am rising issue think with my lantus split and no carbs in the evening meal. Which ever I will keep up both.

My levels have been pretty good since last week. Not ideal but miles better so jm
Happy! So everything I have done has helped and I feel great.
Thanks for asking xx

 

[freesia]

Just spoke to my nurse again.
So I decided to correct if it’s over 13 and I don’t think it’s coming down. But I haven’t even needed to.
I have gone 0 / low carbs most meals and it’s helped.
My ratio is 2/10 carbs for breakfast and that works fine and has for always, and it’s still the same I tried 1/10 Since last week and it doesn’t work.
Solved the 1am rising issue think with my lantus split and no carbs in the evening meal. Which ever I will keep up both.

My levels have been pretty good since last week. Not ideal but miles better so jm
Happy! So everything I have done has helped and I feel great.
Thanks for asking xx

I'm so glad things are getting better and you are feeling happier. Its horrible having high levels that don't come down and everything you try doesn't work. Keep up what you are doing and keep us posted as to how its going x