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One week on - how am I doing?

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O

ollie1234

Member
Relationship to Diabetes
Type 1
Hello,

I've been doing lots of tests this week, thinking about my diabetes more that I have in about twenty years 😱

You have all been invaluable in helping me realise the importance of testing and in drawing information and insight out of the numbers. I would love your feedback on my records this week, I've put them online here http://dl.dropbox.com/u/19419/diary/Diabetes%20Diary.html

A few really interesting things I've learned...

I can see how meals and insulin work over time much more clearly now. Many of my comments in the records towards the end of the week are my thoughts about if I'm spiking straight after a meal or if I'm still working through a dose.

I had an interesting one after breakfast on Monday 12th (readings from 8.18am to 12.30 midday). I started the day well at 4.8, ate some melon and grape for breakfast, hit 10.8 shortly after. Just a few weeks ago, before I joined this forum, I'd have thought my breakfast insulin was finished and my blood sugar was high. Now I thought about the three hour release and that fact that fruit has a lot of fast acting sugar. I saw it as a spike and waited a while. Half an hour later, 7.7, another half hour, 6.1. It was an amazing experience to have my intuition telling me one thing (high blood sugar, correct it), the newly learned theory say another (spiking, wait for a bit and retest), and the results reinforcing the theory. I learned a lot from that.

Top priority for me now is to get my lantus dose correct. I don't think I have enough data yet to adjust from 18 - do you?

Close second priority is to work out my insulin to carb ratios for meals. I seem to be ok with 4 units for 25g carbs at breakfast, but that's a ratio of 1 unit to 6g. I'm not a heavy guy (about 6 feet tall, 11.5 stone), this seems like a very high dose. I could really use some feedback on this - any input appreciated, I've also got in touch with my doctor and have a referral to my local diabetes clinic.

I seem to be around 1 unit for 10g at lunch and dinner which seems more usual, but I realise I have to get the lantus right before I can really tune the ratios.

I have a graph from Diabetes Diary:
l0E8i.jpg

It's great to see my levels stay in a more reasonable range and very motivating. For all the work left to do I feel I've made a huge leap forward, looking forward to making the next one!

Finally with all of these tests I do wish there were some kind of accurate or affordable CGM. It makes a huge difference to take lots of readings through the day and monitor the changes. What's the news on these? Even the latest ones seem to be inaccurate and expensive. I wondered if - and I know this might sound a bit odd! - I could get some kind of valve implanted in a vein so I could just turn it to get a drop of blood out when I need one. Perhaps that's a bit left-field, but are there any alternatives at all to finger prick tests?

Despite the hassles of testing I am feeling a lot better than before and in really good spirits about it all! Thanks everyone, you helped make all this possible 🙂

Ollie
 
Hi Ollie.

Just a very quick reply.

Brilliant that you're working trough it all so well. Huge leaps forward and you'll see the results in your HbA1c as well as your meter averages.

6g to 1u for breakfast isn't too bad. I'm currently on 9g to 1u but I think some are on 5g:1u so keep a check on it as you get your basal sorted.

As for a vein implant. Some way of non invasive blood testing is the holy grail. You could make a fortune if you think of a way that's accurate and affordable. There are devices that use some sort of electrostatic thingummy on a wrist watch but it was so inaccurate that it never seemed to catch on. CGMs are hideously expensive but getting better all the time.

Keep up the good work.🙂

Rob
 
Hi Ollie

Just wanted to add my congrats. You're doing really well 🙂

Great news about getting the referral to the clinic too. Things can only get better I'm sure :D



Sarah 🙂
 
PS re CGM - you still have to figerprick and feed your odinary meter reading into the elelctronic one 4 or 5 times a day.

Once you have your Basal set right, and your ratios nailed, you should be able to relax on the testing on an 'day-in, day-out' basis - minimum 5 thoough - fasting, pre each meal, before bed. And not if you go hypo and not if you go mega-high, of course LOL. Or if you are ill. Or if summat weird happens, cos sometimes it does!

May as well get on with it, you like me, are stuck with it mate! LOL
 
Thanks everyone.

There's just no getting around all the blood tests, is there? I know this really, at least on an intellectual level, but it's something different to actually adjust to it and live with it.
 
Hi Ollie

Didn't get a chance to look at your DiabetesDiary sheet until today. Having had a quick look a few things struck me...

1. You are doing brilliantly. Give yourself a pat on the back
2. It's hysterical how much your little comments remind me of mine
3. Some of your wobbles seem to be down to carb-underestimation (eg the 3/4 pizza which looked to be carbier than you'd guestimated)
4. Some of your wobbles may be due to 'hypo fallout'. The high-low shuffle is very familiar and I find it's tricky to be certain of what's going to happen if you;ve had even a low-level dip into hypo. My liver can sometimes muddy the waters for 12 hours afterwards
5. It *might* be worth knocking a unit or two off your basal so that you run slightly high rather than slightly low. That way you can have a few hypo-free days and (as long as you are not tooooo high) be in a better position to run some fasting basal tests.
6. You are eating a great selection of food, but in terms of carb counts it's not all that easy to be sure. It might pay you to 'eat boring' for a day (or two or three) so that you reduce the number of variables while trying to tweak your ratios
7. Love the way your 7-day graph gets so much narrower on the right. Things are looking up! But don't get disheartened if you have a few more rubbish weeks yet.

Keep it up!
M
 
Thanks Mike, glad you enjoyed my comments! 🙂

Putting your fourth and fifth points together, if I were to run slightly high for a few days so I could get my basal straight, what kind of range would you suggest I aim for? I don't really know what an acceptably high range would be... 6-9? I've been aiming for 4-6.
 
Hi Ollie

4-6 is fine for pre-meal, but recently I've been aiming 4-8 generally and trying to target 6 as a mid-point when calculating boluses (well, my Expert has!)

I'd say 6-9 would be fine targets pre-meal for fasting basal test purposes, if that means you can avoid hypos (which mean you can't really run reliable tests). Not sure if I've given you his link before, but this is a good description of basal testing (and insulin generally) for MDIers:

http://www.diabetes-support.org.uk/info/?page_id=120

Good luck with it!
 
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