Re insulin corrections

[mum2westiesGill]

We all have our insulin correction factors - mine is 2mmol - 1u to drop me 2mmol - but is anyone ever advised by their DSN to only correct over a certain level?
My DSN advised me a while back to only correct if my bgl is over 10mmol but now I don't know what my DSN has seen or spotted in my recent bgl"s but she thinks I'm over correcting with my insulin....

 

[JJay]

I was advised to generally only correct at mealtimes (for any BG higher than range), and only between meals if BG was over 12. My DSN at the time advised a correction ratio of 1:3, which is pretty standard I think, but personally I've found 1:2.5 works for me up to 14. Any higher and I would need to add another unit.

 

[rebrascora]

I don't think I was given a level and just as well really as I would ignore it unless it was obvious that I was correcting too often and then going hypo, but that doesn't happen. I am the expert in my diabetes and I make the decisions on how to manage it and I would challenge anyone querying my decisions and I often correct levels under 10 between meals. Yes. I make mistakes, we all do at times, but as long as I am not making the same mistake every time then it is not a problem.

If you are only following her advice which it is clear you have been from the results you have posted then I can't see how she can criticize you and you should be asking her to show you specific instances of where she thinks you corrected unnecessarily so that you understand what she is getting at, otherwise her comments are not helpful as they just frustrate and undermine your confidence.

 

[mum2westiesGill]

I was advised to generally only correct at mealtimes (for any BG higher than range), and only between meals if BG was over 12. My DSN at the time advised a correction ratio of 1:3, which is pretty standard I think, but personally I've found 1:2.5 works for me up to 14. Any higher and I would need to add another unit.

I only correct at mealtimes too.

 

[mum2westiesGill]

I don't think I was given a level and just as well really as I would ignore it unless it was obvious that I was correcting too often and then going hypo, but that doesn't happen. I am the expert in my diabetes and I make the decisions on how to manage it and I would challenge anyone querying my decisions and I often correct levels under 10 between meals. Yes. I make mistakes, we all do at times, but as long as I am not making the same mistake every time then it is not a problem.

If you are only following her advice which it is clear you have been from the results you have posted then I can't see how she can criticize you and you should be asking her to show you specific instances of where she thinks you corrected unnecessarily so that you understand what she is getting at, otherwise her comments are not helpful as they just frustrate and undermine your confidence.

Brilliant thank you! I've added that into my email
"show you specific instances of where she thinks you corrected unnecessarily so that you understand what she is getting at,"

 

[Sally71]

I don’t understand how she thinks you are overcorrecting unless you are going low after every correction, which would suggest your ratio is wrong. So make sure she tells you why she thinks it was an unnecessary correction!
We only really correct at mealtimes, pump does it automatically even if it’s only a tiny bit out of range, because pump can do very tiny correction doses. In between we don’t tend to check much, although now we have Dexcom we tend to correct over 14 because that’s when the alarm goes off.

 

[Thebearcametoo]

When she says over correcting is she referring to specific incidences or does she mean you’re micromanaging your diabetes? You’re putting a lot of work into it and if you’re happy with that that’s fine. If it’s causing you anxiety then you can afford to not be managing quite so closely now your basal is better for you. If she means specific incidence then she needs to give more detail as to what you should do differently. You seem to have a sensible correction factor, only correct at meals and only when you’re above 10 so nothing out fo the ordinary there ‍♀️‍♀️

 

[rebrascora]

I am now wondering if she is talking about carb corrections at bedtime because you were eating more carbs than was ideal/necessary at one stage. Of course she should have made it very clear if that was her meaning but maybe you misunderstood or she didn't make herself clear enough. I definitely think she needs to explain her concerns to you in more detail with specific examples so that you understand.

 

[mikeyB]

@rebrascora, read the first post. The discussion is about insulin corrections.

 

[rebrascora]

@rebrascora, read the first post. The discussion is about insulin corrections.

I appreciate that and initially responded to that if you read my previous post, but I think if a nurse mentioned too many corrections we would automatically assume/infer she was talking about insulin corrections..... but what if she was talking about carb corrections and Gill either didn't pick up on that or she didn't specify but was thinking that.... Knowing Gill's recent BG results/diary she has been doing more carb corrections than insulin corrections recently which is why it suddenly occurred to me that the nurse might have been meaning carb corrections which is something that Gill has been overdoing a little whereas, she doesn't appear to have been doing unnecessary insulin corrections.

 

[Deleted member 25429]

I appreciate that and initially responded to that if you read my previous post, but I think if a nurse mentioned too many corrections we would automatically assume/infer she was talking about insulin corrections..... but what if she was talking about carb corrections and Gill either didn't pick up on that or she didn't specify but was thinking that.... Knowing Gill's recent BG results/diary she has been doing more carb corrections than insulin corrections recently which is why it suddenly occurred to me that the nurse might have been meaning carb corrections which is something that Gill has been overdoing a little whereas, she doesn't appear to have been doing unnecessary insulin corrections.

I agree with you she may have meant how many carbs were being eaten to increase bg

 

[mum2westiesGill]

It's definitely insulin because she left a voicemail saying - "I think you may be over correcting on your insulin again"

 

[Deleted member 25429]

It's definitely insulin because she left a voicemail saying - "I think you may be over correcting on your insulin again"

It could still be your taking too much insulin and having to correct ie eating before bed

 

[mikeyB]

I appreciate that and initially responded to that if you read my previous post, but I think if a nurse mentioned too many corrections we would automatically assume/infer she was talking about insulin corrections..... but what if she was talking about carb corrections and Gill either didn't pick up on that or she didn't specify but was thinking that.... Knowing Gill's recent BG results/diary she has been doing more carb corrections than insulin corrections recently which is why it suddenly occurred to me that the nurse might have been meaning carb corrections which is something that Gill has been overdoing a little whereas, she doesn't appear to have been doing unnecessary insulin corrections.

I think I can work out what you are trying to say, ( a few full stops would help stylistically) but your guesses and assumptions are wrong. The discussion is about unnecessary insulin corrections, as the nurse made clear. There is no inference to be made about whether the nurse was talking about carb corrections, as her voicemail made clear.

In many ways, this is a spurious discussion. Carb corrections in Gill's case are a consequence of inappropriate or inaccurate insulin corrections.

 

[rebrascora]

In many ways, this is a spurious discussion. Carb corrections in Gill's case are a consequence of inappropriate or inaccurate insulin corrections.

Can you give specific examples of where Gill made "inappropriate or inaccurate insulin corrections" recently so we can understand and learn from the situation? Otherwise your comment is as unhelpful as the nurse's message.

The carb corrections I was referring to have been at bedtime to prevent hypos during the night from basal insulin.

 

[SB2015]

Hi @mum2westiesGill

With the records you are keeping, and your regular checks, you will have the information that you and your DSN will need to make decisions about alterations needed. Keep a watch over the weekend and see what your nurse suggests.

With each of these changes it might help you in the future if they explain how they come to the advice they give you, and talk through their reasoning.