Hi all
Just a quick update: things going well generally, with numbers floating around 7/8 mmols most times. Yesterday a high (11) after a hypo correction (again, a mild one, have adjusted that basal rate slightly!), and during a dual wave...
Dual wave: we found a better system (we think!) for dealing with rice. We *used to* weigh risotto when made, but there's a heck of a lot of absorbed stock etc in that, so felt we were usually erring one way or the other....So last night, something different: weighed dry rice, estimated how much of overall amount he would have (about a third!). This equated to around 105g carb. Cooked rice rates would have produced a considerably higher carb. Also, it makes instinctive sense that a large rice meal would not be that far off a large pasta meal, eg 100g. It's good to know for estimating purposes! (Oh, and forgot: he also had a magnum ice cream as treat! That seems to have dosed no problem with a straight bolus -- no blip, anyway, in the middle of the dual wave!)
SO -- we dual waved over longer time (having hypo-ed at 2 hours into a 3 hour one last time): 4 hours, 30% right away/70% over rest of time. At 2 hours in, he was 12. At 3 hours in, 12. At 4 hours in, 9. At 5.5 hours, 8mmols. The long process of being at 12 seems a bit high to us, so we think we might try 4 hours again next time, BUT re-jig proportions, so that we are doling out 40% of dose at first (in an attempt to lower him quicker right away), then the remaining 60% over the 4 hours.... We hope this will keep him lower over that time frame...
But we are pleased with the four hour stint -- ending up at 8mmols an hour after dose finishes is pretty good, when he started at 7.7 or something....
Nighttime too seems stable now, though he *is* raising one mmol at the moment. We will leave it a night or two to see if it's a pattern, then maybe raise his night basal again to .75u/hour (which, ironically, was his starting point way back when!). We want to get him closer to 7 at bedtime more frequently, then we will really know what is happening with his rate. It's a good feeling though to be back in the land of night stability: he goes to bed on 10, wakes up at 11. Goes to bed on 8, wakes up at 9. Etc. We just need to get him going to bed a little lower!
We never corrected without food much on MDI unless over 12 really, because the effects were always too unpredictable, and it was so hard to know how much insulin was still about, and for how much longer, etc...
On pump corrections much more predictable, it seems, so yes we are beginning now to always correct (without food) whenever a number over 10 presents. Of course with the wizard, there is *always* an in-built correction, aiming for whatever your target is (in our case, 7.5) with food, in the same way that you would correct with food (aiming for 7 or whatever) on MDI. For us the difference in correcting is not what you do with food (you always correct, on MDI or with wizard, though wizard is more accurate), but how frequently we feel we can correct without food, eg anytime E encounters a higher number in the normal day of testing (eg two hours after meal or whatever)...
Hope that makes some sense...!
xxoo
Just a quick update: things going well generally, with numbers floating around 7/8 mmols most times. Yesterday a high (11) after a hypo correction (again, a mild one, have adjusted that basal rate slightly!), and during a dual wave...
Dual wave: we found a better system (we think!) for dealing with rice. We *used to* weigh risotto when made, but there's a heck of a lot of absorbed stock etc in that, so felt we were usually erring one way or the other....So last night, something different: weighed dry rice, estimated how much of overall amount he would have (about a third!). This equated to around 105g carb. Cooked rice rates would have produced a considerably higher carb. Also, it makes instinctive sense that a large rice meal would not be that far off a large pasta meal, eg 100g. It's good to know for estimating purposes! (Oh, and forgot: he also had a magnum ice cream as treat! That seems to have dosed no problem with a straight bolus -- no blip, anyway, in the middle of the dual wave!)
SO -- we dual waved over longer time (having hypo-ed at 2 hours into a 3 hour one last time): 4 hours, 30% right away/70% over rest of time. At 2 hours in, he was 12. At 3 hours in, 12. At 4 hours in, 9. At 5.5 hours, 8mmols. The long process of being at 12 seems a bit high to us, so we think we might try 4 hours again next time, BUT re-jig proportions, so that we are doling out 40% of dose at first (in an attempt to lower him quicker right away), then the remaining 60% over the 4 hours.... We hope this will keep him lower over that time frame...
But we are pleased with the four hour stint -- ending up at 8mmols an hour after dose finishes is pretty good, when he started at 7.7 or something....
Nighttime too seems stable now, though he *is* raising one mmol at the moment. We will leave it a night or two to see if it's a pattern, then maybe raise his night basal again to .75u/hour (which, ironically, was his starting point way back when!). We want to get him closer to 7 at bedtime more frequently, then we will really know what is happening with his rate. It's a good feeling though to be back in the land of night stability: he goes to bed on 10, wakes up at 11. Goes to bed on 8, wakes up at 9. Etc. We just need to get him going to bed a little lower!
We never corrected without food much on MDI unless over 12 really, because the effects were always too unpredictable, and it was so hard to know how much insulin was still about, and for how much longer, etc...
On pump corrections much more predictable, it seems, so yes we are beginning now to always correct (without food) whenever a number over 10 presents. Of course with the wizard, there is *always* an in-built correction, aiming for whatever your target is (in our case, 7.5) with food, in the same way that you would correct with food (aiming for 7 or whatever) on MDI. For us the difference in correcting is not what you do with food (you always correct, on MDI or with wizard, though wizard is more accurate), but how frequently we feel we can correct without food, eg anytime E encounters a higher number in the normal day of testing (eg two hours after meal or whatever)...
Hope that makes some sense...!
xxoo
