Toying with an experiment....

[rebrascora]

Definitely getting into a routine with this now.....
Yesterday was Day 8 and I used 22 units of Fiasp in 7 jabs and 6 units of Levemir overnight.
TDD = 28u in 8 jabs.

And VERY happy with my overnight graph, especially as I had a dried fig before bed when I was on 6.9mmols and wondered if it might be too much as they are generally about 7g carbs each but I thought I had a tiny bit of Fiasp left active to use up.

Going to give it to day 10 and then decide if I am adopting this as my new regime. That is looking likely at the moment as I am actually starting to find it easier than my old routine.

 

[mashedupmatt]

I am in awe at your tenacity and perserverence with this experiment @rebrascora and it does look like your graphs are very good (not sure I could put up with that many injections though!) - top work for effort

 

[rebrascora]

I am in awe at your tenacity and perserverence with this experiment @rebrascora and it does look like your graphs are very good (not sure I could put up with that many injections though!) - top work for effort

I often have to inject 7 or 8 times a day because of my low carb diet, so a few more is neither here nor there. I confess that I don't change my needle every time, so there is no faffing about in that respect and no calculating what I need, so no real thought involved. When the high alarm goes off at 8mmols, I need 2 units. It takes seconds to get my pen out and jab it and my pen is in my over the shoulder pouch during the day and under my pillow at night, so I can do it almost on the run, certainly whilst walking or during sleep, although I am no longer needing any during the night now that I have morphed the experiment into taking 6 units of Levemir at night which is working really well and just managing daytime levels by jabbing a bit of Fiasp every now and then when I need it.

I would stress that there is no way that I could do this without Libre and it being so reliable for me.

 

[rebrascora]

Day 9 results....

Fiasp 10 jabs amounting to 21u
Levemir 1 jab of 6u

Total for the day 11 jabs and a TDD of 27



Confession, I didn't do much exercise yesterday and I jabbed a correction of 1.5 units Fiasp at bedtime when levels hit 8.9 and rising. I tried to resist doing it when the alarm went off at 8mmols but it continued to rise, so I guessed I needed a bit extra and that seems to have worked out OK.

Tomorrow will be a busy day as we are hosting a driving event and I have refreshments to sort out for attendees and an obstacle course to set up, as well as looking after guests and driving horses, so it will be a full on test and whilst I said I was going to halt it at 10 days which will be the end of today, I am extending the experiment to an extra day to see what happens on a really busy stressful day. I expect some wobbles so my graph will not be nearly as good, but as long as I don't have any disasters, I think I will be adopting this approach long term as it just seems easier for me (more jabs but less thinking) and my 7 day TIR is currently 97% and improving day on day as I get into a routine with it.

 

[Inka]

Interesting @rebrascora 😎 What do you find easier about it? Is it not having to inject early and wait for the morning Levemir to get going or is it having what seems a more stable amount of Levemir at night?

Good luck for tomorrow 🙂

 

[rebrascora]

Interesting @rebrascora 😎 What do you find easier about it? Is it not having to inject early and wait for the morning Levemir to get going or is it having what seems a more stable amount of Levemir at night?

Good luck for tomorrow 🙂

I think it is partly because I am just responding to my levels rather than taking this that and the other into consideration and not having the morning basal just seems to have removed an unknown quantity as to how it is working and when and how much and long. The evening dose being higher than it used to be, but taken earlier, seems to be working well through the night even with exercise, whereas previously I was having to adjust the dose almost every night and even on a 0 dose I was having too many nocturnal hypos. I can now see the large morning dose of Levemir was a contributing factor to that and because I rarely plan my activity it wasn't something that I could adjust before the start of the day or extract at bedtime. 🙄 It was rare for me to have a week using the same dose of evening basal, probably because that morning dose was contributing quite significantly to it, so just jabbing a slightly larger evening dose to get me through the night and help out with FOTF seems to be giving me much more stable results.

Another benefit is that I am also a hole down on my belt since starting the experiment. I don't regularly weigh myself, but definitely feel like I am loosing a bit of weight and if I dropped another hole or two on my belt, I would be quite happy.

So far the only draw back is a few more injections, but lots of benefits. I doubt it would work for most other people as my diet, way of life, Libre reliability, Levemir and Fiasp all contribute to making it work well. I think particularly the short, fast nature of Fiasp is a key factor. In fact, since starting this experiment I now have a little less regard for Levemir than I did but a much greater liking for my Fiasp.

 

[Inka]

That makes total sense @rebrascora If it’s working for you and is safe (which it certainly seems to be) then stick with it 🙂 Nothing’s written in stone. You can always adjust it as you deem necessary if things change in future. I’m a big fan of ‘what works for the individual’.

 

[rebrascora]

Graphs for Saturday and yesterday not so great and I did feel like I was chasing the dragon's tail at one stage on Saturday night. I am guessing I went high due to stress as I hadn't had anything obvious to take me up that high and I had done loads of exercise during the day which I fully expected to drop me overnight.

Day 10 of experiment ...Saturday

Fiasp.... 31 units in 10 jabs plus 6 units of Levemir overnight
TDD - 37 in 11 jabs.

And then Sunday...

Sunday's afternoon diet was much higher in carbs than I normally eat and involved bread and cake and porkpie and a drink with apple juice in it, plus I didn't factor in the activity after an already very long and hectic day, so it is a bit of a mess.
The breakdown was 8 jabs of Fiasp amounting to 23u plus 6 units of Levemir. TDD 29u and 9 jabs.
Got things back on a reasonably even keel this morning....
I think the hypos yesterday afternoon probably partly illustrate that this approach to diabetes management is easiest with a low carb diet. When I ate more carbs and had to factor in exercise and basal needs, it became unmanageable. Happy to be back to low carb today and intend to continue with this system for the time being, but will not bore you with any further details.

Thanks for all your comments. both the encouraging ones and the concerns expressed about it, as they were helpful in me keeping myself safe and being self aware which are primary factors in good diabetes management.

For anyone looking at all those trips into the red 😱, particularly yesterday and thinking that is shocking, I have had days like this with my "normal" basal routine, so whilst not ideal, they are something that happens from time to time with diabetes. Libre generally reads low for me so these were very minor lows (if all of them were even below 4 at all) Apart from meaning I had to leave my car at the farm after the event, which was the only time I double checked a low, I was 3.9 with a finger prick when Libre said 2.9 🙄 and so I just picked the car up later, none of them stopped me doing whatever I was doing. I just ate a couple of JBs and carried on.

 

[Satan’s little helper]

Graphs for Saturday and yesterday not so great and I did feel like I was chasing the dragon's tail at one stage on Saturday night. I am guessing I went high due to stress as I hadn't had anything obvious to take me up that high and I had done loads of exercise during the day which I fully expected to drop me overnight.

Day 10 of experiment ...Saturday

Fiasp.... 31 units in 10 jabs plus 6 units of Levemir overnight
TDD - 37 in 11 jabs.
View attachment 31855
And then Sunday...
View attachment 31856
Sunday's afternoon diet was much higher in carbs than I normally eat and involved bread and cake and porkpie and a drink with apple juice in it, plus I didn't factor in the activity after an already very long and hectic day, so it is a bit of a mess.
The breakdown was 8 jabs of Fiasp amounting to 23u plus 6 units of Levemir. TDD 29u and 9 jabs.
Got things back on a reasonably even keel this morning....View attachment 31857
I think the hypos yesterday afternoon probably partly illustrate that this approach to diabetes management is easiest with a low carb diet. When I ate more carbs and had to factor in exercise and basal needs, it became unmanageable. Happy to be back to low carb today and intend to continue with this system for the time being, but will not bore you with any further details.

Thanks for all your comments. both the encouraging ones and the concerns expressed about it, as they were helpful in me keeping myself safe and being self aware which are primary factors in good diabetes management.

For anyone looking at all those trips into the red 😱, particularly yesterday and thinking that is shocking, I have had days like this with my "normal" basal routine, so whilst not ideal, they are something that happens from time to time with diabetes. Libre generally reads low for me so these were very minor lows (if all of them were even below 4 at all) Apart from meaning I had to leave my car at the farm after the event, which was the only time I double checked a low, I was 3.9 with a finger prick when Libre said 2.9 🙄 and so I just picked the car up later, none of them stopped me doing whatever I was doing. I just ate a couple of JBs and carried on.

It don’t look as bad as you made out on the other topic. 🙂 to me a valiant wrestle to keep the time in range.

 

[rebrascora]

Just revisiting this thread with the action I have taken as a result of it.

I am now back on 2 doses of Levemir a day. I started with the night time dose, to find what I needed to keep me reasonably level in the absence of a large daytime dose which had been significantly overlapping, as I mentioned in my posts above and just used Fiasp during the day instead of a morning dose. I did this for well over a week and 6 units seemed to be the optimum overnight dose, reducing to 5 if I had done a good bit of exercise that day.
I then started to re-introduce a morning dose at 10 units and gradually increased it until I am currently at 15u in the morning, as soon as I wake up and that seems to be working pretty well. My TIR is up to low 90s again which is more or less my norm (except when things go haywire as they do from time to time) but more importantly only 3-4% below range which is really good for me, so whilst still early days, this redistribution of my basal doses of Levemir does seem to have helped my issue of overnight hypos. I am also using probably slightly less Levemir in total at 21u as oppose to the 20-25 I was using before, depending upon exercise/activity levels. I think I am probably using slightly more Fiasp but that does vary quite a bit from day to day and I really can't be bothered to total it regularly in order to find an average. As we all know, you need what you need, so I am not sweating it.

Overall, the experiment was really quite fascinating and so far looks to have been beneficial too but as I said it is early days. I think what surprised me most was that a couple of units of Fiasp every couple of hours was remarkably effective in mimicking the action of a pump and keeping my levels pretty stable, whereas I had half expected to have to be injecting smaller doses more frequently similar to a pump. Libre was absolutely crucial to the experiment being a success.
The other thing to come out of it is that I have dropped my high alarm to 8.0 as oppose to the 9.2 it was before and I am finding that surprisingly helpful rather than tiresome. I follow the same action as I did before in that I inject 1.5-2 units of Fiasp if the alarm goes off unless I know I absolutely don't need it. Obviously I keep a close eye on things after that but this seems to be catching the protein release earlier and managing it more efficiently. Not recommending anyone who is not low carbing, correcting at 8mmols or even 9.2mmols but just saying that this is working well for me with Fiasp on a low carb way of eating.

 

[helli]

a couple of units of Fiasp every couple of hours was remarkably effective in mimicking the action of a pump and keeping my levels pretty stable, whereas I had half expected to have to be injecting smaller doses more frequently similar to a pump.

Given my total basal is a little lower than yours but in the same ball park and my hourly basal rate averages at about 0.50 units an hour, a couple of units of Fiasp every couple of hours is what I would expect. When I was able to temporarily disconnect my pump (e.g. when going to a spa) for a few hours, I would only reconnect every two hours for a quick bolus "basal top up". Likewise when my pump failed and I hadn't bought a backup, i did the same thing.
While I could adjust my basal every 30 minutes, my profile is pretty flat most of the time with a few bumps and troughs.
Given Fiasp stays active for hours, I do not think this approach would have a huge impact to our BG compared with a background basal.

Good to see your experiment proves this hypothesis 😎