Type 1 conundrum. ??????

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Robster65 said:
...she decided we were being too obsessive about it and need to ease back on the testing and the exercise...
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How ridiculous! Well done for standing your ground. Sounds like you'd be better off seeing a consultant at the hospital.

Robster65 said:
She did mention a pump as a possible solution, so I'll be reading a few of the pumper threads to see some of the pros and cons in case I'm offered one.
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You might find these links useful (I certainly have as I've also been considering whether pumping might be right for me)...

Pro: What made the difference? - A pumping success story

Con: Returning to MDI from pumping

Cheers
M
 
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>M Thanks for the links. It's exactly what I need to be reading. I would imagine they'll keep it as a last resort, but I want to be prepared.

>Helen I'll send an email to the SiDiary people about it. Might be worth it for the long haul.
I was doing some more reading about the CGMS and it may be that we have enough data with the 2 hourly, sometimes 1 hourly 🙂eek🙂 tests to show the true response curve.
If they suggest it, it will probably be because they don't trust our figures !🙄 But I would be fascinated to see how everything reacts to different situations.

I was low again before bed last night, had an Alpen bar to blitz it and woke up testing 9.1 so it may be dawn phenomenon combined with too much humalog in the evening, or there could be mini hypos in the night that are triggering the glycogen.
It's all an enigma, wrapped in a fugue.

Rob
 
Robster65

I was in a 'post conversation' the other day on a different forum about the absolutely critical nature of getting your basal right.

For many MANY years I pretty much left my basal alone and was constantly furstrated by 'errant' and 'inexplicable' readings during the day with no seeming pattern or explanation.

Since Feb this year I've been paying a lot attention to my control generally (and like you have begun to take lots of notes/readings, which is the first time in years I have bothered to do so).

My experience over recent months convinces me that the importance of your basal level cannot be underestimated, and that it is not necessarily going to be fixed. My own requirements have changed both up and down by a unit or two over the months.

If my basal level is wrong (even slightly) then I haven't a hope of getting boluses right - especially with all the other factors that can affect bgs (level of activity, food fat content, weather conditions/temperature, the ole 'liver mucking about' etc etc). If my basal is off by one unit I can find myself banging in 4-6 units of correction bolus with little or no apparent effect. Conversely a little too much basal can mean 'normal' insulin:carb ratios send me relentlessly low all day.

Like you I'm on Lantus, and as you probably know the 'flat 24 hour profile' is a wildly optimistic view of how the stuff actually works. I am also aware (after quite a bit of testing) that my basal requirement is not consistent over a 24hr period either - I seem to need less overnight and have begun taking Lantus at breakfast to that the tail-off in activity matches my reduced requirement.

Have you ever tested your basal dose? If it's not able to keep your bgs stable over a morning/afternoon/evening (test one at a time!) where you are not eating and not bolusing, it may be the part of the enigma...

Mike
 
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Sounds like we may need to mess about a bit yet. Things have been ok so far today.

I'm finding it hard to isolate the basal for testing. Usually lunch is within about 4 hours of breakfast, so still a small effect from bolus, but pre-tea and pre-bedtime tend to either drop away sharply or climb sharply with no real cause.

We did think about moving the lantus to mid-evening so that the tail-off is covered by the evening bolus. I've never fancied the lantus close to one of the mealtime humalogs. One jab at a time is usually enough ! 🙄

Rob
 
Hi Robster

I came across a method of basal testing earlier this year. The idea that your basal should keep your bgs completely stable during times when you don't eat/bolus is, looking back, entirely logical but i just hadn't thought about it before.

I've described the method here if you are interested.

M
 
Excellent mike, thank you.

I was ramping down last night again from about 9ish but, after the meteor watch, we settled down and ate a variety of foodstuffs to see me through without going too high. Woke this morning on 7.1 which leaves room fro improvement.

When I'm feeling brave, I'll have a go at that method. I remember when I was in hospital, they used to wake me every few hours through the night for testing. Bless 'em.

Rob
 
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