Month: March 2016

So for this most recent adjustment adventure, I made my first basal rate adjustment on Feb 18th… on the left you can see two weeks of what prompted me to start making changes…  to boil it down it’s an avg BG of 225, estimated A1C of 9.5, 71.4 % in high range… not great… so 4 basal adjustments later overall to bring me down, but also a time window adjustment for my 6pm drops (still a mystery)… and I’m now down to an avg BG of 182, estimated A1C of 7.9, and 54.8% of time in the high range… significant improvement. Still a bit to go, I think my dinner time ratio might need to be extended later because I’ve been eating later lately… also desert pop tarts… hey, diabetes is supposed to fit into my life, not the other way, right?! (#pipedreams) but my last adjustment was on March 25th, so I’m going to wait to see how this floats out before making any more changes, can’t be changing more than one variable at a time #science. The sum of this is that I am doing a good job. I get down on myself a lot, but looking at this progress over the last two months I’m proud of the fact that I made these choices myself, I consulted with my doctor, but she just confirmed the decisions I had already had/proposed. Feeling better, now just starting to incorporate exercise and since I’m back in normal ranges I can’t just do whatever because I’m minus most of the buffer now, so back to being aware of using temp basal rate lowering for 3 hours around/including exercise time… ugh… maybe I should wait on that too? haha, yeah no.

another day, another full day +5% temp basal rate… this is not how it is supposed to be… my diet is mostly on point for a diabetic, which is equivalent to being way on point for normal people… and still averaging mid-200s with the 1-3 random quick/dangerous drops, sometimes around 6pm… yeah, that’s a workable, livable situation… /not. Oh, and maybe I’ll try to get into a gym routine again… that should be easy/fun … /not.

So here it is… report card for two weeks on the new basal rate — I had to go back down for a 3:30pm to 6:30pm time frame, I’m not sure if it is the basal rate or my commute (walking to the bus and then walking home from the bus), but really the amount of walking shouldn’t (and hasn’t previously) affected my BG to that extent… so that explains/accounts for the lows around 6pm.  Other than that… let’s take a hack at analysis…

All of this is good — I came down an average of 37 BG, but looking specifically at the average numbers over time, that change was mostly during the day, with night time numbers staying around 230 BG — I estimated that the change across the board would be 30 BG… so that’s pretty damn close… the night time highs could be affected by the lower basal rate from 3:30pm to 6:30pm, but that’s a stretch because really it’s at least 4 hours from the end of the adjustment to when I go to bed, so there should be sufficient basal on board…

lower estimated A1C, lower average BG, minimal increase in time with low BG, but it also indicates that there is more to be done to bring me into my goal range, particularly looking at night time highs (also known as cinnamon brown sugar pop tarts for dessert… or at least exacerbated by…), between a little dessert and having to rebound/treat for a 6pm low my over night numbers are significantly higher than my day time numbers, and outside of my goal night time range of 80-180.

So next possible hypothesis/adjustment… another basal adjustment or a carb ratio adjustment in the evenings… I’m hesitant to raise my basal at all in the evening because of the pattern of 6pm lows… my current average BG over the last two weeks has been 191, so I could lose another 30-40 (.05 /hr adjustment result of -37 BG) and that would put me in range at 154… but if I wake up in a better range it should bring my whole day back into a better spot… okay, so night time basal adjustment, plus trying to cut night time eating… or at least being sure to bolus for the correct amount… so night time bumps up .05/hr to 0.4/hr from 10pm-4am… night time bumps are scary, but okay….  another hypothesis of 30-40 BG average drop… with better night time numbers and minimal change to day time numbers…