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.
Year: 2016 (Page 3 of 3)
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…
This is roughly the 24 hours from adjusting my basal rate up by 0.05 units/hour across the board. I know that 24 hours isn’t a real comparison, but I’m excited anyway…
and then I started living real life and this is what happened (the previous two weeks before adjustment on the left and the 5 days since adjustment on the right)
so there is definite improvement, bringing the general average down, but also adding an evening low, could be explained by my commute that involves walking to and from bus stops, but it’s 10 minutes at most, so I think I need to look further into a cause and maybe ramp back that basal rate… TBD.
I had to do more ridiculous math to figure out a correction this morning. I’m trying not to override corrections while testing out this new basal rate, but when you have to come down you have to come down. Slowly adjusting to the school schedule of five days a week up at the same time, eating at the same time, sleeping more… I need to add a bit more activity, but I’m trying not to over do it on changes, hoping the good eating and sleep schedule will stick. fingers crossed.
you know those mornings when you hear laughter and it makes you feel like jumping out of your skin and crushing everyone like you’re a mortal combat character circa 1998… yeah, that’s how my day is going. I just spent the time I should have been reviewing material for today’s class installing diasend onto this computer so that I could stare at data that confirms my headaches and constant dehydration with the blotches of red all over my screen. Then comes the math, it looks like a basal issue, I’ve been rocking a 5% increase temp basal the last few days and that seems to have helped, but then looking at the numbers, I’m way over bolusing with most days around a 60/30 bolus to basal ratio, so that’s great… then add in the fact that for a solid two weeks… no wait, just double checked it… a full fucking month I’m averaging 200+ BG… all fucking day. No wonder I feel like shit. Ugh, but guess what the 5% change that’s been helping… it’s less than 0.05 units/hr… which means my options are risk going over by roughly double the increase I want to make or stay where I’m at… great, just fucking phenomenal. So today’s roulette decision… increase basal by 0.05 units/hr across the board… so I just drew it out… and because my average (across 24 hours) is 259 and my lowest average at any given time is 175… and given a rough 60 minute peak time, with my correction ratio should put an across the board 0.05/unit increase at (again roughly) of 30 BG/hour which puts me at least closer to my goal range of 90-180 BG at any given time… (145-230)… so let’s see if this hypothesis is correct… I’m going to try to eat similar meals, it includes two school days and one weekend day, so that should be pretty representative for my week… TBD… the mental bullshit that it took to get here… at least the shit that was too much for me to do just in my head…
I found this the other day, I wrote it as a submission for a medical conference, although I was not accepted to the conference I am still really proud of how I was able to articulate my story….At 24 I was diagnosed with Type 1 diabetes, an incredible blow to a previously immortal millennial. I have a distinct memory of the first time a tech took my blood sugar, a sense of foreboding that I was witnessing a process with which I was about to be intimately familiar, I dismissed it as me being overly dramatic and went back to answering email on my phone — little did I know how spot on I was and how my entire life was about to change.
Being diagnosed as an adult, I had a whole life before diabetes, where I ate pizza, played sports, travelled the world, all without having to worry about being my own pancreas. This freedom was not something I am willing to give up. I grew up an engineer, by nature and by nurture — where everything was up for debate, where building your own solution was always an option. So when the diagnosis haze began to lift my favorite question came to mind — how am I going to fix this… that’s what I’ve been asking myself ever since.
I looked to existing solutions first — a continuous glucose monitor and an insulin pump. To a person with a working pancreas these tools might seem like a no-brainer, but as a fiercely independent person, accepting dependence on an external device was an immense mental hurdle. This is where the mindset shift happened, these devices were going to keep me alive… the Arc Reactor kept Tony Stark alive, and Iron Man is cool… I confirmed this logic with my sister, who agreed that choosing to go on a pump made me cool like Iron Man and not sickly and weird, like I feared it would. These tools proved incredibly useful, but still left me short of my goal. I searched for others that had solved it, but rather than solutions, I found others like myself struggling along to find an answer, a protocol to replace a pancreas. I embraced Iron Man as my alter ego and became my own beta — testing out my own systems, those designed by others, and many hybrid methods. I am still searching, trying to enjoy the thrill of the chase, holding onto my faith that there is a solution.
I’ve shared my story with you, and now I’m going to tell you why it matters — because I know there are other diabetics who, with a simple mindset shift could go from patient to patient engineer, their own Iron Man, and we need all the Iron Men we can get. We need to stop looking solely to doctors and research teams for the answers and take the initiative to hypothesize and test in our own world. There are estimated 1.25 million type 1 diabetics in the US alone. Think about the possibilities if each diabetic was also a part of the team looking for the solution… with this shift, I believe that we will achieve the goal of finding a protocol to replace a pancreas, and much more.
It’s been a bit rough. I almost died last night, moderate exaggeration, but only moderate… my sugars dropped hard while I was sleeping, not sure what would have happened if my Dad hadn’t called me (yay dexcom! even at a distance and even if I’m super surly and low-BG-rude! go team!) — and now to commence with stashing juice boxes all over my new apartment…
last night. ate some cereal as insurance on a slowly declining “good number” – went to bed, drifted off. dex alarm. 50 and dropping. fruit snacks. sleep. up. mouth tastes terrible, thanks overnight rebound high. breakfast, okay. spiked. boo. class start, still spiking. level off, but I’m starving, protein bar… SPIKE. barely staying with it and not asleep in class, this is fucking embarassing. insulin kicks in right before lunch, I finally think clearly… and now it’s time for food (also, I’m hungry again), correction override, bolus, more coffee… TBD. fuck this. I’m going to try to go learn/review all the shit I should have been able to pay attention to all morning now… fuck you diabetes, fuck you.