stupid stupid stupid

[bonerp]

think I misjudged my bolus last night at teatime. Had about 80 carbs and bolused for 60! At bedtime was 15.9. So had a scone (30 carbs) and did a correction of 4 units (that a ratio of 1:10) and a bolus of 3 units (ratio 1:10).

So why did I wake this morning to 15.4!!!?

Can other pump users say how they correct BGs when over say 10mmol as 1:10 doesnt seem to be enough? Doe you use a different ratio?
Might go and change my set too if its not come down in an hour.
thanks
Paul

 

[Steveee]

Re: stupid stupi stupid

My correction bolus is the same whatever my BG is. Generally for me, 1 unit of insulin will reduce my BG by 3 and 1 unit insulin for 11 grams CHO. Personally I would not have eaten with the correction bolus. All that does is slow down the correction and leaves you with high blood sugar for longer. If you are really hungry, do the correction bolus and food bolus together but eat later, e.g. after 30 mins.

Also are you saying you had a total bolus of 7 units? My DSN recommended me to never take more that 6 units at once. If you need more, use a square wave or dual wave bolus, e.g. 6 units immediately and 1 unit over 30 minutes.

As to why the correction bolus did not work as expected - that could be for many reasons, i.e. set dodgy, air bubbles in the line, scone larger than you thought :wink:

 

[bonerp]

Re: stupid stupi stupid

steve do you mean you never do more than 6 units for a correction or a bolus? So if you have a large meal do you just do an extended for anything over 6 - so for a 12 unit meal you do 6 now and 6 extended?

I've not been told this but can see the idea behind it as I guess the body can only deal with so much at a time.

Maybe I should try using multiwave where I can bolus a % immediately and the rest comes in over an hour or whatever time I decide to use.

Can peeps give me some more guidance on this please? Might stop post meal crashes too.

 

[Steveee]

No, if I have to take say 10 units of insulin as a bolus, I will do either a square wave of 10 units for 30mins to 90 mins depending on the type of food. If my BG is over my target I will do a dual wave, e.g. max 6 units straight away and then 4 units over a period of 30mins or more.

All this depends on the type of food you are eating as well. For example a roast dinner could be 110gms CHO. As this is a high fat meal the carbs are absorbed slowly. I would take 10 units of insulin using a square wave over a period of 120mins.

Hope that helps.

 

[heidiphillips]

from Bernsteins book - if your BS is high, there is increased insulin resistance and as a result your BS goes even higher. In other words, your insulin sensitivity will change depending on how high your BS is. I find that when my daughter is high, I will correction bolus her once, then have to recheck in an hour and often wind up correcting her several more times through the night.

 

[Slinger]

hi bonerp

i know this is an old thread now but dont just start changing the way you use your pump without talking to your diabetic nurse or team. what might work for one person might not work the same for another

cheers
Ste

 

[kegstore]

Of course the danger with multiple corrections is the stacking effect of active insulin. My correction ratio remains at 1:3 whatever my blood sugar is, and I have learnt the hard way not to over-correct but just be a little bit patient. What does vary is my insulin/carb ratio, which is 1:13 during the day and 1:16 in the evening.

I tend to use an extended bolus according to the food type, not the amount, but I can see the logic of doing so. The advice given by my DSN is really only a guide to a starting point. With a fair amount of experimentation over 4 years pump use, I can now eat a variety of different GI foods and maintain a reasonably flat bg. Takes a LOT of practice though!

As with all things, what works for me should only demonstrate how I got there, not for anyone to replicate my settings.