Carb Counting And Exercise Questions

[evilclive]

No, 8bs to 8bs is stable.

14bs to 5bs is not stable.

You get the carbs and the timing right to achieve the former trend.

As I say it takes some experimentation to get this right.

Sorry, I disagree with your interpretation of what's going on there. Yes, ideally I'd eat so the sugar from the food is effective while I'm out at exactly the rate it's being consumed. But that's less than precise, and I'm not going to worry too hard if I've erred on peak before rather than crash during.
That 14 is the peak after eating the food for the run. If you look at the whole thing, it's not 14 to 5, it's about 7 to 5. And this was just one day.

 

[Draco16]

If you look at the whole thing, it's not 14 to 5, it's about 7 to 5.

Ok, I’m just going on previous information you posted. If it’s actually 7 to 5 (not 14 to 5) then hard to suggest any changes as you have this pretty much spot on.

 

[evilclive]

Ok, I’m just going on previous information you posted. If it’s actually 7 to 5 (not 14 to 5) then hard to suggest any changes as you have this pretty much spot on.

I did say peak Yes - back to the original question, I'm moderately confident that within the bounds of what I can do (inject basal, inject bolus, eat), I'm not doing too badly even without formally carb counting. But I'd like to be able to tweak basal a bit more than I can at the moment - the long acting insulin means you're committed for 12+ hours and I'd like to be able to react to what I want to do rather than having to commit at that point. But I'm going to struggle to get that past the DSN...

 

[Draco16]

But I'd like to be able to tweak basal a bit more than I can at the moment - the long acting insulin means you're committed for 12+ hours and I'd like to be able to react to what I want to do rather than having to commit at that point. But I'm going to struggle to get that past the DSN...

Will keep trying as I really want you to get this pump as I think only that will give you the flexibility you want!

But for now you need to get the DSN happy using MDI. You need to clarify with them what are they looking for before they will consider you for a pump - Fewer spikes? Fewer hypos? Lower HbA1C - of what to what?

You say you vary your basal already so you probably have something like (made up numbers for illustration, the relative change is the point I am making). (And definitely do a basal test to get the base level right).

Inactive day - 12/12
Normal day (1 hour active in evenings) -12/11
Active day (several hours of activity) - 10/10

Then if on:
A planned Active day a surprise storm comes in - you eat less / inject more bolus / correct with bolus away from meal times, then go back to 12 in evening.
A planned Inactive day you get a surprise call to the mountains - you eat more / inject less bolus, etc, lower basal to 10 in evening.
A planned Normal day becomes an inactive day - increase evening basal to 12
etc

So I don't entirely agree that you are committed once morning basal administered, there is still some flex.

Not perfect - though there is some flex on 2x Levemir injections per day - but that is a downside of MDI... and you're stuck there until the DSN is happy. If you can prove your ability to manage this to meet their targets (of x,y,z?) then hopefully you can get that pump.

 

[EllieM]

I did say peak Yes - back to the original question, I'm moderately confident that within the bounds of what I can do (inject basal, inject bolus, eat), I'm not doing too badly even without formally carb counting. But I'd like to be able to tweak basal a bit more than I can at the moment - the long acting insulin means you're committed for 12+ hours and I'd like to be able to react to what I want to do rather than having to commit at that point. But I'm going to struggle to get that past the DSN...

Have you done a DAPHNE course? (I would do one if I still lived in the UK and I've been T1 for 48 years.) I suspect it would teach you stuff you don't know and as a side effect qualify you for the carb counting element of the requirements for getting a pump. AS @Draco16 said, you need to find out exactly what the DSN needs for you to qualify for a pump and jump through those hoops. Annoying, given that you know your own body and regime much better than they do, but probably worth putting the effort in if it gives you the result you want. Just because you know how to carb count doesn't mean you have to do it if your old methods work fine.
Good luck.