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Type 1 Diabetes
Confused about how insulin is working
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<blockquote data-quote="oldgreymare" data-source="post: 2396911" data-attributes="member: 20373"><p>[USER=542544]@CoolUserName[/USER] Until recently most diabetic care focused on HbAc1 targets, but as these are 3 month weighted averages, they do not provide any insight into BG variability. With greater use of Libres and CGMs, UK targets for type 1s are slowly being adjusted to concentrating on "time in range". But controlling T1 is tough, and I understand that more than 70% TIR is considered a good first target. Thankfully the challenge of volatile puberty hormones is a long way behind me, but still my insulin ratios are massively sensitive to day to day variations in my lifestyle - did I have 1-2 days of more carbs (up to 100 g/day), did I take long walks 2 days in a row?, an intense morning of emails and black coffee, emotional stress, etc, etc, all mess up calculating any insulin ratios for a given point in time. So I I use these as a starting point. Also vary time of injection depending on how quickly I think the meal will spike me.</p><p></p><p>But because I use a CGM, I can compensate by multiple small correction doses if staying high - definitely not recommended if you do not have access to a libre or CGM. Pragmatically while I do have lows these are typically under 3% of the time, but make sure I always have glucotabs to hand. Easy enough to carry in a pocket.</p></blockquote><p></p>
[QUOTE="oldgreymare, post: 2396911, member: 20373"] [USER=542544]@CoolUserName[/USER] Until recently most diabetic care focused on HbAc1 targets, but as these are 3 month weighted averages, they do not provide any insight into BG variability. With greater use of Libres and CGMs, UK targets for type 1s are slowly being adjusted to concentrating on "time in range". But controlling T1 is tough, and I understand that more than 70% TIR is considered a good first target. Thankfully the challenge of volatile puberty hormones is a long way behind me, but still my insulin ratios are massively sensitive to day to day variations in my lifestyle - did I have 1-2 days of more carbs (up to 100 g/day), did I take long walks 2 days in a row?, an intense morning of emails and black coffee, emotional stress, etc, etc, all mess up calculating any insulin ratios for a given point in time. So I I use these as a starting point. Also vary time of injection depending on how quickly I think the meal will spike me. But because I use a CGM, I can compensate by multiple small correction doses if staying high - definitely not recommended if you do not have access to a libre or CGM. Pragmatically while I do have lows these are typically under 3% of the time, but make sure I always have glucotabs to hand. Easy enough to carry in a pocket. [/QUOTE]
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