Monday, November 8, 2010

Habits are Weird Sometimes

Have you ever done something continuously without thinking about it later to realize what you were doing?
 I just realized how long I’ve been doing this and maybe I should bring it up at my next appointment.  Let me explain first.  So the 2hour post meal blood sugar reading is an important one.  My pump is set for an active insulin duration of 4 hours. That means that it takes 4 hours until all of that insulin is out of my system.  Of course this often depends on the type of food but lets not add that in right now.  So post meal I have a target blood sugar reading I need to be at which is a bit higher than normal because there is still 2 hours of working insulin left in my body to bring it down to range.

I know for myself that I need to be hovering around 9.0 mmol/l (160 mg/dl) 2 hours after I’ve eaten.  If I am any lower than 8.0 mmol/l (144 mg/dl) then I usually need to have a tiny little snack so as to prevent a low an hour later. If I am higher, however this is where it gets confusing.  Often times I go through the Bolus Wizard on my pump to see what correction bolus it recommends.

FOR EXAMPLE: I take 4units of insulin and eat. 2 hours later my blood sugar is sitting at 12.6 mmol/l (225 mg/dl) which is clearly higher than my target 2h post meal of 9.0.  I use the bolus wizard which takes into account my IOB (insulin on board) and it recommends a correction dose of 2 units but says there is already 2 units on board so the result is no correction.

When I follow Mr. Pumps suggestion of no correction I end up still high hours later.  So one day I overrode the IOB and dosed the recommended correction.  The result was perfect blood sugar 2 hours later in which I pound my head at the obvious human error of incorrect carb counting.  I have gotten into the habit of doing this every time my 2 hour post reading is high.  After doing this for eons and eons I’m just realizing now that maybe I should look into why I do this and figure out how to adjust it.  But, here’s where it gets more confusing.  When I correct an out of the blue high say if there has been no IOB for a few hours my pumps correction ratio works just fine to bring me back to range.  So one begs to question, how can my correction ratio be ok for no IOB but not enough when there is IOB?

Just asking.  This blog brings out the wonderful world of second guessing myself and posing questions to see if I’m the only one, or maybe there’s something I’m missing. 

1 comment:

  1. Maybe you're duration of insulin action isn't really 4 hours. I've contemplated this issue myself, just haven't gotten around to doing anything about it! The book Pumping Insulin gives a strategy for testing that (as well as every other setting under the sun). If you don't have the book, let me know and I'll email you a synopsis!


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