I know, not really a news flash! But, it is part of a larger story that is about a lesson I have to keep relearning.
Sometimes, when a pattern of bg readings starts to emerge – whether for myself or the Bear – I start to adapt to it by lowballing carb counting, overriding the bolus suggestions, or overusing temp basals rather than figuring out what is going on and changing pump settings accordingly.
We’ve had a few nights where the Bear is lowish or has CGM arrows down after dinner, around bedtime. So, she will have a snack and we won’t cover the carbs, or only cover part of the carbs, or I’ll set a lower temp basal for an hour or so. Then at 10 p.m. when we test her before we go to sleep, she’s in the mid to high 200s and I grumble and mutter under my breath, set one or two alarms for overnight, and start the whole process over again the next day.
When I get sleep-deprived enough, I start forcing myself to try to do some real testing — cover carbs by the book, treat lows, log what’s happening, with the intention of getting to those settings changes. At which point, the pattern goes away. Is there for one night, but not the next. Or there is so much snacking or bolusing that it is next to impossible to test the existing settings.
[side note: this is a pet peeve of mine with our CDEs… they are always asking me about basal testing, or saying it would be “nice” to have a few nights of testing where she went to bed in range with no food or insulin on board. I agree, that would be “nice” but it seems like those nights come along about once every two months so it’s pretty unlikely for it to happen in the 7 days before our appointment.]
So this is where we’ve been the past week or so. And with a couple of nights of one of us out at a meeting or something we had nights where we went back to under carb counting, etc. just to get through. I could upload her data but of course it won’t show all the work-arounds we’ve been doing.
So, Diabetes, you are driving me crazy. I know that I need to change the Bear’s I:C ratio at dinner, or for evening, or her basal at one of those times — but I don’t know which needs to be changed, or by how much. I’m tired from getting up twice each night and still no closer to having good numbers.