The week just gone has been absolutely frenetic, with last minute course prep (still not done, and it's Sunday!), moving the entire Art department into a newly refurbished facility, oh yeah, and 3 days of compulsory academic staff training!! It's been super nuts.
I know my diabetes control has been degrading. It's like, seriously crappy at the moment. Here's the last 7 days for you:
(Apologies for having to twist your neck to see that!)
As you can see, I'm all over the map. There are some trends, which I guess are a blessing as it may just mean the Lantus (basal) dose is screwed up:
Massive peaks and troughs = massive headaches, tiredness, grumpiness, and brain-fogginess :(
So what I'm doing about it is some intensive tracking and analysis to see if I can figure out where the hell I'm going so wrong. I've just purchased Diabetes Diary for iPhone and that's where I got the pretty graphs. Have to say that so far, I'm liking this app the best of all. And I've tried most of them!
I'd been using the Insulin Calcilator app, made by the same folks (http://www.fridayforward.com/) for nearly a year now and I credit it with a 1.5% drop in my HbA1c, so I figured their diary app was worth a shot too. I like how the two apps work together. I can take a bloodsugar test, enter the results into the Insulin Calculator, then just press a button and it transfers all the data across to the Diabetes Diary, where I can add more info and make adjustments. Cool eh? :)
I think it's really good that I'm back in intensive analysis mode, because if 10+ bloodsugar tests a day aren't giving nice smooth control there must be something else going on. And I can't find it without graphs, averages, and data to help me.
Let's be clear: I test constantly. I inject semi-religiously, and I track it all in my paper log book:
But that doesn't give the instant clarity of a graph, or the insight of weekly averages. I hope this system helps. I suspect it will. I've done this intensive analysis thingy before and it has always had positive results, even if only minor.
BTW, if you can spot any major issues for me by looking at the graphs, please let me know in the comments. All help on nutting this one out is appreciated. :)
I take Lantus twice a day (11u breakfast, 9u dinner), and bolus with Humalog. I'm incredibly sensitive to changes in insulin, and am on child-size doses of Humalog. My I:C ratio is 1:14. I eat between 90 - 180g carbs per day including emergency food like juice and stuff. I walk, weather permitting :P And I work hard and get pretty stressed out at times, which never helps. Anything else you would like to know so you can help, let me know in the comments. Cheers everyone.
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WOW. I have absolutely no suggestions, but even I can tell that's not good! I hope you can find a way to better treat it soon!
ReplyDeleteSounds like your environment isn't helping! It's hard to see patterns based on arithmetic means without standard deviation, as that gives a measure of confidence/spread in the readings. (I use the same iphone app too by the way and love it)
ReplyDeleteI can only offer generic ideas (things i would try) and of course your mileage may vary .....
- are you over-treating lows?
- are you over-correcting highs? Either might explain the big swings you're seeing
- is there a pattern with the exercise?
- focus on getting the basal right first. Cut overall carbs as much as you can and start with a carb free breakfast, so you're looking at what the lantus is doing to you overnight and in the morning ... then move through to lunch and dinner and so on. (Cut the test if you go low of course)
- Lantus once daily and exercise played havoc with me. I moved to Levemir twice daily at the suggestion of my endo and the exercise lows were substantially reduced.
- Finally, have you considered pumping?
All the best with your endeavors!
Oh my, I'm not help at all. Type 1 diabetes is a tricky little bastard, as far as I've seen from friends who have it.
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