Generally speaking, when you give a correction bolus, your blood sugar goes down.
I usually operate with that in mind. You know, blood sugar is higher than target, you take an appropriate amount of insulin, and your blood sugar starts going down.
Of course there are all of the scenarios that we know all too well. Being sick, fighting ketones, infusion set or site problems, bad insulin, whatever. Those are (hopefully) rare encounters, and they are easily explained away once we get to the bottom of it.
Here is how my morning went today:
- Wake up, test blood sugar. Time is 7:40 am.
- 142 mg/dl
- Not too bad. Three digit number starting with “1”.
- Enter that number into pump and deliver a 1.20 unit bolus
- Get ready for work, drive to work, get to work (as in “arrive”, not like “yay! I get to work”)
- Do some work stuff, walk down to the cafeteria and get breakfast
- Get back to my desk, ready to eat my english muffin & peanut butter
- Test blood sugar. Time is 8:58 am.
- 142 mg/dl
But wait – I did deliver a correction bolus right? You know, that one that is supposed to make your blood sugar go down? Yep, I sure did!
And typically when you take insulin, particularly a bolus it’s job is to make your blood sugar go down, right? Yep, I thought so.
So what happened to that 1.20 units of insulin that I took? Did it just magically disappear? Did it wha..?
Well, I do realize that it had only been a tad short of an hour and a half, but on that note, IT HAD BEEN A FRICKIN’ HOUR AND A HALF!!! All things considered, I would expect to be at least lower than what it was when I took the insulin.
Just one of those things.
I didn’t really have the time this morning to sit back and see what would have happened given another hour or two – but I’m really curious now.
Stepping back a little bit, it makes me wonder if I don’t need a different correction factor for a certain time period in the morning? You know, that I might be a little more resistant to my insulin for some time after I wake up.
But is it a “time of day” thing or a “waking up and moving around” thing?
And if I do come to the conclusion that my correction factor needs to be different for some period in the morning, how the hell do you figure what time you go back to your regular correction factor?
A lot of testing. A whole lot of testing. Then some more testing. And yet more testing.
And the presence of mind to watch and see if it worked or not. Sometimes I feel like my attention span is really bad when I can’t keep track of something a short two or three hours later.
Or if I get distracted and forget to keep the variables out of the mix during that time.
I feel that there is a shortage of days that I can really take the time to eliminate those variables. So many days where something is going on that I need to take care of. Days where I just don’t have the hours to really watch and see what’s happening. Maybe two a week, excluding weekends.
With that in mind, it seems like such a big job to work through. Something that takes so much trial and error – and the daunting task of trying to keep track of it all over such a long time span.
I know, I know. I have to do it, and I just have to start. And it’s not really as hard as my overly complicated self talk makes it seem.
Never do today what you can put off until next week.
Wake me up when things are easier.