Eureka! The experiment worked!

It was Saturday night and I was tired. I’d already brushed my teeth and was about to climb into bed and tuck myself under the covers.

But first, a quick glance to make sure I could safely turn in.

PM CGM 101I was starting to flatten out from my downward trend, and there were no arrows indicating the trend was ongoing, but it was still a bit too close for comfort for me.  A quick confirmation on my handy-dandy meter confirmed my suspicion: 91 mg/dl.

I really didn’t want to eat anything. For me, every carb gets magnified tenfold when I eat it before bedtime. Then it strikes me again in the morning. That wouldn’t work. (Besides, I had that minty-fresh Crest taste in my mouth, and didn’t want to ruin it!).

So I decided to try an experiment (it’s the second bullet in that ambitious New Years post).  I turned to the most unlikely of tools: my Bolus Wizard.

First comes the blood glucose level: 91; then the carbs: zero.

PM BG 91

Have you ever tried to photograph a flashing number with a slow camera-phone? Not so easy!

Then the magic happens.

Estimate Details

Two pages. The Medtronic pump has more scrolls than the Dead Sea.

Looking at those Correction and Active Insulin values, it appears that I’ve got 0.4 units of excess insulin flowing through my veins already. If only I could take 0.4 units of Anti-Insulin…

But wait!

Status w IOB

My basal rate is 0.4 units per hour!  (Interesting how they didn’t put the leading zero before the decimal point on that screen).  If I could just suspend my pump for the next hour, everything should be good, right?

Well, I’m not feeling quite that confident. And besides, at midnight my basal rate goes up to 0.5.  So I did what any PWD would do: I SWAGged my math.

Temp Basal 10Ten percent temporary basal for an hour and a half.  A little higher than completely suspending it, but extending the temporary basal for one-and-a-half times what I should really need. (By the way, have I ever mentioned how deathly afraid I am of getting a basal of zero? I feel it’s asking for DKA – even though that is nonsense. More below…).

Then, with the aid of my sleepiness and my reliance on the CGM to wake me if the experiment failed, I went to bed.

* * *

It was a crying baby, not a crying CGM, that woke me six hours later. Let’s see how that experiment worked…

AM Meter and CGMIt looks like I rode out the night pretty well! (That peak and gradual decline towards the left side of the graph is the same one that you see in my first image.

So my CGM and my meter are about 10 mg/dl off. But I avoided a low without eating anything, and my blood sugar remained about as still as I did as I slept. It’s the little moral victories that make me feel good.

Now, to deal with that morning breath…

* * *

PS: A little about that DKA fear I mentioned earlier. I talked to my endo about how I’m worried about suspending a basal for a super-bolus, and he said that there’s no reason to be. Novolog has about a four (or more) hour duration before it’s entirely out of the system. Also, in an attempt to demonstrate the safety of Low Glucose Suspend (LGS) technology, a test was done where people’s pumps were randomly suspended for two hours without them knowing. Their BG prior to suspending could have been anything. None of these study participants went into Diabetic Ketoacidosis (or any type of ketosis) as a result.  I’ll be trying some more super-bolusing in the future…

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Posted on January 24, 2013, in Continuous Glucose Monitor (CGM), Diabetes, Insulin pump, Personal, Type 1 and tagged . Bookmark the permalink. 4 Comments.

  1. Awesome… I think this makes you both a pump wizard and a math wizard.

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  2. Dude! That’s a beautiful thing! Nicely done.

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  3. For the mathematically challenged (me), can you show me how you figured out 10% was enough? Thanks!

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    • It was a guess, really. A temp basal of zero SHOULD have done the trick, but I tend to find that the Active Insulin number on my pump tends to be higher than the amount of insulin that has yet to work (or maybe it’s just food that’s yet to consume more insulin, I dunno). So rather than go to zero and assume the 0.4u’s would cancel out, I went a bit more conservative.

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