Yesterday I had my six-month appointment at the Diabetes Centre.
You might remember last week when I wrote about my two-week log of food, exercise, blood glucose readings and insulin doses. I mentioned that I had been experiencing one low per day, pretty much every day, for two weeks. Without much of a pattern to it. Sometimes at 3am. Sometimes after breakfast. Sometimes before dinner. Or after dinner.
I had a nice chat with my diabetes doctor and here is what I learned.
I'm having too many lows.
We both agree on that.
She reminded me of the general rule of thumb when it comes to lows:
- If I'm low within two hours of eating, I need to reduce my bolus amount.
- If I'm low before a meal, or in the middle of the night, I need to adjust my basal rates.
I told her that I had reduced my basal rates across the board because the lows seemed all over the place. She said that was fine. I also said that I was just (and I mean just as in five minutes ago) reduce my dinner bolus calculation to avoid the pre-bed second dinners I've had to eat to avoid 3am lows.
Within seconds of flipping through my information she noticed that I was low or under 5.0 every day at lunch time. She recommend that mornings are probably a good place to start. Since I was low by lunch, not after breakfast, my basal rates are probably too high, especially considering I exercise most mornings. So I'm dropping those down and we'll see if that helps with the before lunch stuff. Once those are better I'll be looking for after lunch and before dinner patterns.
She was really helpful. No judging. No lectures. Just another pair of eyes to pour over the numbers and try to make sense of them.
She also suggested that I try uploading the information from my pump which I have yet to try. She said it will help me identify patterns there too. Looks like I need to pull out my big bag of Animas stuff that I have tucked away in the closet and figure out how to do that this weekend.
My A1C was 6.6 which, as she put it, is fabulous if I can achieve it without too many lows. I'm experiencing too many lows so she wants me to fix that and aim for closer to 7.0 for my next appointment in February.