Ramping up...

I'm getting ready to run another food gauntlet for Christmas.

I've been doing pretty well overall - my week of training being a minor exception.  My machine averages are running 130, which is bit higher than I want, but not dreadful.

Lately I've been undershooting a bit.    Today in particular I've had a couple of higher-than-I-like highs.
Even when I think I'm overestimating, I have gone high.  So my average for today is high.

Lunch for today was all-you-can eat Chinese buffet.  I bolused in a way I've never tried before - rather than try to guess the whole thing and shoot in one, I did a shot per plate.  I still got it wrong, but I like it as a strategy.

I was on the low side going to bed last night - and I'm pretty sure I went hypo overnight.  Woke up 175, which sure hurts the averages.  Waking up twice drenched in sweat should have been my first clue.  I had a fierce headache going to sleep so that may have masked some symptoms.  Next time I wake up at 03:00 I will have to test myself.

Oh, and before I forget...

Merry Christmas, everyone.

Bolusing

I've been meaning to do a post about the mental process I use to determine my insulin doses.  I thought it would be easy.  Heh.

See, there are two primary inputs to use when calculating your bolus size - the amount of carb you're going to eat in the next couple of hours and your current blood sugar.  If it's high, you need to take some extra insulin to bring it down again.  (This is often called a corrective.)

The first two factors are close to determinate, but there's still some variability, especially the exact carb count. There's a little fudge factor there, and there are times when your guesses are off a little.  So that will lead to extra Smarties/Lifesavers/juice (or whatever's handy) or corrections later.

But there's a third component that has to do with intuition more than anything else, and that's the hardest to quantify.  If I'm feeling like I'm trending low, I may hold off on a unit to let myself go up a little.  If I'm trending high, I may take an extra unit to come down.

It's not quite the same as basing the dose on the exact BG reading, it has to do with whether today's results have indicated a little extra resistance, or creeping up.

Historically, I've been very conservative about taking extra when I'm in the 80's or so.  Today marked a little bit of a change in that for me.  I've been worried about about going hypo due to too much insulin.  Sometimes I get low, but I have always had plenty of warning since I am very sensitive those situations still, and it's not hard to find appropriate sugar sources if something comes up.  (Or goes down; you know what I mean.)  Sometimes those highs seem very "sticky" in that they don't respond well to correctives, or a little extra carb has more impact than it seems like it should.

The difference between handling this third factor well or not can mean 10-20 points difference on the machine average in a given day.  (That's different from just blowing it and hitting 328 on the meter and fighting that.)  Time will tell how much difference that makes in the long run.  Of course, I'm looking forward to taking my first official post-diagnosis A1C, and we'll see how closely that correlates with the machine average.

I think this is what people mean when they talk about the "art" of bolusing and carb counting.