Don't sweat it, Patti - you're on vacation!
Latest news - sorry, I suspect it's not very interesting to read a blow-by-blow account of every day, but it helps I think to be able to talk about it with people who can personally relate and not just sympathize!
I've not been helping myself lately with my choice of meals. Have to do better about that this weekend. Anyway last night had delivery restaurant food. I used the restaurant's online nutrition info to work up the carbs, which ended up being something like 120g. This is the sort of thing I would likely need an extended bolus for but I haven't yet had the training for that (not that I would need training to figure it out necessarily, but I want to do things by the book for now! Especially as my confidence is not the greatest just now. It will all come in time
BG had been at 11-12 most of the day and never below 9, in spite of doing several corrections. After that meal, BGs rose to 19-20, but no ketones thankfully. About 2 hours after eating when I saw that there was no hint of downward movement beginning, I went ahead and did a correction through the pump (so that IOB could be taken into account). 2 hours after THAT, still no sign of BGs going down, so I did another correction. And again 2 hours after THAT. Went to bed on a 17. By 6 a.m. this morning had gone down to 14. Woke up again at 9:30 at 16, Libre shows a nice straight line overnight, so basal does seem to be working, but corrections and meal boluses are having almost no effect at all.
I'm really concerned that this site or the insulin might be a problem, but then basal rates do appear to be working, so maybe it's just the bolus calcs? Weird that it seems to only have started when I changed pod though, but could just be a coincidence. Clinic said if it were the site or a problem with the insulin I'd be in the 30s within a few hours, and when I don't eat BGs are reasonably steady and flat, they just don't go DOWN when I want them to. Certainly I haven't had any ketones since before I changed pods, so clearly I am getting SOME insulin I have heard of it taking 4-5 days for Tresiba to be fully out of one's system so perhaps it's just that - in the intervening time we'd made adjustments that were based on BGs I was getting with the tail end of my last Tresiba dose still having some effect, and now it's not, those adjustments are "off" again.
So this morning, BG being 16.1, I have checked for ketones again (still none, thankfully, although I feel pretty rotten and symptomatic!). Then I had an idea. So I ran the bolus calculator on the PDM for a BG of 16.1 with no carbs, and got a suggested bolus of 3.35u. Then I backed out of the bolus calculator and instead injected 3.5u (closest approximation I could make to 3.35) with a pen. My reasoning is:
- if the pen correction is MORE effective than pump corrections have been for roughly the same dose, then the problem is likely with the pod (site or insulin degradation from body heat)
- if the pen correction is EQUALLY or LESS effective than pump corrections have been, then the problem is likely with the pump settings and I will perhaps dare to adjust the correction factor back to 2.5 (CDE had me move it to 3.0 a couple days ago just as all this was kicking off).
So the next 3-4 hours will tell the story I think!