Not to leave you all hanging: after my latest bout of unexplained high blood sugars (S.U.S.), I was determined to make my actions count. In fact I was lying in bed awake night after night with a fierce determination to do something -- other than "correct" all day long and write pissy posts about it :)
Was it my insulin-to-carb ratio that had gone off, or was it just that my basal settings were no longer doing the trick? Start from the ground up, I thought. Only one way to accomplish that: basal testing. Oy vey! That dreaded don't-eat-for-hours / get-up-all-night-to-check-glucose test. I did my homework, and the methodology looked ugly:
- Fast for 4-5 hours prior to beginning the test and do not take any insulin other than that provided by your basal rate.
- With blood sugars between 90 and 140, start the test and measureyour blood sugar levels every 2 hours. If BG above or 65 — 165, stop test.
Night 1, test at:
Night 2, test at:
Not to mention all the daytime tests, every hour on the hour, according to some sources.
But then it dawned on me - D'OH! This is what CGM is for, Silly. Why set my alarm for 4 tests a night when the continuous glucose monitor can do it for me? I still had my DexCom Seven in the drawer where I left it, and suddenly, it looked pretty sexy again.
What a fantastic invention. Think of the parents who have to basal test their children. Those poor, sleepless, exhausted people. I can honestly say I have walked in their shoes...
Anyway, to make a long story short, I wore the DexCom for seven-plus days about week ago now with mixed results. I found it more comfortable and easier to use than my last round. But the accuracy -- or lack thereof -- was a bit shocking. It had me at 60 when a fingerstick confirmed 120. Or it read in the 200's when the fingerstick said 130. Huh? Two possible explanations: There's a major lag time that I'd forgotten about, or I had a bad sensor. Either way, I ended up tossing the data. No need for my endo to see anything that off. Still, it made me pay close attention to my readings throughout the day and night.
I ended up adjusting not my basals, but my insulin-to-carb ratio for bolus dosing, which has helped a lot. I'm running MUCH closer to target these days.
Latest Glycomark results: 4.1 (normal at my lab apparently starts at 6.0) Oh, when will those post-prandials EVER behave?
Latest A1c: 6.1 !!! So a big, wet raspberry to the Glycomark test.
Without frequent lows to offset the high post-prandials, I have no idea what this combo of test results is telling me. But since the A1c remains the Gold Standard, I'll take that 6.1 and run. Yay me!
And as for old-fashioned basal testing... that gets a raspberry, too!