Sarah Howard (nee Tackett) has dedicated her career to supporting the T1D community ever since she was diagnosed with T1D while in college in May 2013. Since then, she has worked for various diabetes organizations, focusing on research, advocacy, and community-building efforts for people with T1D and their loved ones. Sarah is currently the Senior Manager of Marketing at T1D Exchange.
I was told when I went on the 670G CGM to keep my fingers off the scale. But I had to correct daily. When I went on the 770G, nothing was said and I don’t correct but twice a week or less. It must be learning my paterns.
I picked other. 99% of the time, I don’t need an adjustment. Then I hit a day where I have to adjust over and over again. For some reason, I occasionally get stuck in a high, usually around 200, that takes most of the day to get down. I would think it’s a problem with the insulin, but eventually it does come down.
I have gastroparesis (nerve damage to the gut, delaying gastric emptying and therefore delaying absorption of food). As a result, I have to dose quite conservatively for the food that I eat — with extended boluses, etc. — but then monitor and correct as the food passes through (or doesn’t pass through) my system. My gut motility is variable, so some days, things pass through so quickly that carbs barely register; at other times, I might only be able to eat a few saltine crackers over the course of an entire day, but I might need to take several correction doses as my body slowly converts whatever meals I’ve eaten over the past week into carbohydrates, raising my blood sugar, because those meals still haven’t passed from my gut. I average an A1C of about 5.8, so I’m managing decent control overall, but only by doing many small corrections.
Totally depends on the day…if I get stuck in a “high” day, I may use several correction boluses, on a “normal” day when everything cooperates, none are needed.
I find that it can vary because I often find some infusion sites are not as good as the others (which requires constant corrections/additions). But due to yesterday’s question (where my insurance will only cover the exact number of infusion units/pods for my three month supply) I am too afraid to replace the infusion/pod sites and run out before my next round of supplies are shipped. Insurance companies don’t seem to allow for normal infusion site issues or accidents when it gets ripped out during everyday life issues.
Like all the other comments ends on the day I am running closed loop but even that needs help sometimes. And for me if I run high today on MM algorithm, I am going to run low tomorrow. It pays more attention to the last 24 hrs than it should in my opinion.
>10. Gastroparesis, as so eloquently stated by Anne Blaynes. wrecks havoc with digestive speed. Even the Control IQ gets challenged and requires manual intervention. ☔ ☔ ☔
With the Dexcom-Tandem loop system, I still figure 7 or so corrections (added insulin) per day, breaking down to two after each meal and an extra at bedtime. Given the uncertainty of carb counting, exercise, and site viability, this is not unusual. Sites to fail and must be handled with a change of site. When I run short of supplies, I expect my doctor to order another box. I haven’t had to go this route yet, but I have extended the site time to more than 3 days on occasion.
I’m not looping or using Control-IQ. I usually don’t have any correction boluses other than as part of a meal bolus, but there are some days (like yesterday [when I used more insulin than usual but only ate about 1/3 of the normal carbs]) where my blood sugar spikes for no apparent reason and requires several correction boluses before I get back into my normal range.
Nevin you brought up a great point. I think any comments for any topic listed here should start off stating ones: (1)-current A1-C # (2) years of Type 1 (3) current insulin delivery regime (4) average daily carb intake (5) Anything Else… That way us readers can be educated as how to learn and approach our own situations. SO… 1.- 6.3 2.- 38 years 3.- pen user 4.- 150 carbs 5.- Dexcom G6 CGM This was just a suggestion to anyone that feels ok about sharing this info. but definitely not a prerequisite. As far as this topic goes I bolus 1-2 x a day between bolus meals as needed when I don’t have time to walk or exercise my way out of eating what I want to eat. Anyway… Anne I think your doing great with your regime keep up the good work you are handling your challenges very well. Stay strong.
It truly depends on the day. If I have a bad site out my site goes bad I can give more correction boluses. If everything is working accordingly to plan, no correction boluses. S with anything else Diabetes related, one day is not like another.
I maintain a 5.0-5.4 a1c with pens by fairly consistantly overdoing my boluses (or “juiceboxing”) and then correcting with juice. For most meals and foods I can nail it most of the time so I don’t need to drink gallons of juice or anything weird. But I always carry gels or juiceboxes when away from home. It doesn’t always work perfectly and I sometimes go high despite all of this so I correct when needed. It works for me but I imagine it would annoy many. I am athletic and active for my 51 years so that probably helps too. The real driving reason for my shenanigans is I prefer a quick 15 minute fix for a low than a 1-2 hr fix for a high.
The way I look at it is that it does not matter. The whole basal/bolus model is something humans created to try and emulate a pancreas. How we implement it day to day really gets down to are you managing your blood sugars. Probably as measured by your HgA1c, how many doses you use to you get there is unimportant.
I use very few corrective bonuses. My pump is set up under the Control-IQ mode. That system makes small corrective bolts adjustments as many as 3 or 4 times a day. I only make a manual adjustment when I see the BG trend moving faster than the Control-IQ is likely to take more than two or three hours to adjust. That adjustment is rare
Depends on how focused my personal physical, emotional, and mental energy is for the day and if I am being fully mindful of each diabetes self-care step. Usually the Control IQ corrects whatever needs needs to be tweaked. Sometimes I am functioning on automatic pilot in distracted mind-set mode and forget to bolus for a mindless nibble or a bite of food outside of mealtimes and then I have to do a bolus chaser.
I manually do correction boluses 1-2 times per day due to carb count errors and/or stress highs. However, I have Tandem’s Control-iQ and it does correction boluses automatically so they probably amount to 3 times a day as my life now has a lot of stress.
I was told when I went on the 670G CGM to keep my fingers off the scale. But I had to correct daily. When I went on the 770G, nothing was said and I don’t correct but twice a week or less. It must be learning my paterns.
I don’t correct at all but Loop with auto bolus does an average of 57 micro boluses a day to keep me in range 92% of the time.
I would like to see these answers correlated with A1c and average carb intake.
I picked other. 99% of the time, I don’t need an adjustment. Then I hit a day where I have to adjust over and over again. For some reason, I occasionally get stuck in a high, usually around 200, that takes most of the day to get down. I would think it’s a problem with the insulin, but eventually it does come down.
I am another Looper. The algorithm takes care of correction boluses.
I have gastroparesis (nerve damage to the gut, delaying gastric emptying and therefore delaying absorption of food). As a result, I have to dose quite conservatively for the food that I eat — with extended boluses, etc. — but then monitor and correct as the food passes through (or doesn’t pass through) my system. My gut motility is variable, so some days, things pass through so quickly that carbs barely register; at other times, I might only be able to eat a few saltine crackers over the course of an entire day, but I might need to take several correction doses as my body slowly converts whatever meals I’ve eaten over the past week into carbohydrates, raising my blood sugar, because those meals still haven’t passed from my gut. I average an A1C of about 5.8, so I’m managing decent control overall, but only by doing many small corrections.
Totally depends on the day…if I get stuck in a “high” day, I may use several correction boluses, on a “normal” day when everything cooperates, none are needed.
I find that it can vary because I often find some infusion sites are not as good as the others (which requires constant corrections/additions). But due to yesterday’s question (where my insurance will only cover the exact number of infusion units/pods for my three month supply) I am too afraid to replace the infusion/pod sites and run out before my next round of supplies are shipped. Insurance companies don’t seem to allow for normal infusion site issues or accidents when it gets ripped out during everyday life issues.
Like all the other comments ends on the day I am running closed loop but even that needs help sometimes. And for me if I run high today on MM algorithm, I am going to run low tomorrow. It pays more attention to the last 24 hrs than it should in my opinion.
>10. Gastroparesis, as so eloquently stated by Anne Blaynes. wrecks havoc with digestive speed. Even the Control IQ gets challenged and requires manual intervention. ☔ ☔ ☔
With the Dexcom-Tandem loop system, I still figure 7 or so corrections (added insulin) per day, breaking down to two after each meal and an extra at bedtime. Given the uncertainty of carb counting, exercise, and site viability, this is not unusual. Sites to fail and must be handled with a change of site. When I run short of supplies, I expect my doctor to order another box. I haven’t had to go this route yet, but I have extended the site time to more than 3 days on occasion.
I’m not looping or using Control-IQ. I usually don’t have any correction boluses other than as part of a meal bolus, but there are some days (like yesterday [when I used more insulin than usual but only ate about 1/3 of the normal carbs]) where my blood sugar spikes for no apparent reason and requires several correction boluses before I get back into my normal range.
Nevin you brought up a great point. I think any comments for any topic listed here should start off stating ones: (1)-current A1-C # (2) years of Type 1 (3) current insulin delivery regime (4) average daily carb intake (5) Anything Else… That way us readers can be educated as how to learn and approach our own situations. SO… 1.- 6.3 2.- 38 years 3.- pen user 4.- 150 carbs 5.- Dexcom G6 CGM This was just a suggestion to anyone that feels ok about sharing this info. but definitely not a prerequisite. As far as this topic goes I bolus 1-2 x a day between bolus meals as needed when I don’t have time to walk or exercise my way out of eating what I want to eat. Anyway… Anne I think your doing great with your regime keep up the good work you are handling your challenges very well. Stay strong.
It truly depends on the day. If I have a bad site out my site goes bad I can give more correction boluses. If everything is working accordingly to plan, no correction boluses. S with anything else Diabetes related, one day is not like another.
I maintain a 5.0-5.4 a1c with pens by fairly consistantly overdoing my boluses (or “juiceboxing”) and then correcting with juice. For most meals and foods I can nail it most of the time so I don’t need to drink gallons of juice or anything weird. But I always carry gels or juiceboxes when away from home. It doesn’t always work perfectly and I sometimes go high despite all of this so I correct when needed. It works for me but I imagine it would annoy many. I am athletic and active for my 51 years so that probably helps too. The real driving reason for my shenanigans is I prefer a quick 15 minute fix for a low than a 1-2 hr fix for a high.
The way I look at it is that it does not matter. The whole basal/bolus model is something humans created to try and emulate a pancreas. How we implement it day to day really gets down to are you managing your blood sugars. Probably as measured by your HgA1c, how many doses you use to you get there is unimportant.
I use very few corrective bonuses. My pump is set up under the Control-IQ mode. That system makes small corrective bolts adjustments as many as 3 or 4 times a day. I only make a manual adjustment when I see the BG trend moving faster than the Control-IQ is likely to take more than two or three hours to adjust. That adjustment is rare
Depends on how focused my personal physical, emotional, and mental energy is for the day and if I am being fully mindful of each diabetes self-care step. Usually the Control IQ corrects whatever needs needs to be tweaked. Sometimes I am functioning on automatic pilot in distracted mind-set mode and forget to bolus for a mindless nibble or a bite of food outside of mealtimes and then I have to do a bolus chaser.
I receive many correction doses with my CGM, but I give myself fewer than one a week.
I manually do correction boluses 1-2 times per day due to carb count errors and/or stress highs. However, I have Tandem’s Control-iQ and it does correction boluses automatically so they probably amount to 3 times a day as my life now has a lot of stress.