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How often do you typically change your insulin dosage settings outside of T1D-related appointments (e.g. basal rates, insulin-to-carb ratios, etc.)?
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What does “appointment” mean? Dr appointments?
I believe T1-related appointments mean medical appointments, whether with an endocrinologist, primary care doctor or diabetes educator, etc..
I very seldom change basal rate (glargine long acting insulin). I don’t think my insulin to carb rate changes much. But other variables may require pre meal bolus (lispro) changes, or even additional doses, from day to day. I may have to subtract 1 or 2 units lispro or add 1 to 3 units lispro as determined by One Touch blood glucose (and/or Dexcom). Exercise or delayed meal or alcohol have the biggest effects on determining lispro (fast acting) adjustments.
Answers are really out of context. Probably nobody changes their settings on any set schedule and only changes settings on an “AS NEEDED” basis meaning maybe several times a month one time, every few months another time, and if everything’s going well, maybe only once or less per year.
How can I say how often I typically change my Insulin dosage settings when it varies so widely, anywhere from several times in a week to once or fewer times in a year???
Only if I am having repeated lows, and usually after endo has made a change. Actually very rare as I wish to keep endo relationship I have and I am a CDE.. I like to discuss this before changes. It helps to respect an objective persona’s perspective which mine have always been
I said never because rarely wasn’t a choice. But I wasn’t thinking of “temp basal” which I do, when I remember, for exercise or increased activity.
I would love to use temp-basal, but then I can’t use the control-iq with it. I like having the pump change my rates when either going too high or low. I hope when Tandem makes changes to their pump, that they will have control-iq being able to be used when the temp-basal is on.
My hybrid closed loop settings are as effective as they can be for now. I haven’t adjusted them on my own for over a year now. I did a an adjustment about a year ago at my CDA’s recommendation. My basil rates out of auto mode are not nearly as good. I would like to see average basil levels in auto mode and use that to change my basil programing.
My settings are a constant work in progress. I often think that this is as much art as science. I routinely edit my profile, including my basal rates, correction factor and carb ratios. I adjust for seasonal changes in my blood sugars, changes in exercise, and most often to correct often unexplained changes is the patterns of blood glucose levels. I answered a couple of times per month. There is no regular frequency to the adjustments made.
That was strangely reassuring.
As needed which works out to a few times a year.
Before moving to the Dexcom-Tandem combo 6 months ago I would make adjustments maybe 2-3 times in 6 months. But I haven’t made any adjustments since that transition.
I started Omnipod Dash in mid-December 2021. I’m close to having it zeroed in, but still tweaking a bit.
Actual answer is “as needed”
AAARRGGHHH! The limitations of multiple choice! This past week, I have have changed my I:C ratios because of higher BG’s. Last week, I tweaked some of my basal rates. Prior to that, weeks and months can go by with no changes needed. I closely monitor my glucose levels and when a change is needed (as it inevitably will with diabetes) to achieve tighter glucose control, I make those changes. My goal has been to keep my A1c in the low 6’s. My last one was 6.1. and my time in range is in the 90%’s.
The wording of this question is an issue. ” Typically” doesn’t relate to reality. My correct answer would be “as needed”.
As needed should be an option here. As others have mentioned. It varies based on life and circumstance that are constantly changing.
I chose twice per month but like everything else with diabetes, it just depends on what’s going on with my life. I usually adjust the time or dosage of my basal, but don’t normally change anything else.
I would have chosen “as needed” if that was an option
My settings stayed stable until 2 years ago (had the pump 3 years?), wasn’t until October’s incident I needed any changes (increased the basal, adjusted the “insulin to carb” ratio). In January completely changed my diet and made minor adjustments since.
I clicked “2-3” times but am wondering it whatever caused the changes 2 years ago might reverse?
Not very often, I’ve got it all pretty well dialed in, but is the question asking if I rely on a Dr for advice about doing it? Nope. If I need to, I just change it.
I am not comfortable with changing these in my own. I am afraid I’ll screw up and wake up dead! I prefer to do it with my endo instructing me what to change to after she views my charts reports on Dexcom and Glooko.
I think my standard basal rates and associated insulin-to-carb ratios are actually the same for at least most of the 24 hours as they were 24 years ago, but I do change out of it to one of the 4 other profiles I have programmed into my tandem x2. Have to remember to change back when return to normal from whatever has caused a change, and temp basal was really useful on my previous pump. Though I do really appreciate the ratio being programmed along with the basal, because those needs do usually change together. I answered a couple times a month as an average, but that doesn’t describe the variation: can go for months without changing, then be changing frequently. I think I changed the programming a couple times when I first got the pump, and tweaked it again once after a year or so later.
I answered with “every few months”, but there was not a choice to say “as needed”. Whenever an adjustment is warranted by my blood sugars and control, I do the pump adjustment myself.
I agree with so many of answers that say, “as needed.” Too bad it wasn’t an option. So, I guessed and said 2-3 times a year.
There is no given answer that covers my case. I change basal rates when my blood sugar rises and drops when I’m not eating anything. Sometimes that doesn’t happen for 2 or 3 or 4 years; sometimes it happens weekly for a few months in a row. It most frequently happens to me a few weeks after shifting between standard time and summer time.
Took a guess at 2-3 times a year. Maybe more than that. I change things when they need to be changed.
But for temporary basals, I change rates less than once a year. I do use temp basals several times a year for some foods like pizza or french fries.
It depends on whether I need to or not… If there have been changes in my eating habits, in my work or exercise habits, etc. If I’m seeing a negative trend in my BG readings…. I correct it by making adjustments to the insulin settings. So, to answer your question it has been anywhere from once to multiple times in a year… It just depends on other variables.
I’m another T1D that would have answered “As needed”
I think this is an excellent question. If one of the answers was “as needed” it would not have forced people to think about what that actually looks like in practice. The answers reveal a huge spread.
As someone who is forced to make changes often more than once a week for no reason at all, it’s interesting to see that 75% of respondents change their dosing settings once a month or less; and almost 50% of respondents change their dosage settings a couple of times per year or less.
It would also be interesting to know how large these changes are. Sometimes I have to take 10u of bolus with a meal for a week and then it will be 30u the next week, for the same carbs, same time of day, same routine/exercise, same basal, no illness, etc. etc. I am pretty sure this is extreme but it’s very hard to get any data on it.
This is an interesting question, and more interesting answers. I been T1D for 20 years, and use very flexible insulins with MDI. I modify basal doses almost daily to adjust for monthly female hormones and activity levels. I love being able to use my results to inform my dosing decisions, and modify frequently to get them to align. My last A1c was 5.2% and 18 SD.
As needed, though perhaps not as aggressively as I should.
For us long time T1D’s (55 years) and on a Pump and a CGM system, I have no Virgin sites left. So, most of the time after a “Q” Set change, I wait one day then change the Basels. However, never more then 20% at a time. As all you should realize the Diabetes Researchers really don’t want to hear from us Senior.
Change it whenever my life style changes ie for a vacation with much more exercise, etc.