Is this bad?
I’m assuming the high yellow starts at 200?
And the red low starts at 70 or 80?
Welcome to the forum by the way!
Range is 70-180mg/dL. Low starts at 69, high 181
Thank you for the warm welcome. I hope to learn a lot here and learn to remember to bolus and relearn carb counting.
Welcome to the forum!
Believe it is more of a personal goal than what others think. However there can be value in learning what others focus on and their management goals. For me I have an in range goal of 95%, at a 180/70 range, and a average goal in 120s.
@pphatphantomofunderw Welcome lo to the JDRF TypeOneNation Community Forum!
A graph or a grouping of numbers is neither good nor bad; in this case displaying someone’s body glucose levels over a period of time is nothing more than a display or presentation. In my eyes, these values are noting more than guideposts providing information.
As has been pointed out here already, we each can set values of “high” and “low” as our goals - for instance, my Dexcom Trange is about 65% of international standards. The real question(s) is/are, are you satisfied with this result, and if not, what are you doing about the this. Personally, I like to challenge myself.
Honestly I’m not sure how to feel. I have so much self-doubt about this.
Hi @pphatphantomofunderw and welcome to the forum. Are you new to diabetes - newly diagnosed? There are ranges that are recommended, and going too far below can affect your ability to function and cause loss of consciousness fairly quickly; while going too far above can result in long-term complications, not to mention DKA, which can be life threatening. But it’s not like a switch is automatically flipped if you hit the bottom or top number, and according to the statement below - taken from The Big Picture: Checking Your Blood Glucose | ADA -
Blood glucose targets are individualized based on:
- duration of diabetes
- age/life expectancy
- conditions a person may have
- cardiovascular disease or diabetes complications
- hypoglycemia unawareness
- individual patient considerations
Your doctor can help you determine the range that will work best for you given your considerations, and you can and should use your graphs as a guide to see how your body responds to foods, doses, exercise, etc., and to show trends that may mean you need to make some adjustments. If you’re new you should work closely with your endo and nurse educator to make changes, but over time you may learn to make them on your own.
I highly recommend you check out the book Think Like a Pancreas by Gary Scheiner. He has diabetes and works in the field so has a unique personal perspective that is particularly helpful.
Again, welcome to the forum and I’m looking forward to your contributions.
I’m not newly diagnosed but new to prebolusing. In the past I would use corrections and would often (>1 occurrence) go low. I use a t:slim and was not taught all the features like sleep mode or exercise mode or even using different dosing ratios. On Tuesday I was ready to go back to mdi. I decided to look for peer support groups and find resources in this method. I asked the trainer and my medical team a myriad of questions numerous times.
hello @pphatphantomofunderw welcome to T1N. The general forum rule is we cannot give medical advice, so I wont, but I will tell you about my story and what I do. Your experience will be different than mine.
In my experience with T1, I can’t depend on a doctor for real-time assistance because blood sugar support needs immediate action and there isn’t a good way to get this kind of support. I hear you, it is good that you are not newly diagnosed, because that means you have experience with T1. When I got my first pump I blindly followed the pump trainer and endo recommendations for my initial pump settings and my blood sugar went to 300+ immediately. I nearly threw the brand-new pump out a window. I decided to give the pump 1 year, so I had a deadline, and I also committed to 100% effort in pumping that way I could do a real evaluation without emotion.
here’s my observations; a pump isn’t anything but a fancy syringe. whatever you were doing on MDI you can do with a pump and it’ll be exactly the same. that’s where I started. I knew I needed 8 units for a meal, so if the “bolus calculator” . says 4 units, I know it is wrong.
the beauty of programmable basal. I started using a pump because I could never get a shot of long acting correct. My go-to strategy was a little too much lantus, that way I’d be good overnight and I would definitely have to eat and add carbs during the day. Job number one is getting the basal rate down right. Even if the pump is an AID, programming your basal rate is still the biggest important thing. I bought 2 books, “Think Like a Pancreas”, and “Pumping Insulin” the books outlined how to test basal and that’s how I did it… myself… and after about 3 months I was really happy with my basal rates. I didn’t have a CGM at the time so I burned through many test strips, but in 3 months I was good to go. AZfter basal, I tested my ratios and my sensitivities… after that, things settled down to a nice, predictable alternate to MDI for me.
Tandem isn’t going to tell you how to pre-bolus. to tell you the truth, pre bolusing can get me in trouble and I rarely do it unless it’s Halloween and I am fixing to eat candy. Or a birthday and the cake looks really good. For me, I use my pump and pre bolus for an estimated amount of carbs… I wait 15 minutes or if I see the first sign of my CGM dropping and then I eat. Again, I only do this for “fast carbs” and for me it is super rare. Most of my meals are mixed carbs (fat + carbs) so I specifically do not pre bolus because fats slow down carb absorption. depending on the meal I either bolus as I am eating or if it is a higher fat meal, I bolus afterwards and I use “extended bolus” (whatever your pump calls it).
you have to know your meals and if there is a lot of fat, how your body reacts to that kind of meal. (for me, a lot of fat is a steak, or pizza, or a really good tomato sauce)
you are already an expert on your own - you survived as many years with T1, so that’s my proof, if you were bad at it you would not be here to talk about it. Now you are learning new tech and it can be frustrating. It can also be great. I wish yhou good luck and please check in and tell us about it.
Let me repeat what everyone on this forum will tell you- get yourself a copy of thinking like a pancreas. It’s an enormously helpful book and has a lot about prebolusing, carb counting, information about how different types of food affect bgs, basal rates, etc. Taking control of your diabetes (.org) also has resources about this stuff. If you haven’t already, get your hands on your tandem pump’s user manual and read it all the way through. You’ll likely find a lot of boring info as well as a lot of super helpful information. Learn the ins and outs of your pump. Tandem also has a YouTube channel with videos that highlight certain features such as sleep mode or exercise mode and general suggestions on how to use them.
@joe mentioned that he rarely pre boluses- in my case, I eat more carb heavy (vs protein or fat heavy) foods and I’ve found that I really do need to pre bolus about 10-15 minutes ahead of time for optimal results. That being said I don’t always do that (sometimes I’m lazy, or forget, or don’t have the time, or because of where my BG is or what I’m eating decide that prebolusing is unnecessary). Neither of us are wrong in our approaches, our bodies and lifestyles are just different.
For carb counting stuff- do you have access to a nutritionalist? What are you having trouble with in this area?
I kind of lost confidence with a lot of this pump, insulin and carb counting among other related things. I’ve recently rebooted my confidence last week but estimating carbs is not there yet.
Simply put, I was overwhelmed to the point of a breakdown.
There are a number of good resources for carb counting. I use Glooko now (not my favorite for carb tracking) and Sugarmate and MySugr are popular free ones. MyNet Diary was my favorite but had an annual subscription after a trial period. A nutritionist can help you with shortcuts for measuring.
The key to diabetes is to use instructions as a starting point, but learn what works best for your body. As someone mentioned we can’t give medical advice - only suggestions to try - but if pre-bolusing sends you low, wait until you’ve started eating - or don’t bolus as far ahead. You may even find that bolusing ahead works with some foods and not others, so watch for patterns.
Hi @ [pphatphantomofunderw,
Welcome to the group! I have my settings the same as yours. For me, this graph shows more highs than I would want in a 24 hour period. That said, at least they are not in the 300"s or above! Personally, I would be looking to get the majority of my readings in the mid-range of the gray area on the graph, but that’s me.
T1D 58.11 years and counting!
Oh, and I forgot to mention that my target is to eat between 20-25 carbs per meal (counting fiber as a half carb). I’m new to diabetes so on MDI and find carb counting to be a guessing game that comes with lots of peaks and valley’s. Instead have found foods that make it easy for me to count carbs and meet my goals. Maybe someday I’ll be an expert at counting carbs to eat whatever I want whenever I want it, but feel that day is far away. So instead I choose the option that makes this disease easier for me to manage. At least until I find new ways to make living with this better.
I totally get that overwhelmed feeling- I went through a similar period where I just wanted to throw my pump into the ocean and never see it again. Diabetes and carbs and pumps and everything it all entails is…. A LOT. Learning to carb count takes a lot of time and practice, loads of trial and error. But keep preservering- you’ll get the hang of it!
For foods you eat frequently you could make yourself a cheat sheet and stick it to your fridge (or other obvious spot). Like if you drink a lot of milk or love chocolate chip cookies you could write those down on there and post the sheet where it’s easy to find.
You can also write the carb count of one serving on the front of a box of food- you can decide how big the serving is and using the carb nutritional info on the box calculate the carb count in your customized serving size. Sometimes the company’s serving size is totally different than what a normal human being really eats.
If you haven’t already, you should download the calorie king app- they have all sorts of food from many restaurants, fast food chains, and general nutritional info (for example I went to chick fil a the other day and looked up their small waffle fries on calorie king app. Then this morning I was at a friends house and needed to find the carb count for grapes- “1 cup = 16 carbs”). They don’t have every single food on there but they’re pretty darn close. Sometimes there’s still some guesstimating (how big is “one spring roll?”) but the app helps a lot.
Basically get good at carb counting the normal stuff you eat before venturing out into the land of restaurants and craziness. Of course this may not always be possible but if you are at a restaurant you can try to order familiar things- I’ve gotten pretty good at counting chicken strips and fries or ceasar salad, which nearly every restaurant has. Carb guesstimating is tricky and everyone can improve here.
In my experience with carb counting I’ve found that sometimes my body needs more insulin than my calculations would say. For example if I’m eating pasta I always need to add on an extra unit or two of insulin to avoid going super high. This is one of those things that you start noticing and adjusting for over time- for now stick to carb counts.
I will add that I don’t restrict my carb count like other diabetics do, and never had. I don’t eat over 100 carbs per meal but other than that I don’t have a strict rule of fewer than 50 carbs or something. Everyone does stuff differently. I have found that eating a balanced meal with carbs as well as some protein and fat does help avoid those highs afterwards since the protein/fat help slow down the faster carbs and prevent spikes (as much as possible- they still do happen)
Also after eating it’s normal for your blood sugar to rise a bit but after 2 hours your blood sugars should be back in range/close to where you were when you began eating. So like if I eat breakfast and my BG is 127, it’s completely normal to see a rise to around 200 and then a decline back down to 105. You want to avoid the super high, quick spikes but don’t freak out if your BG drifts up a little after eating as long as it comes back down later. If your blood sugar doesn’t come down within 3-4 hours after eating, that may be a sign that you need to adjust your insulin:carb ratio or maybe your carb counting needs some help.
Wow that’s impressive. What’s a normal meal like for you?
I was petrified of eating new stuff when I was diagnosed. I ate the exact same things for a while until I felt confident enough (or my parents forced me) to eat new stuff. It’s going to be a few more years before I’ll be able to eat English muffins again. The control aspect is huge. If it makes you feel comfortable and you like how your BG is responding, then keep doing it. But just be careful not to get yourself stuck in a place where you’re too afraid to eat anything new because you like your system too much.
You’re right- carb counting is hard. I don’t think anyone can really call themselves an expert carb counter. But I think the day that you get good at counting carbs is closer than you think!
I typically eat homemade foods but I don’t prepare them. Often ingredients are added without measuring.
Lo @pphatphantomofunderw, what I hadn’t mentioned before in my comment about “is this bad”, is that this graph indicates to me that you have good management skills. Look at the 24-hour range of the readings - between 150 and 230 - indicating to me that you are well regulated. I’m guessing that over an extended period, if this graph is your typical day, that your standard deviation (SD) which I hold to be the best gauge is below 30 and, your Coefficient of Variation is about 25% - awesome!
In discussions I’ve had with diabetes scientists and researchers, it appears that people with long-term diabetes whose BGL did not fluctuate “too much” appear to be healthier. If your concern is that your stable range of BGL readings is too high, I suggest that you attempt to get a lower starting point - if you can’t do this on your own, consult a professional.
This leads to your discussion about “pre-bolus”. If your before meal BGL is close to your target level, with CIQ at 110 mg/dl, you may not need to begin meal-time bolus before eating; a personal concern here is “how low” can you go and still feel comfortable. The only time I take a bolus early is I’m way too high for my liking; my choice is that sometime before I plan to eat and my BGL is stuck, and not sinking, above 125, I will do a manual correction.