Hi everyone,
Been trying to learn how to use features on tandem pump particularly when I run high after meals. For the past few days my BG after meals shoots up into the low to mid 200’s even when I think I’ve counted carbs correctly. It seems to stay high for 2-4 hours which I think is too long? Do you ever add your own manual correction along with control IQ? Thanks.
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Only if I knew I’ve miss-counted my carbs - realized after the fact that I used too small a quantity, or I added something that I didn’t bolus for at the time. If it happens regularly and you’ve ruled out anything else, you may need to change your carb ratio.
Fatty foods can also cause a delayed spike - an extended bolus can help with that.
Be sure to work with your doctor since you’re new.
Diane @DFBB, I may start a “manual correct Bolus”, but ONLY after checking the pump history to see if and when, how much of an automatic correction [CIQ] has been delivered. Always be cautious when doing a system override with a manual correction.
As Dorie @wadawabbit mentioned, higher fat content meals may need additional insulin a few hours after the meal - more insulin than what was calculated for carb count. For instance, last week when eating at a restaurant, there was way more cheese than I usually might eat in a meal, and I knew if I included insulin, even in an extended bolus, what I thought would cover the cheese, I didn’t dare taking that total dose knowing that my already BGL [around mg/dl] would drop too low long before the cheese began its effect; I did a nanual correction a few hours later.
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Hi @DFBB. In my experience, extended highs of that length are almost always due to poor absorption at the infusion site. I do give correction boluses, but they won’t fix a bad site. If I stay high for an abnormal time, for me that would be over 3-5 hours, I change the infusion site. In case you’re not aware, you can insert a new site, then connect the tubing from the suspected bad site, and do Load->Fill Cannula. That way you don’t waste the insulin in the tube. Best wishes, Mike
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Thank you all so very much for sharing your thoughts and wisdom, this forum is so helpful in navigating T1. I really learn so much and feel more competent to make some of my own treatment decisions.
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Like Dennis said high fat and even occasionally super high protein meals will cause me to spike my BGL several hours after a meal. I did not know this was happening to me prior to wearing a g6 sensor. I know have learned to bolus a correction amount about 3 hrs after my meal. If i take that amount at the time of the meal i will drop low before all the carbs process and have to correct for a low to then get a big spike about 3 hours later. You will have to figure your body’s timing out but this is a very common issue. The great thing is that you can use all the tandem software to help you figure out when you do need to correct. I keep a small notebook with indo like this and info on my insulin requirements when i am ill to reference at later dates. You will find that many of lifes changes can affect your insulin requirements.
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Infusion sites make a definite difference. I’ve had it where I didn’t give any bolus with some sites. Still went low. Not an exact science, but that’s the way it goes. Much better than it was 50 years ago.