Hi Becky, I’m glad you’re enjoying this thread ! It sounds like you’ve learned a lot in just a few years about what works for you and that’s great. Although I’m in love with my CGM (can one love a medical device, lol?) I’ve found them unreliable for the first 24 hours of wear- so I supplement with fingerstick readings during that time period. I started with the original 10 day Freestyle Libre in 2017, then the Libre 14 day, then the Libre 2, and currently the Dexcom G7. ALL have been inaccurate for the first 24 hours, then get much more accurate for the remaining days (13 for Libre, 9 for Dexcom). The good thing about Dexcom is you can calibrate it, which definitely increases accuracy. Remember too that CGMs measure interstitial fluid, not blood- and that the CGMs lag blood sugar numbers by about 10 minutes. I don’t expect the numbers to match- they almost never do, and that’s okay, because they’re sufficiently close starting on the 2nd day (taking into account lag time). So, I’m finger pricking FAR less than I would otherwise, and getting trend info and alarms when I go low during sleep- which is invaluable !!
Jess- Keep in mind that Walmart sells its own brand of glucometers & test strips (under the brand name Relion) and they’re MUCH less expensive than most brands- plus you won’t need a prescription for them. That might solve the problem with your insurer not covering a CGM and test strips. I use the Relion brand myself and they seem as accurate as any other brand. A CGM should never be painful to wear. A needle is inserted initially but only a small, thin flexible wire is left embedded in the skin. If/when you try a CGM again, be sure you’re applying it into a fleshy part of your arm and avoid insertion into muscle or bone. If your arms are very muscular, you may need to try wearing a CGM somewhere else such as your tummy. The Dexcom G7 is only approved to wear on the arms in the USA- but is approved for the arms and the stomach in Europe- because in Europe both sites were tested, while in the USA only the arms were tested.
Hope this post wasn’t too long to read- have a good night, everybody!
-Joanne
Hi Joanne.
I’ve lived with T1D for 50 years and am on MDI.
I’ve been quite active over that time, but have also come close to death on numerous occasions. The best thing for me has been the CGM. I’ve had the Dexcom G6 for a couple of years now and it’s been a life changer.
For all those using MDI, do you have a good way to rotate your injections? Because I eat frequently throughout the day, I am injecting a lot. I don’t mind that as I feel like it keeps my BS stable, but don’t to develop areas where the insulin won’t absorb well (there’s a technical term for that but i don’t remember what it is!).
Greg, you mention that running also drops your BS quickly. How do you handle this aside from having quick sugar with you? (I carry smarties or candy corn). Sometimes I try to start higher (around 150 or 160?) but is seems like maybe there’s a better way… If I run first thing in the morning before eating or injecting any insulin my BS goes UP, so that doesn’t really work for me.
Thanks Joanne for sharing your experience and advice! I’m glad it works so well for you. Not having to finger stick so much is super nice. Onward, T1D soldier…
Happy to share Becky, it makes T1D feel a bit less lonely. I never thought of myself as a soldier- I like that analogy .
Jess- I looked up that term as I couldn’t remember it either, its called Lipohypertrophy. This info from JDRF might help you with rotation: Insulin Injection Techniques and Tips - JDRF
7 injections a day is an awful lot. That many shouldn’t be necessary. Keep in mind that dosing is more art than science. Try speaking to your Dr. about this- then make small adjustments as necessary, if you’re comfortable doing that. A larger dose of basal might reduce the number of injections needed - just a thought.
Alex- Would you mind sharing your insulin regimen (types taken & frequency), for comparison purposes ?
In regards to Jess–imo, 7 injections per day isn’t a lot. I do two for Lantus, and I only eat two meals per day no snacking, and I still average around 6 injections per day. This number goes up or down depending on how well I get my meal bolus right as well as on what I’m eating that day.
There’s also the fact that I know for some meals I need an extended bolus, which for a large carb meal requires insulin to be spread out over two or three injections, otherwise taking too much at the outset will make me go low in the short-term and then shoot up hours later. Bread and pasta, for whatever reason for my own body, also require an extended bolus no matter what, with 1 pre-meal, a bit of insulin 90 minutes later, and a little bit more 2.5 hours later.
So my usual per day is two injections of Lantus, then anywhere from four to eight injections for boluses (including pre-bolus and extended bolus) and for corrections. To me, seven injections is totally normal.
Also, a larger dose of basal can really drop your blood sugar, and keep bringing it down all day and overnight, neither of which are good options, imo. So be careful with that. My own strategy is the opposite–do the least amount of Lantus I think I need (usually 6.5-7 units per day), so my blood sugar doesn’t keep getting unnecessarily pulled down by too much of it, then if I’m a little higher than normal for whatever reason, correct with short acting. I’ve taken too much Lantus, and on days I do, it’s miserable, b/c I keep having to buffer my glucose w/ sugar, and I feel like crap b/c my body keeps sensing that I’m trending low.
Becky, I’m going to make a suggestion here. You might consider a different approach to the two meals/day. If you only want to eat two meals each day, they should be breakfast and lunch, not lunch and dinner. Has everything to do with circadian rhythm and your body’s metabolism over the course of a day.
Hi Everybody- We seem to have a helpful conversation happening here. I’d like to try to get a once-per-month Zoom call set up for T1Ds on MDI. Please email me if you’re interested in participating.
My email is jomc348@gmail.com
Thanks, Joanne
Jess, I usually will eat carbs before hand. Knowing it will drop, I’ll try to eat something maybe 15 minutes before I start a run. But, I try to start the run with BS of like 130-150 mg.
Becky, it sounds like we use the same approach. It works for me to split doses at times, depending on the foods I am eating. It seems the curve of the insulin release is never going to match the curve of the carbs being processed exactly, but this seems to help!
Staci, I know just how you feel. Just turned 60 in January. Diagnosed LADA/Type 1 last September after being diagnosed Type 2 in January 2018 (on my birthday, sadly). I take Lispro & Tresiba insulin & had my doses pretty well figured out. Now after Valentine’s Day, these dosages have seemed to changed (needing insulin for breakfast & lunch when I previously didn’t, if I ate low carb). The constant changes wear on me mentally, as I also have health anxiety. The answers I get from my endo & dietician are something like “that’s just type 1 diabetes”.
Hi Joanne, I wasn’t diagnosed as type 1 until last September. I take MDI (Lispro & Tresiba). My endo is really pushing me to go on a Tandem pump, but I don’t want to. To me, it seems that taking insulin with my pens is easier, as I have needle phobia, and think I would have trouble changing out an infusion set every 2-3 days.
Hi Sherry, Many people seem to prefer ‘pumping’, but I’m very well-controlled with MDI so have resisted a change to the pump. It’s also very hard to find a truly knowledgeable endo who will listen to their patients.
Since you prefer using pens, don’t let your endo push you to change to pumping unless/until you agree that the change makes sense for you. You were diagnosed so recently; it’ll take awhile to get used to managing T1D- and it’s never gets easy- but it does get a little easier/more familiar. You do need to listen to your body and be willing to adjust insulin dosing when needed.
You are using a CGM I hope ?
I put a question on this thread awhile back to see if people on MDI would be interested in Zoom meetings, but didn’t get much response. If you (or anyone else reading) anyone IS interested, please let me know.
The past few days I’ve been on the blood sugar rollercoaster ride. It happens every time I try to eat just a part of a desert and think I’m dosing enough insulin. My chart last Friday was the worst one I had seen on my Libre account since right after I was diagnosed in September of last year.
Hi Sherri, I know it’s easier said than done but try not to get down. Even after 51 years with T1D, I still struggle with unexpected highs & lows any time I’m off of my regular routine (which is not travelling, eating similar meals at the same time, and not sick). Even a mild cold will send glucose numbers way up. I’ve read that only about 25% of diabetics meet the clinical goals for “good control”, meaning glucose in the range of 70-180 70% of the time. This is a VERY difficult disease to manage.
For the majority of my time as a T1D I was measuring glucose first by testing urine (which was very inaccurate in the bad old days of the 1970s) & then finger pricking (more accurate but painful). I literally thank G_d & the scientists every day for inventing CGMs. They’re not perfect, but SO MUCH better than only finger pricking.
As I mentioned, try brisk walking after eating any carb-heavy meal or dessert (along with your insulin of course)- it should help a bit. Reach back whenever you want to chat or have questions.
-Joanne
Thank you for all your help, Joanne. I was doing finger sticks twice a day when it was thought I was type 2. Yes, I can’t imagine what everyone like yourself, has had to go through in dealing with this disease. I guess if anything, I try to think that at least I was diagnosed later in life, and the advancements in treatment are so much better than when my Dad was alive. He was diagnosed in the early 1950’s at age 7.
Joanne, I’m now using my fifth pump but I never thought such use of a pump has ever been a “NEED”. For me, I chose my first pump for the convenience it afforded, especially when traveling even though what is now referred to as MDI afforded more efficient diabetes management.
I relied on MDI for 30 years, beginning mud 1970s while developing the theorem / formula while inturpreting “shades of green” on BS strips - a CGM or even a digital BGM would have been wonderful, if available.
Oh, living with diabetes for only 67 years.
Hi Dennis, Thanks for the feedback. I’ve always thought the main benefit of a pump was improved control. Since I’m typically in range (70-180) 90% of the time, and I know obtaining pump supplies will require use of a medical supply company versus pharmacy (I’ve had poor experiences getting my CGM supplies through DME companies); it doesn’t seem worth the effort to make the change. The fact that I live in a rural area without great diabetes medical care is another hurdle.
67 years- good for you, stay healthy!
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