Learning Curve

When attempting anything new or remotely new there is a learning curve.  That is what my first week back to MDI’s has provided.  I made it through the week with minor bumps and lumps, (literally lumps from the injections) and am still trying to smooth out the wrinkles.  I counted on having a few weeks of fine tuning and I am reminding myself daily to not be so hard on myself, that this will not be a perfect journey, but as long as I’m giving it my best effort hopefully all will work out in the end. 

I’ve conducted a few experiments on myself this week; the first experiment being timing and splitting dosages of my long acting insulin, Levemir.  I was told my by MD to split the dose into 2, 1 AM and 1 PM.  I did try that but long acting insulin doesn’t last as long during sleeping states and your body also encounters the dawn phenomenon which drastically eats your insulin like a ravenous bear.  The 12 hour split resulted in higher morning readings.  Therefore I tried splitting my long acting into 3 dosages, 1 in the morning, 1 at about 9PM and 1 at 2AM.  This seems to work a little better, however I still think that the actual amount I’m injecting may need to be adjusted.

The second experiment was with the times that I am eating.   I’ve found that any type of snack after dinner, not that I’ve really needed it but it seems to be the hardest time NOT to snack, is disturbing my sugar levels all night even if I am bolusing for it.  I suppose having food sitting in my stomach at bed time is going to be a no go from here on out.  The funny thing is, growing up T1D, the doctors shove the bed time snack down your throat, like you might die if you don’t eat it.  Well, as we see here that’s not the case.  In fact, I’d be better off 95% of the time without it.

The third experiment was pre-meal boluses.  I decided on the days that time permitted to try using the Regular insulin.  This does match the break-down of protein into glucose much better than Humalog insulin.  In fact the difference is quite amazing.

When I was using my insulin pump I would have numerous low blood sugar incidences each week.  This week, I had ONE!  It was pre-dinner and the reading was 56. 

Besides all of my little experiments, it has become even more evident just how much stress, whether good or bad, impacts blood sugar.  This week, on top of starting a new insulin regime, I started a new job.  I do feel that this could have very well impacted my sugars running slightly higher than I anticipated.

I have adjusted some of my rates.  Last week I started with using 20 units of Levemir per day and now I’m using 23 units per day.  My Humalog and Regular insulin bolus ratios have stayed the same, 1unit:6carbs.  

The only thing that I am unsure about at this moment are the "lumps" I referred to in the 1st paragraph.  My long acting insulin is causing some injection site swelling and a lump feeling under my skin, in some cases for more than 24 hours.  I am hoping that this will dissipate with time as my body adjusts to the medication??  But I just don't know honestly what will happen with the Levemir issue.  I find that injecting it in my legs causes greater reactions than if injected in my buttocks or arm.  Strange!!   

Besides that one issue, I'd consider week 1 a success.

Thanks for reading!

~D