1. Use the Aviva Expert meter- which means I really count my carbs (as opposed to my "eye ball" method I have discussed in previous posts), because I have to enter that info into the meter for it to spit out it's recommended insulin dosage to cover my meal. I thought at first it seemed a little silly. I'm able to figure out the math in my head, since my ratio is 1 unit of insulin for every 20 grams of carbs I take in. As it turns out, the meter is really helpful when making a correction a couple of hours after taking insulin if my blood sugars are still running a little (or a lot) high. The meter knows how much insulin is still "on board" and can calculate a good dosage for me to get my blood sugar in my target range safely.
2. Switch to the NovoPen Echo- so I can give my shots in 1/2 unit increments.
Type 1 diabetes is very much a self managed condition when you get down to it. I have- and will- absolutely try implementing whatever my doctor suggests, but I thought of a few other things to implement to further tighten my control:
1. Reducing carbs. I don't eat a ton of carbs anyway, but I know the less I can eat, the better. So little by little, I keep peeling away at how much I feel like I must have. I think having to document all that I consume really motivates me to reduce my consumption!
2. I'm taking my Lantus (long acting/non-peaking insulin) in the morning now instead of at night. I was having so many lows during the night. I learned at the Type One Nation weekend that although Lantus lasts for 24 hours, it tapers off and you get a slightly larger percentage of it during the first 12 hours. This change has helped my lows somewhat during the early morning hours. Sometimes I don't even have to eat a snack before bedtime! And honestly, sometimes that makes me sad. Ha!
3. I've been (usually) taking my insulin a good 30 minutes before eating my meal. Sometimes even more if my blood sugar is high.
Over the last few weeks, since making these changes, I've noticed only a subtle change in my blood sugars- I'd say reducing carbs is the most impactful thing I know to do right now. I wish I didn't love them so much and could just give them up completely. Sometimes my stomach just feels like it needs a little bread, or a cracker... And then what about fruit? How can I give that up? Do I have to? Would I want to? My head and my heart and my stomach are all telling me "No! Please, no!" And I'm listening... at least for now.
My biggest challenge currently seems to be my night time blood sugars. Unless I go to bed with them a little high (150-180), I still often wake up by 3am with my Dexcom beeping at me because my bs is below 60. I am sick of 3am snacks!!! It's funny, when I first switched my Lantas shot from 10pm to 10 am, I thought I had solved the problem. But after about a week, I went right back to the early morning blood sugar dips. I think it might be slightly less of a dip, but it's still problematic.
My appointment is tomorrow, so I'm excited to see what's next!