[jlconrod]

  SiDiary 5 and SiDiary Beta 6 En Help me manage ICT and "Brittle" Type I

Note:  This post was a reply to Joerg in SiDiary > Beta-Tester Stammtisch > SiDiary Beta 6, http://www.forum.diabetesinfo.de/forum/index.php/topic,5463.msg151384.html#msg151384.  That Forum thread is in German, so I'm also posting this in SiDiary English.  The comments apply to both SiDiary 5 and SiDiary Beta 6.  --John

(snip)

  With often brittle, sometimes Insulin-resistant Type I (for almost 40 years), using ICT, my control is a constantly moving target.  I test 4-6 times a day, and balance insulin intake against current BG.  In the U.S. this used to be called "Rainbow" coverage.  I have used the Rainbow method with good effect these many years.

My practice is to test BG upon arising, followed by a "Rainbow" Bolus or Correction Bolus+Bolus (R) and a longer acting Basal (NPH).  Depending on the BG, I eat a modest meal (laughingly called Breakfast).  In the case of high or x-high values, "Breakfast" is delayed an appropriate interval for the Bolus to take effect.

I next test 4 - 5 hours after the "AM" (arising) BG.  I adjust the next meal ("Lunch") based on the BG, eating more if lower, less if higher.  When I used Apidra, I could take a "Booster" if needed at Lunch.

4-5 hours after Lunch, I test again, followed by a Bolus or Correction Bolus+Bolus, as needed.  As with Lunch, the timing of my Dinner meal depends on Dinner BG level.

Finally, late evening or early AM (I'm a night owl!), I do another BG, followed by a combination Bolus (R) plus Basal (NPH).  Depending on BG, again, after an adjustable time period, I have a light Bedtime Snack.  The Bolus R covers the Snack, the Snack carries me through the night helping to reduce the chance of nighttime Hypo while sleeping, and the Basal NPH helps control Dawn Phenomenon.

If any of the AM, Mid-day, or Dinner BGs are extremely high, I'll do an extra BG test a couple of hours after the insulin dosage, before eating.

I try to keep BG levels 70 - 130 mg/dl, though with the brittleness, I more often use Bolus corrections to try to nudge BGs closer to normal.  Because the expense of testing materials is out-of-pocket for me, I haven't been able to use the PP feature of SiDiary.

Except while sleeping, eating every 4 to 4.5 hours an appropriate amount has helped me prevent most complications and keeps A1c closer to an acceptable level.

This is only to share my personal experience, not an attempt to influence you or anyone else on the Forum.

  SiDiary 5 and Beta 6 En have been incredibly helpful in analyzing all the Log Book info over time, especially since I can track multiple longer-term time frames.  I use these data to continue to refine my self-management.

  Thanks again to you (Joerg), Alf, the Forum, and Sinovo for an increasingly useful -- and easy to use -- tool!

Warm personal regards,  John


P.S.:  The 4-5 hour time interval I used is essentially the active duration of the Bolus R insulin.  My computer career sometimes meant rotating shifts (difficult for Diabetes), or "all-nighters".  My "day" starts when I wake up, BG test ASAP (as soon as practical), meal after a "rainbow" period, then repeat every 4-6 hours as needed.  The final BG and snack are then "Bedtime".

It was and is an unorthodox approach -- but it worked and still works -- after an extended period of "debugging" ...