Nurse Jaki Johnson, CDE thinks one of the best ways a person with diabetes can become more knowledgeable about his or her diabetes is by observing patterns. Fortunately, there is no shortage of opportunities to analyze diabetes data.
Using data to make minor adjustments is one way that patients can become more involved in their diabetes care, Johnson said. Feeling a sense of ownership and control is very powerful for people with diabetes.
Here are Nurse Jaki’s words of wisdom for changing your own pump settings/insulin dosing:
1) Look for patterns in your blood sugars over a long period of time, at least 3 days, but a week or more is better. Are you having lows at the same time each day? Or always having high blood sugars 3 hours after dinner?
2) Once you find a pattern, think critically about what might be causing it. Remember that insulin takes 3 hours to work, so if you have a low blood sugar 6 hours after an insulin dose, it is not likely because of that dose, but if you have a low 2 hours after the dose, then it likely is because of that dose. Do you think it is the insulin for carbs causing the lows? Do you think maybe you need more insulin to correct high blood sugars because they just aren't coming down well after 3 hours? Are you having low blood sugars when you skip a meal? (that could be caused by the basal rate being too high)
3) When you've found the cause, then you can make a change to that setting. Try to make changes only 10% up or down at a time and make just one change at a time. After you make the change, observe how your blood sugars do over the next 3-7 days. Did the change work? Was it too strong or too weak? If after at least 3 days you still see a pattern of lows or highs, you can make another change, again try only 10% at a time.
4) Remember it is always better to change your settings than to change individual doses. If you keep seeing lows after dinner, don't just start entering less carbs for dinner or manually change the doses to be lower. You should change the actual carb ratio at dinner so that way everything is consistent and makes sense both to you and to your doctor or CDE.
If you want to learn more about how to adjust your own pump settings or insulin doses, please call 212-851-5494 to schedule a video visit with a certified diabetes educator who can walk you through it all step-by-step.