When I look back in a few months time I suspect I will think to myself that this was just a bit of bad timing. That of course this was going to be a struggle at this time of year with the variety of 'unusual' seasonal meals adding a lot of confusion to the early days.
My first few days with the Accu-Chek Expert have not been easy. So much so that I was tempted to give the whole thing up on day 3. But the funny thing is I can feel myself wanting it to work so much. To be able to abdicate this responsibility of constantly holding all those threads in my mind. What has been injected, how long ago, what has been eaten, likely absorption curve. Level of activity, current BG level, factors which pull this way and that when trying to calculate the correct insulin dose for a meal. Wanting just enough insulin to pull sugars back from being a little high, without going too far and ending up dipping into a hypo. The relentless daily balancing act.
And this is just what the Expert promises to help with. But of course it's only as good as the information it has got to go on, and at the start, unsurprisingly, this has not been quite right. To begin with, perhaps to err on the side of caution, it was suggested by the DSN to try a ratio of 1u:15g (one unit of insulin to 15g of carbs). This was based on a quick '500 rule' calculation based on my total daily dose. I suppose I wasn't expecting it to work, having worked hard for a year to tighten things up if I'd been out by 50% I suppose I would have noticed. Nevertheless I gave it a go. The following day I dropped it back a little during most of the Expert's time blocks (you can set different ratios at different times of the day). But it was still disastrous, perhaps due in part to inaccuracies in some of the other settings (expected insulin duration, expected amount of BG change per unit etc).
One of the things which surprised me is how vulnerable I was to doubting my own experience. Seeing a bolus dose suggested and thinking, "That doesn't sound right...", but then worrying that the figure I had in mind might not have been right either. Kicking myself when I soared high or crashed low thinking, "Bah! I knew that was going to happen." when in fact I could have stuck to my guns and overridden the suggestion each time.
So from a daily BG average of 5.4 (97) and 5.9 (106) which are arguably slightly on the low side in the 2 days before the Expert, I had an average of 10 (180) ouch! Then 8.2 (148), 8.7 (156), 7.2 (130) and 7.1 (128). To make sense of those numbers... if I stayed completely in the recommended range and tested before and after each meal I would get an average of 6.5 (117).
Like many diabetes things, this will take care, attention and more than a little experimentation to get right. My hope though is that I might have Colin (E decided he needed a name) as a little digital assistant every time I eat, to offer a half-decent suggestion of a bolus for whatever carbs are on my plate.
Here's hoping anyway.
Merry Christmas everyone!
Update: Accu-Chek Expert Review - one month in
