Your Diabetes Science Experiment - Experiment 1

WARNING: Long post follows!

BACKGROUND

I have recently been reading Your Diabetes Science Experiment by Ginger Viera (available from Amazon) ISBN 9781481062008. It is highly recommended as it reinforces DAFNE principles, but also goes further in depth and is especially aimed at type 1 diabetics who exercise and want better control of their blood glucose levels before, during and after exercise. The paperback edition appears to be in a better format than the Kindle edition according to the reviews for those interested in purchasing this book.

Along with in-depth knowledge, the book also has a number of experiments to determine correct dosage of BI and QA. The experiments deal with:

General background insulin doses.
Insulin to carb ratios
Correction factors
Dosing for Exercise.

The general idea is that BI doses, insulin to carb ratios, correction factors etc can all change depending on time of year, body weight, stress levels, type of exercise, menstrual cycles, sickness, types of food, amount of food etc.

Based on the fact that another DAFNE graduate and I have found this book so helpful in managing our recent blood glucose levels, we thought that it would be a good idea to start a new forum thread for each of the experiments to get feedback on them, see if they work, and encourage each other in getting the best results out of each experiment.

Experiment 1:

The goal is to identify if the BI dose is appropriate for a specific period of time. This experiment will involve a fast of 7 hours. (The test is for a period of up to 5 hours and begins 2 hours after the last meal making 7 hours in total.)

1) Choose a period of time to test your BI. It could be a time that you find troublesome with regular unexplained highs or lows.

E.g:

Midnight to 5 am
5 a.m to 10 a.m.
10 a.m. to 3 p.m.
3 p.m. to 8 p.m.
8 p.m. to 1 a.m.

2) Test your BGs at the start of the period. Remember that the start of the period should be at least 2 hours after the previous meal.

3) Test your BGs at the end of the period. Stop the experiment early if you hypo or you find that your BGs are rising too high during the experiment and you need to take QA.

Important notes:

1) No exercise other than normal daily activity should occur during this 5 hour period.

2) The time frame for actual testing should not be more than 5 hours.

3) The experiment should not happen with two days of changing a BI dose from its regular dosage.

4) The experiment begins 2 hours after the previous meal.

5) BI dose changes should not be more than 10% of the dosage as per DAFNE guidelines.

6) If QA has to be given during the experiment because of high BGLs, then it is void, and a retest needs be done at a later time.

7) Be prepared for lows and have quick acting carbs available for lows and hypos.

The goal is to see if the BI remains relatively constant. If it increases during the period, then an increase in BI may be indicated. We can discuss ways of checking this if this happens. If BGs significantly drop during this period, then it may indicate that BI is too high.

If you want to take part in this experiment, can you please reply to this post stating:

Times of experiment start and end.
BGs at start and end of experiment.
Whether you needed to take carbs or QA during the experiment.
What type of BI you take and when (note, pump users are welcome too - just put what your basal rate is at the time of the experiment).
Anything else that you think may be relevant to the results observed - e.g heavy day of exercise the day previously etc.

I hope to run this experiment at the weekend. Unfortunately I am following sick-day rules at the moment and have had to change BI for that, but hopefully I'll be back to normal by the weekend.

Thanks,
Warwick.

Hi i am on about buying this book, is it worth getting? And does it use the same methods as dafne, thanks dean

Hello Dean,

It uses many of the same methods - it doesn't contradict DAFNE principles at all. It does use American values, so it helps to have a bit of paper handy with the equivalents in mmol/L for when she starts talking about going into the 300s (Basic rule, just divide the American value by 18 to get the mmol/L value).

I have found it excellent, and I know that JWo has similarly found it extremely helpful. It has explained many things that I just was not understanding, even after DAFNE. For example, it explains why some types of exercise will lower BGLs while other types raise it. This was not covered on my DAFNE course.

Cheers,
Warwick.

Attempt number 1 = epic fail.

I am happy that I have my BI reasonably correct during the week, but have issues with multiple hypos during the weekends. So I actually broke the rules a bit for this experiment and reduced BI by 2 units the night before (Saturday night, and 3 units on the Sunday morning to avoid hypos. 90 minutes after having my lunch and 30 minutes before I was due to test for the first set of readings I had my worst hypo for a while and therefore aborted the experiment.

I expect that this was likely due to spending a couple of hours on Sunday morning helping my 2yo daughter to swim, which given her tendency to clutch my neck and hold on tight wasn't as restful as planned :-)

Attempt number 2 will be this Saturday. I'll drop BI by 3 units the night before and again on Saturday morning and hope for the best. If unsuccessful, I'll try again on Sunday afternoon.

Attempts number 2 and 3 crashed and burned.

Saturday, I found BGLs were 4.6 about 15 minutes before I wanted to drive (need to be above 5 to drive), so I aborted the experiment and took more carbs, and Sunday I watched until my BGLs hit 4.2 and then decided that I couldn't avoid having a hypo without taking some carbs.

Still, on the positive side, I didn't hypo on Sunday which is a major achievement for me - first weekend day I haven't experienced a hypo for a very long time.

The plan for next week is to stick with the same BI reduction (morning and evening basal each drop from 13 to 10), but will look at reducing my insulin to carb ratio at lunchtime from 1/2 to 1/3, then will see if that helps as my BGLs seem to drop too fast in the couple of hours after lunch.

Saturday wasn't an option to try experiment 1 as I was having lunch with my diabetes support group and we didn't start eating until after 1, and I had a hypo at that time anyway. Just too messy.

Sunday, I managed to get the QA right with a 1/3 ratio - no hypos this week in the couple of hours after lunch, but BGs started high and just dropped over the course of the afternoon until the hypo.

Thursday is ANZAC Day, and I have Friday off this week, so will have a four day weekend which should allow me to get this right by the end of it. I will lower BI to 9 units on Wednesday evening/Thursday morning and keep it there over the weekend unless otherwise indicated.

After several highs, I have decided to try testing my BI again. I will be doing the evening slot - diary above. I forgot about the 2 hour after meal thing, but I'm not convinced completely since I know QA is still working.

Will update.

Agreed on the 2-hour thing. I am much more comfortable with a 3-hour window.

I tested last Thursday ( a holiday) and while not perfect, the results were encouraging. I'm lowering my BI from 13 x 2 to 10 x 2 this weekend and will see what eventuates. Also lowering my lunchtime QA from 1/2 to 1/3.

Cheers,
Warwick.