May 16, 2012

Who Needs An Adjustment?

One Thing to Improve - DBlog Week - Day 3

Yesterday we gave ourselves and our loved ones a big pat on the back for one thing we are great at. Today let’s look at the flip-side. We probably all have one thing we could try to do better. Why not make today the day we start working on it. No judgments, no scolding, just sharing one small thing we can improve so the DOC can cheer us on!

Click for the One Thing to Improve - Wednesday 5/16 Link List.

Insulin Adjustments.  Ugh.  The very words make my face do a funny little cringe thingy.  As I told you yesterday, I am a rule follower.  So, I am very capable of following the insulin adjustment guidelines provided by Ally's endocrinologist.  If she is running high or low consistently, for period of time, I can look at the numbers and make a pretty good judgement about whether to change basal or carb ratio.  And the truth is, when I do it, I do it pretty well.  The part where the "One Thing to Improve" comes in, well that's in actually following through with what my brain is telling me to do.

The place where I get hung up (AGAIN!) is all of the uncertainty that diabetes throws in the mix.  My brain says that Ally is running high overnight because she is growing and I know that I need to increase her overnight basal.  But what if it's actually because we are making mistakes in her carb counting.  But what if it is because we tried to squeeze an extra day out of that site or bottle of insulin?   And what if she is running high because she is getting sick?  The what ifs could actually go on and on.

I KNOW that I have seen a pattern over a period of time and I KNOW what I need to do...adjust the insulin!  But it is so hard for me to do.  What if my adjustment is wrong, or I adjust too much, and cause her to go low overnight? 

I'm sure that you can clearly see why this is an area that needs some improvement.  I need to trust myself when it comes to Ally's diabetes care. 

So, I guess the question is, does the insulin need an adjustment?  Or do I?

Thanks to Karen at Bitter-Sweet for organizing yet another fabulous Diabetes Blog Week!



  1. I totally understand what you're saying. I second guess my intuition all the time. Always afraid of over adjusting and causing lows. Need to learn to listen more to my God-given feelings, less to the voices of doubt. :)

  2. I am the same way! I am trying to be better but I always second guess and I am afraid herA1C will show it next month:(

  3. Not an easy task, being a pancreas-in-charge! But sounds like you're doing a great job! I guess all we can do, at the end of the day, is our best and trust intuition.

  4. ahh I do the same thing! I hate that little voice inside sometimes...always 2nd guessing...ugh

  5. this week i did my first insulin adjustment without advice from the endocrinologist. i feel how i felt at 16 when i first drove car--they're really going to let me drive this thing?

    is it growing that makes them go high in the night? i like that--kind of puts a positive spin on things.

  6. Yep! That's me. It doesn't help that numerous times after 4 days (our endo says that 3 days is a trend, but I always watch it for 4) of the same trend, just as I'm about to make a change, I do one final upload of the numbers and everything is back to normal...and I don't have to change anything. Then I start second guessing myself and saying things like "Well last time, I didn't have to change anything..."

    Maybe for my girlie 4 or 5 days should make a trend?

  7. Go with your gut and trust yourself. You've been doing this for awhile and you are a pro, whether you believe that or not. I'm at that stage right now too. My Emily's numbers are climbing again. I had already adjusted her bolus already, now I think I need to change her Basal again. The problem is the 1/2 unit that we dropped down to worked great. If I go back up that 1/2 unit, I wonder what she'll do in the middle of the night. She was dropping all the time before. I guess I need to go with my gut as well. I think I will wait a couple more days and see the trend. Then make a decision. Good luck.


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