12 Week Check Up

It was time for my 12 week check-up. Last weekend I donated blood for the lab work. I logged on to the MedTronic CareLink web site. I uploaded my CGM and then I looked at the reports.

I had a weeks worth of data. The doctor wouldn’t have access to it, so I printed some daily reports and the overlay report.

When I arrive at the Doctor’s office I find out I have put on few pounds. I knew this, but it stings a little more when you have to share the information with the PA and the Dr.

Take my pulse, yes I still have one. My BP is 114/66.

Then we reviewed my medications:

Symilin, Humalog, Humulin R, Lantis, Thyroxin, Nexium, Lipitor, Lisinopril

All the same, plus the Asprin therapy and my allergy to penicillin has not gone away.

Time to review the lab results:

VLDL Cholesterol is good

HDL Cholesterol is good

LDL Cholesterol is good

Triglycerides are good

Hemoglobin A1c is 7% last time it was 6.7% Not so good. I wanted a better A1c score.

Why has your A1c gone up? The Doctor asks. Well you see I haven’t been exercising like I should. I change jobs, I am working longer hours. My routine has changed and I haven’t yet figured out a new routine. I stubbed my little toe. I have a lot of things on my mind and I forget about exercising. I have a boat load of excuses. To bad I can’t lower my A1c percentage by rattling off excuses.

How do you like the CGM he asks? I love it! I look at it several times a day. I am even looking at it in the middle of the night. Those stupid alarms keep waking me up.

Hey! Wake up, you BG is low.

Hey! Wake up, I have a weak signal.

Hey! Wake up, I didn’t really want any thing other then to see if you would look at me. he he he I hear the CGM laughing in the back ground.

Let us take a look at those charts from CareLink. Humm, Oh, Humm, the Doctor said. I see you have a post breakfast BG high. Oh and there is another one after lunch. You seem to be doing alright after dinner and for your early morning BG.

So how do you calculate your insulin correction factor before a meal? He asks. I uh, well I uh start counting at 140 then I add 50 and for every 50 I have over the 140, then I add 1 more unit of insulin. But wait, I don’t do that at meal time. I only do that between meals.

It seems I don’t really have a Meal Time Correction process. And, I don’t really have a Between Meal Correction process. Try this said the Doctor.

((FS -100) / 30) / 2 = Between Meal Correction

And

(FS - 100) / 30 = Meal Time Correction

For example: I am between lunch and dinner. Oh and substitute FS for BG in the formulas above. My BG is 220. Plug it into the formula: 220 - 100 =120. 120 / 30 = 4. 4 / 2 = 2. So I would do 2 units of Humalog to bring my BG into normal the normal range.

Another example: Before dinner my BG is 250. Plug it into the formula: 250 – 100 = 150. 150 / 30 = 5. I plan on eating 45 carbs for dinner, which means I would use 6 units of Humulin R more the meal, then I would add 5 units of Humulin R for the correction for a total insulin amount of 6 + 5 = 11 for the meal.

Now I have a Between Meal and a Meal Time correction strategy. Keep an eye on the reports and see if the strategy works. Plus hit the exercise routine and bring down that A1c.