#77 March 2020 Update on My T1DM Management

This is a monthly update on my glycemic management of type 1 diabetes (T1DM) using Humalog and Tresiba insulin injections with a ketogenic whole-food diet and resistance and aerobic exercise.

If you feel you might benefit from some individual attention and suggestions for achieving success with blood sugar control for type 1 or type 2 diabetes and/or losing excess body fat, I can assist you with a personal consultation via Skype. See the Coaching page for more info.

My books are available for purchase: The Ketogenic Diet for Type 1 Diabetes also available on Amazon in print, and my other book, Conquer Type 2 Diabetes with a Ketogenic Diet, is also available on Amazon in print.

Glycemic Results For March 2020

I was satisfied with my March 2020 glycemic results with a mean blood glucose of 100 mg/dl and a standard deviation of blood glucose of 19 mg/dl, just short of my goal of ≤ 18 mg/dl.

The graph below shows all the blood glucose measurements and daily insulin dose totals for March 2020.

My blood sugar goals are shown in Tables 2.3 below. I used as my measure of normality, a standard deviation of blood glucose (SDBG) of ≤ 18 mg/dl (1.0 mmol/l).

The table below shows my body weight at the end of the month, mean total daily insulin dose, mean basal insulin dose, mean bolus insulin dose, and the mean bolus insulin dose for each meal and the bedtime bolus insulin dose which I take to supplement my Tresiba dose to adjust for the variations in my bedtime blood glucose. Diluting my Humalog 5:1 helps to give precise doses with meals and at bedtime.

The table below shows my blood glucose variability data including the monthly mean blood glucose, the standard deviation of blood glucose (SDBG), the coefficient of variation (COV), the calculated HbA1c, and the percentage of blood glucose values < 70 mg/dl, between 70 and 130 mg/dl, and > 130 mg/dl. My goal is to have 100% my of blood glucose values fall in the range 70-130 mg/dl. I did not meet this goal this month. I did not need to take any glucose tablets (or Smarties™) this month.

Table 2.2 below shows the mean and 95th percentile of the interstitial glucose (IG) and standard deviation of the interstitial glucose (SDIG) of 564 nondiabetic subjects as measured by CGM from the five studies referenced below.

The references for these five studies are shown below.

I have been tinkering with a mathematical model to predict insulin doses. While the method provides an estimate, it is not perfect. There is an inherent variability when treating T1D with exogenous insulin, but as long as normal blood sugars can be achieved while being safe, i.e., with minimal hypoglycemia, then I will be satisfied. I will continue testing it this month and hopefully my current method will be the final version.

Till next time….