#78 April 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.

Lift of the Month – April 2020

Glycemic Results For April 2020

I was satisfied with my April 2020 glycemic results with a mean blood glucose of 98 mg/dl and a standard deviation of blood glucose of 17 mg/dl.

The graph below shows all the blood glucose measurements and daily insulin dose totals for April 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, although I came closer to my goal than I have in the past. 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 continued tinkering with a mathematical model to predict insulin doses. I think I am seeking perfection which is not possible. I have promised myself not to make any more changes so that I can actually test the method using a whole month’s worth of data. I will test it this month and hopefully my current method will be the final version.

Till next time….

7 comments

  1. Nancy Dougherty

    Your numbers are awesome! As a T1 diabetic for 34 years, I can appreciate how difficult it is to achieve those values. Thanks for sharing.

    Congratulations!

    Like

    • Keith Runyan, MD

      Thank you, Nancy. I would not describe it as difficult, but rather an atypical lifestyle specifically designed to facilitate normal blood sugars. The results are well worth the effort.

      Like

  2. Elmas Fregon

    Is there a guide on diluting insulin?
    One unit of R (not Humalog) drops me about 90 points.
    So I tried diluting the R but:
    1. The only sterile vials I could find online came uncapped.
    2. Insulin seemed to only last about 1 or 2 weeks.
    It quickly lost its strength so it became a real pain to constantly dilute it in small amounts.

    Thanks.

    Like

    • Keith Runyan, MD

      Contact the manufacturer of your insulin and they will provide you with the correct diluent usually at no cost because they realize you are already paying for the insulin. If you use the proper diluent and store it in your refrigerator, the insulin should last a long time.

      Like

  3. thracion

    Great job on the lifts, Keith!
    Looked impressive as does your body composition.
    I, myself, have been on a new strength training programme (designed by Hafthor :), the record-breaker), which would peak at mid-summer with one rep maximums and hoping to finally reach that coveted 200kg deadlift.
    Keep up the good work and thank you for sharing!

    Like

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