Now that beryl and I have been acquainted for over a month, I feel like I have got my basal rates pretty much sorted. I have three different ones set up, one for work days, one for weekend days and one for particularly active days (full days walking in the Lake District or expeditioning in Iceland for example!)
Since having done my DAFNE course over a year ago, I really feel like I am pretty good at carb counting and knowing my ratios etc however, I have found it really challenging to work out timings of both when the carbs will start affecting my bg levels and how long insulin is working in my system. I often think that I’ve got something right and then 12 hours later, I see a rise in levels seemingly for no reason. This must just be the delayed effect of the food I’ve consumed but it’s v frustrating and very difficult to dose for on MDI.
Enter the multiwave bolus feature on my wonderful cellnovo pump (aka Beryl). This allows me to calculate the correct dose according to the carbs consumed and then deliver it over an extended period of time, allowing for the carbs to be absorbed over a few hours. This is probably the thing I was most excited about when moving on to the pump so I was looking forward to trying it out and where better than in Iceland where I would be indulging in a couple of celebratory meals for my dads birthday.
The first meal was a two course affair which consisted of veggie kebabs for starter and threw different types of fish with varying accompaniments for main course. Fairly low carb but still warranting a total bolus of 3 units. I dutifully entered this in to the pump handset and instructed it to deliver 50% immediately and 50% over the next 6 hours. I was super excited when I woke up the next morning with a level in the 5’s and my dexcom app showed a straight line all night! Attempt one – nailed!
The second meal was more complicated as it was a 9 course tasting menu (I actually only had 7 of the courses as two were meat based). This included one small slice of bread at the beginning and a share of the dessert platter at the end – two things I would usually completely avoid due to the high sugar and carb levels and not being able to inject appropriately for the timings. I input the carbs to the pump handset and it calculated a total bolus of 5.75 units so again, i instructed 50% for immediate delivery and 50% over the next 8 hours as this was a long drawn out affair. I started the meal on 4.6 and ended it on 6.8. I then went to bed and awoke to a level of 7.9 having had a straight line at about 7 until 4am when it had slowly risen. I then had a low carb breakfast and dosed 1.5 units which brought me back down to 5.5. Second attempt – nailed!
I cannot tell you how excited this makes me as I now feel like I will be able to try all sorts of food that I have completely avoided for years as I just have not been able to get to grips with dosing correctly on injections. Pizza is the ultimate and I’m not quite ready to try that but stay tuned and who knows – in a couple of months, maybe I’ll be so good at the whole multiwave bolus thing that I’m able to enjoy a pizza whilst staying in range the whole time!!