Saturday, April 27, 2024

I have multiple FNEs, how do I choose?

January 2, 2023 by Ronald  
Filed under Integrations

I am suffering from too many FNEs: music, tax preparation business, and type 1 diabetes management with an insulin pump. First, I want to give an example earlier in my career where I hadulletins a 10 Second Miracle. I was charged with creating an information and referral center to tell adults in the five boroughs of New York City where they could find specific education programs and courses provided by more than 550 institutions. This happened before there were personal computers. I told the providers that I needed the galley proofs of their brochures and bulletins so I could have my small staff create index cards for each item and file it in a subject system created by the U.S. Department of Education. This request was my 10 Second Miracle. My staff provided great information to more than 10,000 people annually.

I am leaning now towards finding my FNE for type 1 diabetes management with an insulin pump. I’ve had type 1 diabetes for 35 years and my hardest issue is dealing with low blood sugars. I often over treat lows, particularly if I am not at home. I have a continuous monitoring device that gives me a blood sugar reading every five minutes. Any reading under 80 is low. As I have looked at my readings, I discovered that the biggest challenge was to not have low blood sugars when I am between 80-120. A normal bolus for a snack or meal might create a low forcing me to take glucose tablets or eat more. My diabetic nutritionist suggested that I have a smaller initial bolus to avoid going low and add some of the insulin to the dual bolus. For example, rather than using a 50-50 ratio for the dual bolus, maybe I should try 25-75 or 15-85. A month of data shows improvement. But why can’t my pump, when the current blood sugar is 120 or less automatically suggest a ratio other than 50-50 without me having to change it (if I am rapidly dropping my blood sugar reading I might not be alert enough to program the change which often requires a temporary basal of 0 for 30 minutes to one hour). Temporary basals are not easily seen on my pump’s reports to my doctor which hides the extent of the problem (for example, a two-week report will show I have less than two percent of lows, but my doctor can’t see that I’m using three temporary basals a day to prevent those lows). I haven’t found my FSE for this issue but the level two tools may lead to a 10 Second Miracle..

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