Tight Regulation ... or not

I’ve been toying with the idea of trying Tight Regulation (TR) to keep Isabella’s numbers lower overall. TR involves shooting insulin as needed, rather than on a twice-a-day schedule. So, if she’s rising 6 hours after her last shot, give insulin at that time instead of letting her blood sugar keep rising and then trying to drive a much higher number down. It also involves developing a dosing scale based on BG number (sliding scale).

It makes a lot of sense. It also requires a lot more ear-poking and a certain amount of guts. I decided to try it last Wednesday for the first time. Isabella’s last dose of insulin was at 4pm Tuesday, so when I tested her at 6:30 am Wednesday more than 14 hours had elapsed.

Her BG was 81.

No shot. I waited around, balanced my checkbook, did some laundry. Two hours later: 94. Still no shot. Finally, an hour after than she was up to 141 or thereabouts so I gave her one unit. (Usual is 1.8 units. I don’t have a scale developed yet.)

Finally, I could go about my day! I tested her 6 hours after the injection: 168. Two hours after that: 131. Finally, at 9pm, 12 hours after her morning insulin, she was at 297, earning her 2nd dose of the day. So much for extra insulin.

I tried again on Saturday. She got her morning dose, a test six hours later, and one more test an hour after that. She was high enough at the 7-hour mark to get a 2nd shot. The real test came around bedtime, when I should have checked her again to see if she needed more insulin to see her through the night. But I was sick and I just didn't feel like testing. So I blew it off, and I've not tried again since.

Sigh. Maybe I’m not cut out for tight regulation after all.