The TOTO Technique
Christine and I devised this nickname for my own little "untethered" regime after deciding that I wasn't technically on Steve Edelman's Untethered Regime. On his regime, you take 75% of your basal as Lantus and wear the pump all the time. But I take 100% of my basal as Lantus and I don't wear the pump except for when I eat. So we decided it deserved it's own name: Tether On, Tether Off.
I haven't written much about it since I switched three weeks ago. At first, I had really good results. Then I had really lousy results. Now, I'm havning mixed results. My blood sugar average is actually better than it was before, but that's just because I'm swinging a lot more. I'm like the diabetic Tarzan.
The pattern was pretty clear and it was exactly what I expected. Lows first thing in the morning (on the pump, my lowest basal was between 3am-6am), a fairly stable afternoon once my bolus ratio was turned up a couple notches to make up for the lack of an increased basal rate, then a normal afternoon and dinner and then high at bedtime. It was pretty much like that everyday for awhile.
I kept lowering my Lantus hoping to kill the morning low, but so far, I've either woken up low or overkilled somewhere else and woken up high.
I decided a couple days ago to try splitting the dose to see if I could fake a basal rate change. 11 units of Lantus at 10 pm (I almost wrote bedtime, but what 21-year-old goes to bed at 10pm?) and 14 units of Lantus at 10 am. Today went surprisingly well in the afternoon, but I'm still high because I underbolused for dinner. Oh well. Can't prevent everything.
I actually think I might scrape the two shots a day theory in favor of doing Lantus in the morning. I think the reason why I am high at right at 10 pm (I do my post-dinner test when I take Lantus) is because the Lantus isn't lasting a complete 24-hours and I'm starting to creep up. Does that sound right, O Wise Lantus Users? Maybe if I switched to the morning, when I need less insulin, it would match things better.
At any rate, the TOTO Technique is definitely still in the adjustment period. Lantus amounts have changed, followed by bolus ratios changes. Hopefully something will finally kick in and work. However, I would like to say that I absolutely adore not having to sleep with my pump on. I had no idea how much I hated it until I stopped doing it. Not that it was the end of the world or anything.
Oh, and I bought my first pocketless skirt in New York. I still haven't found a dress that isn't completely unflattering with my pudgy stomach, but I'm quite happy being able to dress without thinking about the pump.
But boy am I happy I don't have to do bolus calculations. There are somethings that you just can't get from anywhere but an insulin pump