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[IP] Stacking Corrections



I am finding that IOB is not a sufficient solution. When I'm having
difficulty with control, it's generally because I'm having additional
glucose from steroids or infection (or sometimes incorrect carb counts).
Often when I correct, I'll check back an hour or two later, and find I'm
*higher*.

Yes, that usually means my basal is too low, but with steroids that's a
very fluid situation, so I'm always playing catch-up with corrections.

So what I've figured out is to know approximately what a correction SHOULD
do for me normally. I discount the first half hour as not having a
significant effect, and since I'm doing this in my head, I use a
straight-line approximation from there for where I *should* be. I then
calculate a correction bolus based on that and where I am now.

Then I estimate a "missing basal" that should have controlled it (if it
looks like a basal problem), and add in 1.5 hours of that missing basal.

This is complicated, but I have yet to over-correct this way.

I think the first part is equivalent to doing IOB, except I'm using a
straight-line approximation, and working with BS numbers instead of U
(they're in a fixed ratio based on my sensitivity). I don't use the IOB
numbers because they're set for some ridiculously long time by MM.

It's this second part, of adding in a "missing basal" factor that I think
is different. I initially estimate the missing bolus by dividing the
correction by 3, and then adjust for factors like timing of my steroids,
recent history, etc. Then I multiply by 1.5 hours, and check at 1.5 hours
and see if I'm on track.

I'm never low. I'm sure that's in part due to experience knowing when to
adjust the "missing basal" factor downward (and being conservative about
it).

Does anyone else do anything like this, or have alternatives for when
simple correction doesn't work? (Besides always having the right basal,
that is! ;)

Does anyone think I'm nuts?

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