How many correction boluses do you make on an average day and does the number of adjustments matter?
I downloaded my pump and cgm data yesterday and realised what a lot of tiny corrections I make to my insulin boluses. I don’t mean great big corrections but 0.1 and 0.2 units just to try and keep my blood sugar as low and stable as possible due to ongoing complications. My basal levels are pretty accurate and as my daily total is relatively low 22-25 units I start going hypo if I increase my basal insulin. Apart from being more accurate in my carbohydrate estimating I can’t find a better way to adjust anything.
On an average day, before I was pregnant, I probably made one or two correction boluses a day. Like you, they mostly weren’t massive, just little tweaks to keep things on track. I don’t know what the official line is on correction boluses but I find them an essential part of getting good control.
I always think about why I’m making the correction – generally it’s because of a carb counting error or a change in my plans ie I’ve been more/less active than I’d intended. Anything more than that and I start looking at whether my basal rates or carb ratios might need a bit of tweaking.
I was told, when I first got my pump, that doing the odd correction bolus in the day (ie one or two, I think) was actually better for you – as it meant you were actually acting like your pancreas does (or rather, would) in reacting to blood sugar deviations. It only works if you test regularly, but on the whole, 7-8 tests a day with 1-2 of those requiring a correction of a small amount is what i seem to do on average.
I think using cgm has made me correct with tiny boluses a lot more just because I can see what is happening throughout the day, As you say it is probably a good thing as I am acting more like a pancreas. I’ll carry on in my new role and stop worrying about it.
The ability to pop in fractions of a unit at any time has been one of teampump’s big wins for me.
If memory serves John Walsh suggests 8% as a guideline. If you total up your correction boluses over 24 hours and it amounts to more than 8% of your TDD then you probably need to look at basals/ratios/activity compensation strategies/dietary choices or all four.