Frustrated. Need insight.
I’ve been on twiist for 3 weeks now, but have yet to achieve a good TIR like most people I’ve seen on here or what my trainer described.
Some background, diagnosed 5 years ago, still getting the hang of managing things. I had a horrific low a while back and still getting over the fear of pre-bolusing. It’s something I have gotten a lot better at on this system, but still not waiting 15min to eat most times. I switched from Novolog to Fiasp last year and the onset is noticeable.
With Twiist, I’m finding the algorithm is far too aggressive at the wrong times resulting in a rapid BG fall. I’m talking like 100+ mg/dL fall in <30min. For example, tonight I had a bowl of pasta, told the pump I was eating 45g carbs and use the longer absorption. I was already sitting at a BG of 200 from a small snack I didn’t bolus for accurately.
Pump gives me 3.5U. Sounds good. Now sitting on the couch, I suddenly feel my BG is dropping fast. Went from 200 to 120 in 25 min. All while I now have 5U of active insulin? (Pump gave me an extra 1.5U). Libre still showing down arrow and predicted to hit a BG of 50 in next 30 minutes.
Had no choice but to eat a large bowl of cereal after eating dinner to stop the fall. I did confirm it with finger sticks, only slightly off from Libre.
I’m not sure what to do. I have these dramatic spikes (in part from not prebolus) then huge crashes where I am symptomatic. My trainer has LOWERED my ISF to 1:30mg/dL and carb ratio. The logic is preventing a spike prevents a drop that can’t be predicted.
I plan on trying novolog again to see if the slower onset would work? But I’m truly at a loss of what I can do. I feel like I’m fighting against this pump everyday not to drop me low.