My averages are definitely down in the last three days. I'm having a lot more lows, but far fewer highs. And the highs I am having, I can pinpoint generally what caused them (which is a heck of a lot different than last week where I was bouncing around for no apparent reason).

Moving the evening Lantus dose up by a few hours has stopped those evening highs, which I'm extremely grateful for considering those highs are the same ones that start my day off. And beginning and ending my days in the 200's is not my idea of good diabetes management.

Using 15 units instead of 14 units in the evening also seems to be working, although I'm interfering so it's hard to say. For instance, the 47 at 4am Monday morning could have been from the Lantus or it could be a late low from my workout Sunday afternoon. And the two morning highs Monday and Tuesday were definitely because of my overtreating lows or not bolusing adequately for carbs before bed.

The one thing I'm still perplexed on is boluses. Is the pump better? Is it neutral so not worth the effort? Are my carb ratios and sensitivity factors okay? Are the lows directly from boluses or some mix of my life?

I know sometimes I can get overly aggressive with boluses, when I'm frustrated with highs. I judge my carbs too highly, bolus too early, or don't account for some foods not needing a total carb bolus. But I'm not sure that's what's going on here, so I'm hesitant to back off at the moment.

I'm thinking that I'm going to continue using the pump for boluses over vacation. It gives me a little better idea of what I'm doing (with the bolus on board factor and the way it tracks each bolus online). Plus it means not needing to sneak an injection when I'm out (although I generally don't care, sometimes outfits or situations don't lend themselves to easy injections).

I'm also using two different (and new) carb ratios with the pump. A 1:9 for anything before 3pm and a 1:11 for anything after 3pm. Those are definitely easier to calculate with the pump and also tend to me less whole numbers (for instance, 30 grams of carbs is 2.7 units instead of my normal 3.0). The greater accuracy of the pump with boluses is really appealing to me at the moment, considering every unit counts miles when you're working on lower blood sugars and avoiding severe lows.

So I'm prepared to use the pump for the majority of my vacation, probably leaving it attached to my body any time I'm not in the hotel room (as it'll be difficult to attach a pump while walking through the streets of Pittsburgh and New York City). I'm going to use another "side" infusion site (the upper, outside portion of my stomach) just in case I want to disconnect in public. And I'll also have plenty of insulin and syringes back at the "homebase" in case I get tired of the pump or something happens (I normally have backups a plenty anyway).

I'm also prepared to need some insulin changes over the next week. I should be doing a little more activity with an increase in walking, but I'm also going to be eating different foods (not prepared by me) so it could go either way on basal and bolus. Either way, I'll be carefully tracking my number and being guided by my "diabetes intuition" to make any changes.

Overall, I'm definitely feeling more relaxed that I can get to the bottom of these blood sugar problems and lower my A1c again. I'm a little worried about the lows, but I'm hoping with the bolus rate tweaking I can get those under control soon. So hopefully my diabetes doesn't throw any more curveballs my way over the next week and I can enjoy a much needed vacation in my favorite city (ahem...New York).