I'm staring at my logbook right now. I have no idea what to do. My averages are still above 200, although my baseline numbers are generally running between 160 and 180. Yet I'm still seeing numbers like 302, 264, or 270 crop up.

I raised my Lantus to 33 units last night and I woke up at 96 when I'd gone to bed at 224. I'm hopeful that 33 units might be the golden number with all this. If I could get my basal numbers to drop back into a normal range (I'm looking for under 150 at the moment), then my post-meal numbers wouldn't be spiking so high. Plus I could keep working on the post-meal numbers more extensively if those basal numbers dropped.

I'm just not sure if 33 units is really the answer. I've had a lot of evening highs...where my last Lantus dose was 24 hours ago and my most recent Lantus injection is only a few hours old. I'm not sure if that means I'm not maintaining the Lantus in my system long enough or not. Because it's also directly after dinner or a late snack. And the Lantus is bringing me down in the morning, typically back under 200.

I think I'm going to bite the bullet on this and hook back up to the pump. I'll be using it to bolus for meals and corrections. My basal insulin will still be the Lantus. I used this method  back in late July/early August when I'd had trouble with a lack of patterns with my blood sugars. It helped, bringing my averages down from 182 to 154.

I wish I could make this work without using the pump and Lantus (translate: I wish I could just use Lantus to get these highs down). But I also know that there is technology out there to help me manage highs and lows and all the in between. So why not use it? Especially when other things aren't working?

I'm so hesitant to get back on the pump (even if it is just for boluses!) because I absolutely hated it the first time around. My A1c jumped 0.7 points because my basals never could get a medium ground between the highs and lows. The infusion sets irritate my sensitive skin, leaving me itchy and with rashes quite often. Not to mention that I hated having something attached to me constantly, always reminding me that diabetes was there.

Lantus gives me more freedom in my life, as odd as that sounds. It allows me to feel normal if I want to. It doesn't bring up questions from strangers about my "pager." It gives me better basal numbers, lower averages, and definitely lower A1cs....which means that my risk of complications is lessened in the long run.

But because of the Accutane/birth control mix that I have going on here, my blood sugars aren't cooperating the way they need to. And Lantus is a slower effect in the results department, so it's taken awhile to get any sort of lower results. Unfortunately, I'm still not satisfied because averages in the 180s and 190s aren't acceptable.

So today is the day to decide: bolus with the pump? or not? I'm hooking up to the pump for my CGMS on Wednesday anyway (to have that peace of mind through surgery and recovery), so it will be there on my hip for the next week or so anyway. It's just a matter of deciding whether or not I want to add tubing and another spot on my body. A matter of deciding if I want to rely on this machine to survive.