A walk through insanity and basal adjustments


#1

On Jan 19th my overnight basal was = 0.85 u/hr.
Today, Feb. 12th, my overnight basal is = 1.45 u/hr.

I am expecting to continue to raise it a bit further to get stable numbers overnight.
So, it has almost doubled in a months time.

My previous Doc wouldn’t like this. She believed that under NO circumstances should I ever be taking more than a unit per hour in basal. But, that’s what the dice rolled. Its a little concerning when it changes this much because what if it changes back and I run super low overnight?

Anybody else frequently get shifts in dosage like this? Do you have ideas about why this happens? How quickly do you change your dosages? I typically only bump it up 0.1 u/hr, per day, at most. I might be being overly cautious with my adjustments.


#2

Are you male or female? If female, the monthly shifts in hormones can make a drastic change over a short period of time. I recall one woman on a different message board who said her basal needs almost doubled overnight at one point in the month, then cut back to the original needed dose at another point. She nearly went crazy trying to figure out exactly what date and time the change would take place. Many women have a change in basal needs, just not that drastic a change.

Other than that, the only thing I’ve seen that makes a drastic change is a major change in daytime activity level. Think about how many people you hear have a night time low after an exceedingly heavy exercise day. A major drop in activity level would work the opposite and cause a greater basal insulin need.


#3

Female. I’m pretty sure its not a temporary hormone shift - although I DO require that as well (up to a 35% increase in PM basal). This shift started about 2 weeks ago and has been a very persistent pattern. The peak has been very consistent. I let it run its course for a while before I started addressing it, just in case it was a temporary, fleeting shift.

Its possible that exercise has played a role, to some degree. I would like to run some tests for that. Those tend to be the most complicated tests that I run. I like my system to be running in a highly predictable way because exercise will tend to increase the ‘chaotic’ nature of my system and can produce highly variable results day-to-day - extreme highs and extreme lows. So, I have to be super stable before introducing that into the mix in order to clearly identify the effect. Sometimes I can identify the effect of exercise and sometimes not. Its right on the boundary of what I am able to achieve. I will try to check. :slight_smile:


#4

I’m gonna make a gross statement here, but if you’re feeling sick or have post-nasal drip, that could be a big cause. I don’t mean the normal I need x% percent basal when I’m sick, either. I’m taking specifically about the fact that we don’t blow our noses while we sleep, and that nastiness rolling down the back of the throat has a LOT of sugar.

Sorry for being gross, but tis the season…


#5

Really? I have never heard of that before. That’s disgusting, but interesting.

I looked at the data for today, and it is similar looking to what Uff_Da suggests might be visible in a hormonal pattern, in that it increases across the board, all day. That would suggest that these adjustments I’m doing are gonna turn around and bite me. But, I think its too long standing for that.

I’m gonna try hitting it ahead of the spike, starting at midnight.


#6

Huh??? Cite, Please.


#7

I googled it. I think its true. Ick. http://news.mit.edu/2013/sugars-serve-vital-function-in-mucus


#8

I have a background in molecular and cellular biology. I’m my own source. One of the main components of mucus is glycoprotein. As diabetics we should be pretty familiar with that “glyco”. In this case, it means that there’s a carbohydrate group joined to the protein molecule. When they gets broken down, the carbohydrate is split off, and absorbed into our system the same as any food we eat.


#9

So if I hock a loogie, and test it with a meter, it should come up positive for glucose? Even when my bg’s are normal?


#10

Actually probably not, but I’ve never tried it, so I’m not sure. It would depend on the enzymes in the test strip. The glucose in your “loogie” is bonded to protein still. It requires digestion to break down into simpler components your body can use… which is what text trips are designed to measure. I doubt the enzymes in test strips have the ability to break that carbohydrate group off, so it wouldn’t react similarly.

Also, if you really wanted to test this, you’d have to wash the saliva and contaminants off which can contain glucose your meter can measure.


Crazy Unexplained Highs
#11

By the way, I totally didn’t mean to derail your original point! I’m sorry. I was merely trying to point out that with cold and flu season upon us, it could definitely mess with sugar levels, especially overnight.


#12

For the last 52 years I have found the spontaneous shifts in my insulin requirements to be massive and inexplicable. Since I eat exactly the same amount of the same food at the same times every day, I can hold the caloric intake and glycemic index of what I consume constant, and my activity is also constant, so the normal variables that patients might use to explain rises and falls in insulin requirements are held constant. Despite this, the fluctuations are huge, so these must be due to internal and incalculable changes in physiology, such as hormonal shifts, stress, etc.


#13

No, no problem. We all learned some surprising things about snot. Worth it!


#14

@Seydlitz, these are the kinda physiological ‘drifts’ in the system that I’m worried that a closed loop system just wont be able to overcome. But, you never know. For sure, it has to be able to react faster than me. I simply can’t calculate this out like a computer could and it takes a lot of bad days to get it back in order. Me no like.


#15

This is WAY more basals than I’m used to. Am expecting that I might send the system into some kinda tangle that I can’t unravel, but so far so good. I might be adding a number of basals that is above my pay grade…three overnight, and six total throughout the day.

It didn’t end up doubling my dosage. if I hit it early (before it sky rockets). Then, it might just be a minor dosage change. I think that if I do a minor increase across the board, then I wont be taking huge correction dosages. Its actually a very small dosage change. I don’t know why this is so confusing.
image


#16


#17

Foiled at every turn…


#18

The data seems to suggest that I triple my bolus for the first meal of the day.
That sounds insane.
15 g carb = 2 x 3 = 6units.
Insane? Not insane?
Should I pre-bolus?


#19

Learn something new every day!


#20

@beacher, Robyn_Hovey is a hard core, respectible researcher. I started to gag reading about that. I salute those who can delve so deeply into the terrible truth.