Ive been lurking on here for a few years now taking tips with I could, but I have a bit more free time so I think I will start contributing more to the discussions as well. I have an issue though that I cannot seem to wrap my head around in how to resolve it. Long story short I have been type 1 since I was 5 (23 now) and never had any issues until I contracted mononucleosis when I was 18. Ever since then then, my insulin sensitivity fluctuates daily causing highs and lows and just all around uncontrolled treatment. I am constantly changing basals on my minimed, but to no avail. I know my bs tends to drop low after a workout, but last night (10 hours after my workout) I had a low in the middle of the night which hasn't happened for some time, and then around 10am this morning I corrected for a reading in the 180's and after an hour I was already at 100 with two hours of time left to go.
Does anyone else have this issue or know a way to level out and keep constant my insulin needs?
Welcome. I go through phases where my insulin sensitivity changes for reasons I can't explain. This spring my basals decreased by over 8% in less then a week! Last week I was rage bolusing and happy if I would drop into the 120s. I believe the important part is to stay vigilant and try to make changes as necessary. When things are extra difficult (like you are experiencing), it may be best to go back to square 1. I would suggest basal testing as basal rates change over time to keep you on your toes. My insulin needs change the most from weight change, exercise change or vast diet change (eating a big steak, pizza) at least that I can predict.
Hi Vik - Delayed hypoglycemia due to extended and intense exercise is a known phenomenon. I have a vivid memory of waking up in a campground, dazed and confused, after a full day of cycling in the mountains. Immediately after my exercise that day, I had a full meal and good BGs. Perhaps setting an evening/overnight temp basal of 6-8 hours at -20/30% would be an appropriate tactic.
Your high this morning was a rebound from the overnight low. Once the liver and the counter-regulatory hormones kick in it takes hours for them to wear off.
You might want to test your basals again. Your actual basal needs may have drifted and it would help matters to get closer to what your body requires.
Interesting that your control suffered post-mono illness. Perhaps that episode killed off some residual beta cell function.
Anyone that takes insulin is faced with changing insulin needs. Exercise helps to maintain sensitivity to insulin but can present its own set of dosing challenges.
I recommend that you adopt a temp basal after exercise (maybe just after exercise that is more strenuous or longer duration than usual) and also test your basal rates. Good luck.
I think a lot of "minor" morning highs (like 180-200 range) can be rebounds from lows. I used to only think I may be going low if I woke up really high like in the 300s. But this past week I've had a mixture of waking up at 65 and 180, which confused me. I couldn't figure out if I should decrease or increase my basal rate.
Last night I woke up at 4:00 AM because my pump was alarming due to an empty cartridge. I tested for the heck of it and was 67. Ate a glucose tablet. This morning woke up at a perfect 99 at 6:00 AM. Went to work without eating breakfast right away and was 139 by the time I got there at 9:00 AM, due to my "rising when don't eat breakfast" problem.
I think diabetes is always a learning process. I never seem to be "stable" because my settings or blood sugars are always changing, always having to make adjustments.
When I work out, even if it's earlier in the day, I will set a temporary eight-hour basal rate of -10% overnight to prevent lows. I find any more than -10% and I wake up high.
Do you keep track of your menstrual cycle? This is important because the hormone Progesterone can influence your sensitivity to insulin. The following diagram shows the typical fluctuations of Estrogen and Progesterone in the cycle. The first day is the day of the menstrual bleedings. As you can see the Progestrone level usually rises in the week before the next menstrual bleedings:
This of course is a generalization. The duration of the cycle is highly individual.
So the task is to find the repetitive pattern that represents your cycle. This would give you an idea of the days/weeks of your cycle with reduced sensitivity to insulin. The next step is to work against this issue with a more aggressive basal profile - and that for just as long as the sensitivity is reduced. This of course is just the theory...
Aside from guys who definitely don't deal with such things, not all us gals do either! (Another thing I'm grateful for in my late onset diagnosis, the other one being diagnosed a month before retirement; this stuff is a full time job!)
Thank you for all the comments. Jen, it would seem as though you are dealing with almost the exact same thing! As far as the basal testing, I do it once a month every month just for this reason, however I have not tried the temp basal option yet.
Terry - Thank you for the insight, I found it to be odd as well for post-mono, however it was the opposite of what you think. My basals were around 2 units of humalog every hour, now Im down to less than half of that.
Holger, I laughed full heartedly over that haha. No worries, no offense taken. I should change that picture anyways. I havent been dating her for over a year and a half!
Hiya...for myself after 39 years Type 1, the insulin thing was (and is) definitely annoying. First, there are "honeymoon" periods where the pancreas is known to kind of kick start sort of and puts out a little insulin. Ever have those days where your intake seems to work too well? Other days, it seems like insulin sensitivity goes right out the window. And yes, it did often happen during the um...PMS days. As of today, I no longer have those parts so no more PMS but I do still have a day here and there of the same thing. I am taking a standard dose of HRT everyday and still have those days.
Being type 1 is one of the most difficult to manage with all of the variables. A "normal" person with a working pancreas also has the same type of days though they don't have to manually manage it like we do. It is perfectly normal, and expected, to experience random days of more sensitivity or less. More doctors need to share this with their patients for sure. For myself, I manage my sensitivity with very low carbs and the addition of Symlin. This seems to keep things on an even keel and I don't see too many "jumps or dips".
