I thought I’d share my flatline of today (with NO glucose tablets needed) and a new strategy that I’ve started using that I’ve found surprisingly successful.
(For reference: Type 1 diabetes for 26 years since childhood, using pump and CGM, eating a low-carb diet, using extended-release metformin.)
I have a bunch of Lantus and other insulin sitting in the fridge that I’d like to use up. I tried the “untethered regimen” a year or two ago and didn’t notice much benefit. I’ve decided to try it again, but instead of dosing 50% of my basal as Lantus, I just injected five units of Lantus and adjusted my basal rates slightly. This is so little insulin that I didn’t think it would make much difference (by basal rates equal 25-50 units depending on hormones).
However, over the past few days my blood sugar has been near perfect. With using Fiasp I usually have not been able to disconnect from my pump for even half an hour without seeing a significant rise in my BG. I’ve been having issues with unstable blood sugar recently and I thought that maybe the fact that Fiasp is so fast-acting makes any small variation in insulin delivery, absorption, or interruption have more of an impact.
With this tiny dose of Lantus, it’s had no real impact on my boluses or basal profile, but I’ve been able to disconnect for showers without seeing a rise in BG. This afternoon I commuted home from work, something that I’ve been struggling with for literally years (I go low, but in trying not to go low I always go high). I suspended my pump for an hour and a half (something I can never do without feeling nauseous and developing high ketones and high BG later) and when I got home did a one unit bolus when my BG began to rise. I always have to bolus after suspending my pump, but the difference is that today’s bolus was relatively small AND the rise turned right around and came right back down. This is literally the firs ttime in ages I can think of where I haven’t gone high or low during this commute period. Also, with only five units of Lantus on board I’m still able to suspend my pump for half an hour and see a bit of a bump in my BG, but it’s a mere “bump” as opposed to a big spike (I often use this strategy if drifting slowly towards low). You can see me using this strategy around 11:00 AM where I was headed low and instead of eating glucose tablets I suspended my pump for half an hour.
If this better control isn’t just a fluke, then it seems to me that having a tiny bit of insulin in the bloodstream at all times versus no insulin makes a massive difference to blood sugar stability.