Increased Basal

1

I'm wondering if any of you typically see significant increases in basal needs over the winter months and, if so, by what percentage?

I am a long term (over 25 years) Type 1 on a pump (using Humalog). In September of 2012, I was using about 23 units of basal each day. Now I'm using about 30 units of basal each day for an increase of about 30% over about a 3 month period.

During this time, I've experienced some really stubborn highs that had me trying temp basal rates of as much as +85% in an attempt to stay in range.

I've also gained about 5 pounds in that time period with no real change in eating that I can associate - I eat very low carb and was very careful with my choices over the holidays.

I probably have a number of factors at play including the weather (it rained 21 straight days here), a foot issue that kept me off my feet for a few weeks in December, and hormones (I've read that decreased levels of estrogen cause insulin resistance)and I am definitely menopausing. I've also been reading a good deal about insulin resistance in Type 1's.

My endo writes it off to the weather and activity level for now. I've renewed my focus on exercise, increasing frequency and duration, with mixed results with my blood glucose so far but it is early on in this renewed effort.

Up until now, if I walked on the treadmill for 30 minutes, I would see an immediate 40 point drop in blood sugar. Now, at 30 minutes, I may see a drop or it may not budge. Being back on track with exercise definitely makes a difference in the stability of my levels as I find it "smooths" things out. For the first time in a very long time for me, over the weekend I had two consecutive nights of flat lines in the 80s overnight. That's enough to keep me motivated.

I'm the type of person that likes to know what the cause is so I can "fix it". That's the part of diabetes that drives me craziest - we can't always isolate the cause.

Any thoughts or experiences that you would be willing to share would be greatly appreciated. Have a great day everyone! :)

2

Yep, I have this issue. Last summer, I used about 20 units of insulin/day and sometimes even less if I was really active. During these winter months, I've been using about 30 units/day. I also get more stubborn highs in the winter that take multiple corrections to bring down (whereas in the summer, a single correction usually does the trick). I'm on the MM pump.

I think the cold results in slower absorption, and I am also a bit less active in the winter. During the summer, I'm far more susceptible to bad lows, though.

3

I have been pumping for 2 years and have noted increased basals during the colder months as well. My records before pumping are too poor to make any guestimates. My basals between warm months and cold months varies by about 15%. I would guess 30% is plausible, especially for someone who is insulin sensative or has different circulation (especially cold skin during the winter?).

Like so much diabetic issues, there are likely many facoters contributing to this that we do not have the tools to effectively measure. I think being pro-active and adjusting as needed is the best you can reasonably expect. I think you are doing as good as can be expected at this point. The extra weight also will also lead to increased insulin needs too.