This is definitely a possibility. A person’s liver can compensate for the lack of carbs by putting out glycogen. It is not something that affects everyone the same.
Ditto for me. I ended up with 3 basal programs: high, med, and low. Just .5 unit/hr difference between them. Depending on how I an responding, I switch programs. It seems to level out my responses to mealtime doses. Also I bolus about 20% more for the first 12 hrs or so after I change a pod. Seems like it doesn’t prime enough or who knows? Had a rep tell me it “needs to saturate the new site”. Interesting way to put it but sounds kinda fuzzy. In using Omnipod for a year now have had 2 pods where my BG results were just bonkers with no plausible cause.
That’s a good suggestion. I’ll definitely try to look again at my numbers between meals.
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I had an interesting day yesterday. Dexcom said 245 when I woke up, and I felt like it was about that much so bolused for it. Maybe 30 mins later, I started feeling a little low and the Dexcom had plummeted to 60, went to check it with the regular meter and it was 33! I didn’t feel anythign close to that low, but right after that I started feeling it as my vision got foggy and stuff. I still had 12 units on board so needless to say I way over did it on correcting, so it later shot up to about 350. I had to change my cartridge, but the Humalog was from the same vial so shouldn’t have been different. My site had also been changed the night before. From that point on for the rest of the day I kept correcting, even giving more than what I should need and things never came back in range until right before bed, so I was definitely feeling like the insulin was inconsistent. Then this morning I wake up and it is 245…bolus for it and the carbs I was going to eat/drink (coffee) and a little extra because I had food that still hadn’t digested, and 30 mins later it was dropping fast! Before this I had had several days of fairly stable in range BGs…
Agree, kmichel. I don’t think we pay enough attention to this issue and there’s vitually no patient advocacy effort to improve the temperature control of the insulin supply chain in the U.S.
I have often switched to new pens just to test this and have repeatedly seen bgs normalize a few hours after making no other changes than switching to new refrigerated pens. The current lack of constant, controlled refrigeration of insulin throughout the supply chain is a big challenge for all of us. From the shippers to the carriers to the pharmacy staff, there’s less attention and care paid to the temperature of insulin throughout transport, storage and delivery. I’ve been using insulin for 50+ years and I’ve seen the controls go from stellar to highly questionable on a consistent basis.
On a separate yet related note, I recently started following Bernstein’s advice to keep insulin refrigerated even after it’s open and in use.
I’m sure if they start taking better care of consistent temperature that they will use it as a reason to jack the price up 5x due to the “complex system needed to maintain temperature” or something…
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Yes, this has been happening to me since October. Things seem to have been settling down until a pump failure on Thursday sent everything askew again. We sorta think that I kick a lot of hormone.
This has been happening to me for several years. I’ve had to switch things up constantly to make them work. Thankfully my endo is only a quick email away and she will suggest new things or adjustments I might not have thought of.
First it was switching from apidra to novalog. Then I used humalog in my pod for boluses, but started using tresiba at night for my basals because of site absoption issues. I switched up sites A LOT but after a couple years of this, 3 sites a week, they just get worn out. Then I took a pod break for several months last fall, kept on the tresiba but used the humalog U-200 pens (hellooooo expensive! Even with insurance!). Because its more concentrated, that combo was working beautifully for me for some time. My endo wanted to experiment with the U-200 in my pods, which we did - she adjusted the basal and bolus rates accordingly and it worked really, really well!
Then I got pregnant. It was totally planned, and my endo had warned me I’d not be able to use my beloved tresiba if I wanted a pod break. First trimester went so well, my a1c was down to 5.4 on just the humalog U-200 in my pods. Second trimester now & things are falling apart. I needed a pod break desperately, was getting bruises and site inflammation from the cannulas, so started in on the recommended dose of levemir (actually I took the dosage on my prescription, told the doc it wasn’t enough, and she cut it back by a third, wth??). Short story - levemir sucks eggs for me. I told my husband last night, this kid is gonna pop out in September and in my first follow up appointment my endo is probably gonna be like “oh hey, so tresiba is now approved for use in pregnancy!” 
So, long story just to say I TOTALLY FEEL YOUR PAIN!! I bolused for 30g of carbs this morning, which was 20 units of U-200 humalog, intending to only eat 20g, its been two solid hours and I’m still cruising at 242. It didn’t even touch it yet and I only ate the 4g of carbs in my cottage cheese.
Dexcom is consistently about 40-100 points off for me, so I never make dosage decisions by its readings alone. (Still using G4) It boggles my mind how people have accurate results with their Dexcoms. I think my skin just hates everything.
I saw that article posted above making its rounds on fb and it honestly p*sses me off. We as consumers need to demand better results from our insulin. This isn’t some little blue pill for pleasure purposes - this is a LIFE-SAVING NECESSARY HORMONE THAT WE NEED.
That said, if anyone knows any consumer action plans out there or places where I can get involved, please let me know.
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Was toying with starting new thread, but figured I’d just continue on this one.
Based off of some of the comments here about switching from very low to moderate carb levels affecting insulin effectiveness/etc, I decided I would test out eating more carbs, consistently, through the day. Nothing hog-wild mind you, but I’d guess maybe 150 a day or so (haven’t been keeping detailed records)? The interesting thing is that after the first day or two, I haven’t seen the wild spikes I would normally experience eating carbs (bread, etc). Easier to cover. I don’t know if my body is not in such a rush to convert over to glucose when I have enough stored (that’s my hunch), but I thought I would post here in case anyone else has seen this before as well.
I had been misdiagnosed as T2 years ago and was able to get my A1C down from 11 to 6 on primarily diet alone (was probably on the tail end of burning out since I wasn’t taking insulin), but that first year or two really shaped my attitude towards food, and carbs specifically.
Who knows if the last week was just a blip for me, but thought I would share. Always something to learn it seems :-)…
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Interesting test. For it to be worthwhile, please record your carb consumption and post prandial BG. You have to have a BASE DATA for comparison. Keep it scientific. Diabetes control is a continuous scientific experiment. It sucks! Please keep us posted with your results. Any results so far?
We keep focusing on the carbs for good reason, but I noticed I have to count the proteins too, divide the protein grams in half and bolus for that too. But proteins digest slowly, combo bolus can address the delayed action.
Omnipod is pretty good at putting out error messages when the pump isn’t functioning.
My guess is its just you, Jason22. Seems like you’ve tested a lot of the variables.
I think of my insulin working in phases. It has phases of working really well and phases of working not very well. Because it takes a lot of time and effort to set the basals properly, I try to set them so that I will survive either way. I might run a little lower under my basal regime for a couple months, but then if the system changes, I wont be running insanely high - just tolerably high. What is acceptable is relative to recent circumstances.
For instance, I changed my basals a couple months ago and was getting some moderate highs, then I was getting some moderate lows, but the system shifted again and now my numbers are pretty spot on (if I remove areas of obvious human error). Thats what I want from a basal program. Just good enough to survive. Ill see phases of lows and phases of highs. I only reset my basals when things become intolerable.