Lower bolus requirements?

Curious as to what your experiences are regarding possible reasons for a sustained–e.g. two weeks or more–and significant decrease–e.g. 30-40%–in bolus insulin requirements (but no change in basal/long-acting insulin needs)?

I’ve had lower insulin requirements with weather changing to warmer temperatures.

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me too as warmer weather sets in, bolus goes down 30%+. I don’t use any Basal insulin as basal/long-acting always drops me into hypoglycemia territory during the night, so gave up on all basal several years ago.

I have lower insulin requirements when I exercise more and if I eat less fat. So eating a piece of dry toast will require 4 units. Where a piece of toast with butter or peanutbutter requires 6 units. If I eat a piece of dry toast and walk a mile it’s reduced to 2 units.
I avoid eating bread, but I did these tests about a year ago to get a handle on how fats effect insulin needs

So that’s a big difference between 2 units and 6 for the same carb content.

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Insulin Genie?

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Phew, maybe I’m not working with wonky alien metabolism. I’m continually surprised by how much blood sugar can be affected by things, even after three years of having T1D. I think it is exercise, which I’ve been able to do more of lately, fortunately. At least, that’s my best guess at this point. I’ve always had to take less insulin for a meal if I exercise afterwards, but lately I’ve been hiking in the mornings, and both lunch and dinner, after walking, are requiring a lot less now, too. Anyway, your feedback really helps–thanks for sharing!

Ok good. Exercise is the best insulin enhancer. I believe it reduces insulin resistance or increases insulin sensitivity depending on how you look at it.

I do intermittent fasting on weekends and even when I’m not eating at all, I have varying insulin needs.

On a hike I’m using 0.8 units per hour and sitting around it’s 1.2 or 1.1,but running or swimming or some intense exercise, it drops to .0.5.

I have a tandem pump and it makes these adjustments for me. But when I look back at what my insulin usage was to maintain 112mg/dl I see that variation on insulin usage

If you do intermittent fasting you can figure out your basal rates hour by hour. If you have a pump, you can switch to different modes. I have basal rates for exercise, one for regular day to day and a whole separate setting for intense exercise and one for sick days. Again the pump will make corrections for you, but the closer you set it up, the better it performs

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Creatures of habit tend to have the best BG control. As soon as habit changes, social, exercise, food etc. knowing how to quickly adjust to a new normal is critical to keep numbers steady.

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Season change.

My insulin requirements have dropped so dramatically this year, with the onset of summer, that I can’t tell my head from my ■■■. Everything is suddenly a mess…a bit of a crisis. I’m seeing really intense and constant low BG throughout the day, AND whenever I eat. I don’t even need to bolus for meals.

I’m trying to drop basal as fast as possible. There’s not even time to collect data - just need to drop everything as fast as possible before something terrible happens. It came on quick and might be associated with increased activity/weight loss/increased circulation associated with the season change and warmer temps. it’s been a freaky-deaky couple of weeks. Work is becoming increasingly difficult.

Yesterday I just walked into a gas station, tore open a bag of m&m’s, and one of the gas station kids brought me a 7up. I didn’t pay. The kids didn’t care. It was an emergency.

Wow that’s horrible. It’s amazing–and scary–how much T1D can throw you for a loop. It can feel like your body is just a sack of chaos, and somehow you have to navigate through it all…it can be so exhausting and stressful. My lower insulin needs have also been correlated with increased exercise as well. I’m hiking longer, and more intensely, most mornings, and on the mornings I do, my lunch and dinner boluses have needed to be reduced dramatically. Like, yesterday I took 60% of what I would normally take. It’s crazy, I’m so sick of eating sugar to keep up, although now hopefully I’ve gotten it through my head that I just need to take way less insulin, and deal with whatever highs might arise. But it’s so hard to manage and do the right thing when things are changing, and you’re just having to guess at what is happening.

I wish you well in figuring out your new “normal”–stay safe, I’m sure it will stop being so rough in time. (And then, just when things are under control, a new normal will present itself… ha).

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Sounds like you need new basal testing.
I fast on weekends for 24 hours so I essentially do basal testing every week.

I m on a pump so I can see the rate of insulin I need hour by hour.
My rates change from .7/hour to 1.2/hour. That’s why I think doing injections are difficult for me since most people take long acting once or twice a day and there is no way to dial it down.

My pump makes corrections hour to hour, but I try to keep my pumps starting point close to my actual needs.

If you are getting confused and dizzy, it’s a very big risk and very bad for your overall health.
I had symptoms like thst when I was taking NPH and regular insulins. I didn’t have a cgm and I never really knew my sugars till I got home.
If I were you, I would start from scratch, work out your basal needs and then figure out your carb ratio and sensitivity/ correction factor.
I’m pretty sure your 7up and MMS caused you to shoot up and the rollercoaster ride continues.

Scary!! So sorry! If you also get dizzy with low BP get checked for Addison’s. (One tests positive only when 90% of your adrenal cortex is toast, but I was dizzy for years before that). Hoping you’re ok!

I meant the above comment for Mohe.
BKN480, if your basal is stable, no adrenal issue. Signs of Addison’s for me were need for much more thyroid med, and way less insulin, plus frequent low BP.

I dropped my basal 20% across the board. There’s simply not time/need to collect anymore data. This is a time for action! I still had some lows yesterday and this morning, but more moderate. I’ll need to drop more, but 20% seemed to get me started in the right direction. Welcome to summer!

If I start to feel like I’m living in the movie Fear & Loathing in Las Vegas, then 20% must be the magic number.

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Glad you’re getting it sorted. Much better (imo) to err on the side of going to high, and changing management from there, rather than the other way around (I try hard to take my own advice–dudn’t always work out…)

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Thanks earthling! I do take thyroid supplement but just had blood work and it’s in the normal range but actually on the low end (indicating move towards hyperthyroidism). So I’m actually backing off a tiny bit from the levothyroxine–just a tiny tiny bit. Anyway I’m glad your issues have found some answers…it’s a continual process, that’s for sure… thanks again!

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