I suspect that my honeymoon phase is beginning to fade. A few days ago, I began to notice that the BG in the morning rose quicker. Breakfast caused unusually high BG spikes (that is, high for me; I do a long pre-bolus in the morning, and usually get 120 at most, but yesterday I spiked at 137, the day before at 145). Then I began to notice that once the bolus insulin was out of the system, the BG began to rise again, reaching 120-130 (starting from about 90). I had to administer multiple corrective boluses to bring it down, only for it to go back up again once the bolus was gone.
I heard an interesting explanation, and that is that slightly insufficient basal can cause insulin resistance due to too many fatty acids in the bloodstream that “clog up” insulin receptors. This is why when you are in ketoacidosis, you need tons of insulin to bring things back under control. So, in my case, apparently the beta cell function is now further diminished, and as a result, I am in that situation. Clogged up receptors means that bolus doesn’t work as well either. So, the solution is to crank up basal.
But, perhaps this is just an intermittent period of the honeymoon phase. A few months ago I suddenly had a period where the insulin sensitivity skyrocketed. I:C ratio shot up from 1:12 to something like 1:25. Hypos abound. So, maybe this is something similar, but in reverse, and the beta cells may someday become more active again … ?
Either way, these past few days have been hugely frustrating. I am very focused on tight control, and having days with an average BG of 110-120 is terrible for me (I do low carb and usually achieve FBG of 90). I know 110-120 is objectively not bad, but I have to run a tight ship here, because if I slack off and let the FBG go up to 180 or more, then bringing it down again is much harder.
So, perhaps I am venting here. But it is damn frustrating. All I can do is wait until the increased Tresiba dosage takes effect, and eat very few carbs until then. I sure wish I had a pump right now…