The low life

Hi all I'm going a little crazy this week and need some advice. I'm on the omnipod, have a cgm and was going along pretty good until this week. For no apparent reason my blood sugar is crashing all day and night. I'm not new to this I've had type 1 for 17 years. It's taking forever for my lows to come back up so I hold back on insulin when I eat and then it goes high. I feel like I'm trying so hard to do everything right even was on a diet and doing good for a couple of months but since I'm constantly having to eat to get my lows up that's shot. Yeh I should call my doctor but I know they are more clueless than me. The go to he tells me when I have any issues with my numbers is call your pump trainer. Just wondering if anyone has had this happen and any advice you could give me.


It sounds like your insulin dosages may be off because of the weight loss. I have also been losing weight, and I noticed that I typically need to lower my insulin dosages approximately every 10lbs.

The big thing is determining whether you need to decrease your basal, increase you I:C, increase your SF, or a combination of all three. Ultimately, it depends on when you're having the lows.

You said that you tend to go high when you hold back on taking mealtime insulin, so I don't think it is an issue with your I:C, and your basal needs to be reduced instead.

Is it possible for you to lower your basal 10-30%, see what percentage is the best for the most low-prone times, and adjusting your basal profile based off the best percentage of basal reduction?

Whenever I go through difficult times controlling my blood glucose (BG) levels, the thing that always comes through for me is logging everything: BGs, insulin dosing (both basal rates, boluses, and corrections), and all food including its carbohydrate content. I recommend weighing food on a digital scale to get an accurate carb count.

I know you've been at this 17 years and you figure you don't need to go back to the basics. The thing is, diabetes is a dynamic disease. It appears that for one reason or another, your sensitivity to insulin has increased. You need to accept that new reality and take less insulin. How much you back off on your doses can be informed by your daily logs.

Have you done any basal rate testing recently? That is a good place to start. Gary Scheiner's protocol works for me.

Writing stuff down is a powerful learning method that has never failed me. Most of us resist doing it because it seems to get in the way of life. But right now your erratic BGs are taking over your life. Lows in particular carry more of a threat. You need to respond in a meaningful way.

Your logging will invite personal experimentation and that is good. You need to relearn your body since it's decide to take another path. Don't be surprised if you adjust to a lower-dose regimen and then find out you need to increase your doses over time and return to your old routine! This can happen.

I've been through these kind of issues and struggled for years. Once I decided to give up seeking a solution from the doctors, nurses, dietitians, and pump trainers and instead sought the advice of my fellow people with diabetes, it was then that I found a way out of the mess. I discovered low carb eating and the lower doses it entailed along with daily walking. That's the routine that solved my erratic BGs.

At the root of all my efforts was a daily logging routine that helped me to devise solutions. I don't log every day but whenever thing start goy haywire, I return to this potent habit.

Good luck. Don't give up. You can beat this challenge!

Thanks for the reply. I've only lost 6 pounds total. The last couple of weeks I went to a wedding etc and wasn't perfect with the eating so my weight hasn't changed in about 2 weeks. You might be right about the dosage & weight loss but it seems odd that it only started this week going low. I've been sick this week I thought I had allergies but it might be a cold. The lows are almost constant at least that's how it feels. I had a bad one last night so I ate 2 packs of gummy fruit snacks and drank a Capri sun all in the dark lol It took forever to come back up and eventually went almost to 400. I didn't correct I was so tired I pushed my cgm under the bed to avoid the buzzing. I looked at my cgm this morning and my blood sugar then came down before I got up to 183. This is just so odd! Normally if I go that high the only thing that brings it down from that is a big bolus and a temp basal. I just want to go back to the way I was before because going low constantly is wearing me out not to mention I'm ready to go back on the diet. I'll cut the basal back and see if that helps. Just wish I knew why this happened so suddenly.

Sounds like you need to do basal testing and make some adjustments. Do you have either Think like a Pancreas by Gary Scheiner or Pumping Insulin by John Walsh? Both will take you through this step by step.
If you don't then in the mean time try a temp basal reduction and see how it goes. Depending on how low you are trending a 5-10% reduction may be a reasonable place to start.

You can get either of those books for e-reader right away, but some like to have a hard copy to mark up and flip through.a Aaron

Thank you for the great advice. I guess considering this is day three of this cycle I hadn't considered keeping logs or even reducing my basal. I've had times where it seemed so obvious that I needed to reduce but this time it's like being on a roller coaster which I never liked. It sure would be nice to be able to call the doctor on issues like this but I know he would have no idea what's what. I once told him when he upped my dose of thyroid meds that it made my blood sugar go up and he told me the dosage change has no affect on it. I knew it did but why bother to argue.

Thanks for the ideas. I've been meaning to get the pumping insulin book. I know I'm far from an expert but never felt I was this clueless before.

You aren't a large woman, so 6 lbs could demand a basal change. I'm about your size and female. Once, I lost 20 lbs in a month, but I didn't notice. I dropped from 170 to 150 and it sent me on a road towards death, like I wouldn't have imagined. I was loosing consciousness left and right. So, I agree with Mimkins. Weight is one of the first variables that I examine when looking for unexplained lows. I live in MN, where the seasons are a huge variable in peoples activity level (and emotional state), so those basal adjustments between summer and winter come at me like a pack of wild dogs. They have to be dealt with.

Thanks for the advice. I reduced it yesterday and still had issues last night but this morning is better. I guess I didn't think of the weight loss because I've been at the same weight going on 3 weeks now. Only Monday did I start having the bad lows. Our bodies do funny things so who knows. I'd really like to feel normal again and I still want to lose around 15 pounds. I really appreciate everyone's experiences and advice.

Prepare to reduce more, for a total of 20 lbs.

At this rate it may be 6 months before I get there. It's sure frustrating to do so good and then have lows and have to eat more calories. Like exercising you burn calories but end up eating all if not more calories than you burned to combat the lows. Temp basals only work some of the time.I need a vacation from my diabetes really bad.