Total Change in Control

Hi all

Yeah, I know I'm using up all my posting privleges, but that's how things have been for me this week.

I had posted on Monday about an unexpected serious low followed by a day stuck in the high 200s and low 300s. Thank goodness that passed. I concluded the extreme highs were from a combination of reaction to the low and poor absorption sites.

But I'm not back to normal because I wasn't normal for awhile before that crisis. I normally have pretty decent control Mostly I'm in range with the occasional spike or low.(My last A1C was 5.7) But starting two weeks ago I started having more highs than not, and these highs were at various times related to both to post prandial to basal. The highs weren't extreme, mostly in the high 100s. But high for me. And my correcting didn't seem to be working as well as normal, or I'd correct come down and go back up.

I do tweak my basals occasionally but mainly they work well (I have 9 different rates) and my I:C's have been consistent for months. So what could be causing all the highs? As I said I think I was having poor absorption in my hips which I had probably been using too long. But now I've switched to stomach and it's the same. I switched my insulin vial; I have no reason to think the whole batch was bad as it was fine before. I threw out a pen I'd been using for back-up as it was a year old. I don't have hormone issues as I'm post menopausal. My eating habits are the same and I'm not under stress.No major change in the weather. The only thing left is illness. As I've mentioned on here I rarely get sick and have a super strong immune system. But I have felt a bit like I'm fighting off a cold. My crazy immune system sometimes does that for weeks before I either finally get it or it passes. That could affect control. Finally I had slow onset adult Type 1, but as of 3 years ago when I started insulin my c-peptide was either .38 or .70 so I am assuming it bottomed out pretty much long before this. But who knows; maybe this is the final death march - my insulin use has been fairly low..around 20 TDD, so maybe I'm now "running on empty" and need to up it.

So it could be incubating illness, insulin depletion or some unknown factor. My question is what to do. A few highs are normal for a Type 1 I know and I don't stress over numbers usually. But this is day after day. I do like understanding things. But someone on here once told me something like it doesn't matter why something is happening just what to do about it. So even though my basals and boluses were well set for awhile before this they don't seem to work now, so should I just start slowly tweaking both until I get good results then watch to make sure I don't start having lows when whatever it is goes back to normal? What do you guys think?

Hi Zoe,

As you say you may be just be fighting off sickness, perhaps just set a temporary basal rate and keep an eye on things for 72 hours and make small adjustments?

Thanks, Buckley. I've actually never used the temporary basal rate feature. I usually just tweak one of my rates if I see a pattern. But with highs across the board a whole temporary profile might be a better idea.

Yes when I start feeling sick, I usually increase my whole profile by 20% for 24 hours and work from there.

I find it quicker and more convenient than changing individual profiles.

Give it a few days, maybe see what is happening and then consider adjusting your profiles long term if trends are becoming apparent.. (You know all this anyway ha)

Hope you start feeling better soon.


Thanks. I'm not actually convinced I'm getting sick, I just wake up with a stuffy nose and a scratchy throat, then it goes away. Like I said, I have a weird immune system!

Actually, no, I don't know it, since I've never used a temporary basal. I was going to go through and figure out which rates to change; I didn't know you could increase the whole profile by a certain percent! So thanks.

I used to have more rates for a while, then I realized that I was jacking basals up around meals and switched those out for increasing ratios a touch and smoothed the rate out to be flatter. Now I have 5 but 3 of those are at night. I like this better as it's easier to track stuff and also a bit more flexible as, unsurprisingly, I'd run into "issues" when I'd eat at different times?

Sometimes I just change and if my numbers run high, I'll increase rates at the particular times they're running high like .05U/hr at a time and see what happens. A lot of times, this will adjust my BG back where I want it. To me, that's easier than "basal testing" and logging?

Hi Zoe. Could you be developing allergies to new pollens, perhaps since you moved relatively recently? Another thought is that perhaps your insulin needs increase slightly, slowly over winter? Maybe they'll decrease slightly, slowly with spring and summer. I'd guess allergies though.

Yeah, normally I do what you say, AR, and just increase basals at the times they're running high. I've never done basal this is pretty across the board.

I was diagnosed five years ago, Shawnmarie, and that test was 3 years ago, so I'm assuming I have little if any now. Thanks for the wishes, but personally I find that simpler!

Interesting thoughts, Trudy. I was ruling out "cold weather" as it's been cold for a couple months and this just started two weeks ago. But I didn't know that needs could increase slightly and slowly over winter. I haven't lived in a cold climate since diagnosis. I did have a dramatic response (needing a lot less) to a hot climate I visited on vacation,so maybe.

I also have never heard anyone mention pollens and allergies! And I thought I knew all the variables! My allergies have definitely gotten worse recently. When I mentioned waking up with a stuffy nose and "maybe I'm getting something" it's a lot more likely to be allergies as I rarely get sick. Hmmm. New one! So if that's what it is do you just do a temporary basal change till whatever it is passes?

Zoe, I live among oak and other trees, hike in metro parks, grow flowers in the summer, so I don't really know what causes my allergies, just that they're always with me. They are therefore included in my basals and boluses. In summaray: it's always something!

I basically live in the woods - mostly fir trees but some other trees and I don't know tree types. Seems a bit early for blooming (there is snow all over the woods this morning) but we did have a warm spell and there were tons of robins around my house the days before it snowed! Since I notice the worsening, hopefully whatever it is will "have its day" and move on. So I think a temporary basal will work. After my 34 Sunday night I'm trying not to do an "rage basals". Meanwhile I woke up at a perfect 84 this morning so I keep hoping this "spell" is over, but not counting on it.

Thanks for your input; I was pretty sure from Buckley's post that a temporary basal is a good idea whateverthe cause, but it's nice to at least have a theory!

Summary -- what happened to my spell check?

About c-peptides. I don't know what mine is now, but I do know that after nearly 20 years of Type 1, I still produce a little insulin in the early afternoon. I have to arrange my basal around that, easy on the pump and not so easy on MDI. On MDI, I take three shots of Levemir to achieve the goal of adding as little as possible during those hours: 1 1/2 units at 8:30 AM; 2.0 at 2:30 PM; 5.0 at 9:30 PM.

There are a lot more things that can cause allergies than just pollen. Indoors dust, dust mites, molds, pet dander, feathers, and so on can cause allergies (these are usually year-round). I have both year-round allergies and seasonal allergies—meaning I have them all the time, but during spring/summer/fall they are much worse than during winter. Allergies definitely have an impact on my diabetes, but only when they are really making me miserable, which causes my body to act as if I'm sick.

Interesting, thanks, Jen. My allergies aren't bad at all, and usually only bother me during the night and when I first get up. (Hence my story the other day of wandering around in a hypo daze looking for tissues at 5AM).

Years ago I only had allergies in the spring, but now I have a low level all year long, and then they seem to worsen a bit at unpredictable times (like now) which leaves me waking up saying, "Oh, I'm getting a cold" but then it passes.

I know when everybody goes into talking about the inexplicable like the tides on mars, but I thought I already knew the known variables. I learn so much on TuD with 23,000 "auto-research subjects" (yep, I just made up that phrase for people who do research on themselves - namely all diabetics. Thanks, Jen.

Have you been tracking your temperature? Are you running a fever at all, even a low-grade fever? That might help you ferret out whether your body is fighting a virus or if you are having allergies. I mention it because I often forget to check when I'm feeling "run down". My sister ran fevers for months a few years ago after a car accident, of all things -- no infection, just a whole lot of healing going on. It's in the body's arsenal of defenses during any kind of healing crisis, and I'm pretty sure that running even low-grade fevers can impact BG's. So can stress, of course.

Thanks, Jean. I don't have a thermometer currently, I should put that on my shopping list! But I really doubt I have a temp. Except for the allergy symptoms I'm feeling pretty normal. My life is about as non-stressed as you can get...except for this of

I just took my breakfast pp and it was a lovely 98 (I was 84 before). Maybe this two week run is finally ending (now that I finally ask for help!) We'll see if I can get through this day without spiking.

Hi Zoe: You had slow-onset Type 1, so it may very well be that you have been honeymooning for a long time, and it is coming to an end. Remember that the honeymoon can last for many, many years with good control, and you have had good control.

For me, I have found that a good basal is what keeps those highs at bay. Sometimes you just need to increase your basal.

Just my two cents! We still miss you at the group. It is going well, you left it in good hands.

I think, Zoe, that this is just the nature of the T1 beast, things change. Sometimes for a few days or weeks or months or for good. Our bodies are not machines or at least not simple machines that we or even the best doctor/researcher can understand. In a way I'm glad I don't want to be reduced to a set of numbers though it would make life easier. For me things keep changing for no apparent reason. In 2004 when I started Lantus instead of Ultralente I got great results, A1C under 7.0 for the first time, but then it started creeping up to 8.0, & I changed to the pump in 2007, my 1st year I was down to 5.7, now it's about 6.3, & I keep tweaking. My basal used to average 9.5 to 10.0 per day now it's 11.4.

What I'm saying is don't give up. You just have to keep trying. Don't get too hung up by numbers what matters most is how you feel. I understand that you've had a horrible& scary last few days but this happens & there often isn't a discernible reason. Look at it this way, you caught the low & didn't end up in hospital, your high BGs did come down eventually, so be thankful.

Thanks, Melitta. I wondered if that was a possibility! I've had a pretty low TDD for awhile. I think I'll work out a temporary basal and see how it goes, then if it stabilizes I'll just "permanentize it". (Yep, I'm on a roll with new words - "autoresearcher" and "permanentize").

Thanks, I miss all of you a lot but am very glad to hear it's going well. I'm still thinking about that Spring retreat idea. (My woods are filled with snow this morning!). I'm also working with JDRF in Sacramento to see if there is enough interest to start a group in Redding. Say hi to everyone.