Type 1 diabetic

Been having SO much trouble regulating bs’s (blood sugar) because of EXTREME variation in insulin sensitivity and exercise sensitivity (will post more about it in another Q b/c I need help) but one thought I had is that I haven’t been exercising pretty much at ALL in the last yr or so due to EXTREME glucose drops I can get from even a small amount of exercise (like 5-15 minutes SLOW walking like in a store, which is just required for like ‘daily living’? And prob wouldn’t even be considered ‘exercise’). I got to where I couldn’t take pretty much any insulin at all (still this way) and exercise without seeing these drops (up to 50 pts/MINUTE! Yes, MINUTE!! :frowning: ) so I all but stopped exercising, even walking like in a store. In the last week or two, have been 'walking ’ more in a day, and now ‘knowing’ what ‘exercise’/walking can do , have been taking SO much less and eating way more. Now due to the extreme swings, (that my Endo can’t even explain and is really not much help), in past, perhaps I was still taking too much even though I’d lessened my insulin. So in last wk or two, I’ve been taking less and STILL, hrs later, bs was about the same, if not a tad lower. I have to ‘experiment’ with what DOES what to bs’s , before I can even try to let them get to a ‘good’ place…but even a ‘better place’ would be good… but there is NO CONSISTENT THING EVER.

So could it be that since I’m SO not used to ANY exercise pretty much, now that i’ve been getting even 10-15 min’s walk, this could be like shocking my system since I’m so ‘out of shape’? For example , my insulin:carb ration is set at 1u:5g and correction of 1u:25 pts…I usually eat no more than 35ish grams carbs/meal and split dose cuz it can be fattening and this still isn’t enough…bs’s are usually higher later…BUT, for example, yesterday i walked up many stairs (maybe 2 min’s of walking, and around my dr’s office for about 15 mins total) and ate about 100 grams carbs total…Since the stairs were huge I knew it was intense exercise so I get SCARED out of my mind to take even any insulin…now for 90 grams at 1u:5g (say minus 10 grams to cover walk) so 90grams, would’ve been 18 units for the food, plus say 4 for my bs ‘correction’, so 22 units total?! I ended up taking 3 UNITS total just to see what it did, and later on, my bs was like the SAME, if not 30 pts lower! SOO… does that mean 3 units covered 90 grams carbs which equals out to 1u:30 grams!!! It seems YES b/c I’ve tried this before, where I exericse/walk (last time it was for 45 mins slow walk, and took 4 units for 55 grams, WITH half basal, and later my bs was STILL 100 pts lower!! …Soo see how then just the insulin:carb ration jumps SOO MUCH? If I took what I 'should’ve" plus correction, I’d not be typing here now…Or even just taking the 1u:5g…Then the ‘exercise’ effects carries over for about 20 hrs for me so I THEN have to be hypervigilant about taking less for the next whole day…But on days I get no exercise, like around house, 1u:5g is what I do…Is it becasue I’m so not used to exercising??

This is SO scary and have NO IDEA what to take/do but I know if i listened to my nurse educator on what to take, I’d not be here :frowning: …AND now I don’t have my CGM anymore (insurance denied it b/c I’m not ‘doing good’!! :()…The CGM has saved my LIFE and I NEED IT FOR DAILY LIVING…Anyone else have any experience like this???

I look at people exercising heavily and eating regularly and want to cry because NOTHING i do works and if it does, will have a completely different result the next time…I feel sick to my stomach with fear, anxiety and stress and don’t want to get out of bed…The swings have been so traumatic, I must have major ptsd now and don’t know waht to do… Thanks for your time, wheww!!

Also, today 1 unit brougt bs down about 75 pts with no exercise! Usually it does about 25-30 :(…This has happened for about the past week or two…So should I change ‘correction’ factor on pump?? COULD THE PUMP BE DELIVERING MORE INSULIN THAN PROGRAMMED??? :open_mouth:

I have been having wild, spontaneous, unexplained fluctuations in blood sugar levels, totally unrelated to food intake, exercise, or insulin dose for the whole 52-year period I’ve been a type 1 diabetic. Blood sugar is so much conditioned by hormonal influences and stresses which cannot be measured by the patient that no one other than doctors believe that blood sugar levels are strictly calculable and than irregularities only ever arise because of patient non-compliance.


Yes the joys & frustrations I’d diabetes. Sometimes it seems to make no sense.
But I must say, I highly doubt the pump is dosing too much. In my 27 years of pumping I have never had that problem & have only gotten one replacement but that was me dropping it on tile.
A visit with your doctor or CDE maybe in order. My years of experience may not be what works for you. But my gut is thinking you like many of us are taking way more insulin than we really need. I had this major fear of high blood sugars. So my insulin levels kept creeping up until I was using 23 units a day for my basal rates. After a major restart ( we wiped the pump clean & used the “formula” to get a new starting point.
Low and behold with some fine tuning I am down to just over 8 units of basal each day, correction of 1:100 & carb ratio 1:12 & 1:14. All that insulin lead me to eat to correct the lows. Which lead to weight gain. My life is so much easier now when i’m not fighting the lows and than the rebounds. My biggest problem with all the less insulin is I can’t snack like I use to. When a basal rate is set correctly, you should be able to go all day with no food and hold the blood sugar flat. So now if I want I snack, I have to decide if the snack is worth testing and dosing for, or should I just skip it.
Again, not saying this is your issue but it might be a discussion you should have with your medical team. And I have found less is better, same with how many basal rates you have. Most usually can get by with 2 or 3. Trying to manage 8 or 9 different rates is tough.
Please hang in there, you can figure this out. Keep asking questions!


I just stumbled on your comment, and I’m wondering if taking too much insulin is my problem. How do you determine how much basal you need? Like the starting over process, etc. I’ve never really been told, I just increase when I find my numbers creeping up. Lately, I’ve taken more basal and bolus than I have in the past with only improvement showing the first couple of days. I don’t even know the basics of dosing basal really, I have just increased from what I was started on 6 years ago after diagnosis :confused: I am also on MDI, so no pump here.

Hi @daisy707, Im on mdi too(14 years) first, what kind of carb do you take to correct an hypo? The best thing you can take is Dextrose tabs, because the body doesnt need to convert it to use it, it goes faster in the blood stream so it brings you up faster than juice/candy. Also gave you heard of microdosing with glucagon? To test your basal I sugest you look this at this https://mysugr.com/basal-rate-testing/
I hope it helps!


What type of insulin do you use? For example, if you are using Novolog maybe try Humalog or vice versa and see if you get the same results. There are also some people who say they do better with Regular insulin or animal insulin (not sure if this is available anymore). No idea if it would make a difference but maybe worth investigating.

Thank you! I usually correct a low with a roll of smarties (6g) and it does the job! Or a 15g juice box if its the middle of the night. I don’t find juice makes me spike. And I haven’t, I’ll have to look on it. But I hardly have bad lows, especially lately. I can’t remember the last time I went below 68 really. Thanks for the link! I will check it out!! :slight_smile:


Hi Daisy707,
Isn’t the diabetes online community the best when you can just stumble on to something!
That being said, you know the first thing I will say is, you really should talk with your medical team on this one. I was starting a major clinical trial and that is when we really discovered that I was talking way too much insulin. The endos took my weight and sensitivity and current TDD and I went to one rate for the 24 hour span with a lower rate for work (due to physical nature of my job). Went from a high of 1.8 per hour to .6 for the whole day. Was very freaked and thought i’d be high all day, but it really worked. I am currently at .4 over night and .225 during work days. Carb ratio went from 1:8 to 1:12 and 1:14.
Please remember I did this with a very good medical team supervising and they continue to make changes when necessary when I notice a pattern happening.
A big suggestion here is a book by John Walsh. He has one called Using Insulin for those on MDI and Pumping Insulin for those on a pump. Very, very informative. You can also find charts and formulas on his website called diabetesnet.com (I think?)
Good luck with the changes! I will say, the ease of my life has been great. Less highs, less lows and i’m Not juggling 8 different basal rates. Less is best for many of us, if we give it a fair chance. I didn’t think it would work for me as us old timers can get pretty set in out ways, but I have found change is good! So tell your team what you want to try and I hope you can make it happen! Keep us posted on the changes.


Hi there thanks for reply. My CDE would look at me and say I’m not taking nearly enough b./c my sugars aren’t even close to what they ‘should be’, but I think I’m in sort of a cycle where at times I might be taking too much, like if I get ANY exercise, like 10 mins slow walking (I’m prone to EXTREME bs drops, even with much less insulin, so have tried taking none, then bs remains high)…but as my example said, that shows that the insulin:carb ration AND the correction factor would JUMP to needing WAYY LESS, like 1u/25-30g instead of 5 or 7 grams…that’s like 5 TIMES as less?! (I took 3u for 90 grams about) AND one unit can then bring bs down over 100 pts so the correction factor jumps a lot too :frowning: . It’s insane and CDE said that doesn’t really ‘happen’ b/c she has patients who do like parkour)… This is with just like DAILY LIVING walking…then it carries over and i’d need less for like almost 2 days after?! It is sickening and scary to think this is happening when my CDE wouldn’t even consider that ‘exercise’ and said to only lower Basal rate!!? That wouldn’t be NEARLY enough reduced insulin! So it’s tough for me to get my bs’s in a good ‘range’ even, and even if I try, it never works, and as a result, I don’t get to eat much or often b/c I try to keep it low carb, and then when I have to space out insulin a little at a time so it’s not too much at once to allow for any activity at all, my eating gets pushed back (to allow the insulin I keep having to take to work/wear off) and I eat like 2x/day if I"m lucky :frowning: …It 's such a vicious cycle and NOW, I don’t know WHAT I’m going to do without CGM, as that is the onlyu thing that allows to monitor myself for SAFETY with crashing sugars :(. So I can’t really take this issue to CDE I’d say? SHe’d just say well your sugars aren’t low…and I’d say they’d be more than low, I wouldn’t even be sitting here if I did waht they suggest…It makes my very very physically limited as to what I can do in a day and now have n’t been able to get/keep a job :frowning: I’ve been denied a few jobs too due to diabetes…It’s such a freak show and the more I try, it seems the more tons of dirt are thrown on me to dig out of with this…

When a basal rate is set correctly, you should be able to go all day with no food and hold the blood sugar flat.

Does this apply for Basal rates overnight too? My bs can sometimes drop almost 200 pts overnight (with no bolus) so that’s why I have to almost keep it real high at bed, which is also contributing to high a1c, besides all my other high bs’s due to extreme variations of how the food insulin and 'correction’s work :frowning: …When you test a basal rate during day, you skip a meal I think, then see how much sugars go up or down in waht, say a 6 hr period between meals? …Is going down 200 pts in a 8-10hr period too much then? …What is considered keeping blood sugars ‘flat’ during a basal period, (with no food at all?) like + or - 50 pts?

I would consider a drop of 200 points in a 8-10 hour period a big sign that the basal rate is way too high.

Honestly, your situation is a little confusing to me. I’ve never had an instance where my blood sugar would drop (at all) with 5-10 minutes of walking… ever. I’d guess that there’s some form of insulin saturation that doesn’t end up absorbing until you start exercising.

Everyone has different levels of insulin sensitivity, but if I were you, I’d probably start basal testing and plan to reduce my insulin intake significantly. If that doesn’t work, I’d consider getting off a pump because you may have variations in your insulin absorption on a pump.

A pump uses fast-acting insulin. Fast-acting insulin is particularly sensitive to exercise. Your body will absorb the insulin much, much faster when you are exercising. When I was on a pump, I had to use a temporarily reduced basal or disconnect my pump when I exercised. My guess is that your basal rates are waaaaay too high, so you’re particularly sensitive to any form of exercise- especially if you have have inconsistent absorption in your sites.

These are just my guesses though. I’ve never heard of the kind of drops you’re describing. I’d probably get off a pump right away if I was experiencing that sort of thing.

My basal rate is totally inadequate during the day, since the blood sugar constantly creeps up even while I’m not eating anything, such as during the 12 hours I fast. (I eat only twice a day.). But during the night, the blood sugar drops about 240 mg/%, so there is no real way to adjust the basal rate except by giving small increments of it all day long to even it out. But that defeats the whole idea of taking a basal insulin, which was hailed as a triumph when it was invented in the 1930s, since it was thought this would finally free diabetics from the need to inject all the time, as they had to do when there was only the type of insulin available which had first been puton the market in the early 1920s…

If you’re on a pump, then you can adjust your basal rate hourly. Are you not using a pump?

On a pump, there’s no reason you should need to have a basal that’s too high during the night and too low during the day. You can change your basal rate so that it’s customized to that time of day. When I was on a pump, I had 4-5 different basal rates throughout the day/night.

Sounds like you could benefit from a split basal dose or a pump. There are multiple strategies for dealing with the issues you’re describing (and I’m sure you’ve tried some yourself). I wouldn’t be satisfied with a basal that was clearly too low during the day and too high at night.

That being said, some people can dial in a one dose per day of long acting insulin and it works great. As with many things, not everyone responds the same.

Unfortunately, since I’m immunosuppressed to restrain another autoimmune disease I have, there are infection concerns that discourage my use of a pump. Generally, though, I don’t like to support anything that delays a cure for diabetes, and buying all the new generation of diabetes gadgetry just encourages Big Pharma to view perpetuation of the disease as more profitable than curing it.

Since I’m busy, I like to take insulin as infrequently as possible, so I resist the idea of taking repeat basal doses. It’s simpler and more pleasant just to eat a big snack before going to bed to avoid overnight hypoglycemia rather than undermining my quality of life by taking more doses than I have to.

Managing any chronic disease is very much a matter of preserving the right balance between aggressive treatment to postpone its late sequelae and letting the patient enjoy as normal a life as possible en route. I think in diabetes management, the balance has tilted too far toward ruining every day with perpetual interventions to avoid the complications, which may well be caused inevitably by genetic factors or by the continuation of the initial autoimmune attack on the pancreas to attack other organs.

Thanks for reply. Yes the situation is very weird and confusing to me too…it seems that if I get no exercise at all, my sugars stay real high (even with a tight dose 1u/5 grams), seems to not cover the food I eat to bring bs down again and then when I get ANY exercise at all, like 10-15 min’s walking (especially if right after bolus), bs can either crash, OR I’ve been experimenting with taking WAY less bolus (while adding minimal walking as in like from car to a store /around a store for 10 mins, like what would be daily living, and sometimes it seems the food ratio of what would 'cover ’ the food jumped up to I took like 3 units for 90 grams, so 1u/30g’s!!! Now my bs’s were still ‘up’ /not where they should be, but I’m just trying to find a ratio that can SEMI-work and get bs’s around the same for the next meal (isn’t that how you measure if a carb bolus was adequate?? So my insulin sensitivity JUMPS THAT MUCH with just like 10 minutes ‘exercise’ as ‘activation’ as you say? That is VERY scary b/c my CDE keeps increasing insulin, but if I didn’t lower it myself as much as I am for just BASIC walking, I KNOW it would CRASH SO MUCH MORE and I’d be in BIG trouble (as this used to happen to me) and I said to her ‘ok if I take more insulin, and walk from here to there it’ll just crash exponentially now with even moer insulin’?! And she disagreed, but this is what happens to me :frowning: It’s like a vicious cycle, and I think you’re right I might need way less basal (and prob less insulin for insulin:carb ratio AND correction?!

I can’t stop pump because when I was on shots I’d get these Lantus ‘reactions’ many times/week where it’d hit a ‘vessel’ and cause an IMMEDIATE reaction where my bs would drop VERY VERY fast, like as if a big bolus dose, and I’d have to eat 150+ grams carbs to stop it and keep my sugars above 350 before shots :frowning: …Landed me in ER once and I ONLY caught it b/c of CGM…Shots were bad for me :confused:

Before I started my pump, I had to figure out what all my dosages and correction values were, since I had no idea. I had basically been winging it for the last thirty years with over the counter insulin and no Endo. I found the mySugr app to be really helpful with these calculations. Once you give it enough data, it will actually tell you what your correction and carb ratio values are. You have to be brutally honest about what you’re eating and drinking, though. I weighed everything I ate and tracked it in MyFitnessPal to ensure accuracy.

You’re going to have more insulin resistance when your BG is high, though, so you’ll have to take all that with a grain of salt if you’re out of range. Still, it could help you narrow the field on your numbers. The longer you do the mySugr thing, and the more time you spend in range, the more accurate the mySugr calculations will get. I don’t use the app anymore because I’m happy where I’m at, but it was definitely helpful to get me here.

That insulin resistance when your BG is high probably has a lot to do with your rollercoaster frustration. You may need more basal and that 1:5 carb ratio when you’re high, but half that when you’re back in range or lower, and it will look like an erratic change. The best you can do is keep fighting that battle we’re all familiar with of trying to stay inside that tiny, happy BG bubble. It’s about the only time your body will behave consistently… And even then, it’ll surprise you

Unfortunately, I don’t think mySugr will be of much help for your basal programming. The fasting series of blood tests is really the only way to test those.

A good basal rate will keep you blood sugar flat during a and it holds overnight within +/- 30points or so, your basal rate is correct. But if you have a 200point drop overnight, that means there is way too much insulin, And keep in mind if your for an overnight basal test and you wake up around 200,that still means the basal rate is correct because it is holding you flat during that time you are testing. A basal rate set correctly should not raise or lower your blood sugars but hold it steady. Your bolus and correction factor are used to lower blood sugars.
And I again, highly recommend the book Pumping Insulin. It has some great starting points on trying to get the basal set correctly. And you really can’t fix anything else until you get the basal set nicely.
And my only suggestion to exercise drops that fast and that quickly, is suspend the pump. It is one thing I love about pumping and has saved me many times. Especially when I have been doing surgeries and have to fast. Instead of eating and maybe having to cancel, I just turn it off for a few hours and things level out.


My problem is that my basal rate is a bit low during the day, since the blood sugar values creep up gradually when I’m not eating, but still, I can easily have a 240 mg/% drop over night, so there is no way a single dose can keep day and night stable.

Since the insulin needs, insulin resistance, and other hormonal outputs of the human body constantly change the blood sugar levels on their own, independently of insulin dose and eating, not all variations in blood sugar depend on insulin dosing patterns. With sleep, many physiological changes occur, and all of them can have their impact on blood sugar levels.