hello, i posted a couple of weeks ago about running low and i am still doing so. in the second week of april i lowered my evening basal from 9 units of levemir to 8, as i was waking up in the 70s.
now im on 8 units and waking up in the 60s. i decided to wait it out for a couple of days before i make any more changes, but have a question for people with cgms who can see their bg readings more frequently. have you noticed that if you wake up low and feel tired, fatigued etc, that you have been low for a longer time than if you woke up low and feel normal? i woke up today feeling beat and it makes me think i was low for a while before waking up and that the other mornings ive woken up in the 60s maybe it was just a short time that i was low. i slept a full 8 hours last night.
i didnt bolus for dinner last night and made sure i had about 15 carbs at dinner, which i have late. there was some fat and protein at dinner.
does this sound like insulin sensitivity or am i still honeymooning after almost two years?
I don't feel low based on the duration. I don't mind waking up a shade low because I'm a zombie in the AM until I have a couple of cups of coffee. I would totally doubt the honeymooning but just that maybe your basal is pretty hot. What is your ratio of basal to bolus? I've read that 50/50 is ideal but I also read, I think in the Francine Kaufman "Pumps and CGM" book (which I haven't finished, since I got distracted by "Dune"...) that many people can do well running their basal a bit higher, particularly on low carb diets. If that can be examined, maybe there's still too much basal in the mix? A big cutback might mandate a slight nudge up in the Carb/ Insulin ratio to be balanced for meals but might result in more overall smoothness, if that makes sense?
I think every low is different and don't really notice anything related to duration or time of day. Some 63s knock me off my feet (almost literally) and some 43s I feel almost nothing. I think there may be more at play then BG alone.
That said, I often find myself having more hypos in the spring. I relate it to more exercise as I am outside gardening, mowing the lawn, playing with the kids and the temperature is higher. Some diabetics find they require noticably less insulin when the temperature increases. My needs last Summer decreased about 15% and then went back up 15% when cold weather arrived. The best theroy I have heard is the warm weather causes increased blood flow near the surface of skin which leads to faster/better insulin absorption. Another thing to consider is weight loss. If I lose/gain 1-2% of my total weight I almost always have to adjust my basals somewhere.
Hypos at night are a big concern of mine and that is one area where I try to error on the side of caution. I would suggest that you consider lowering your basal doseage so you are out of the 60s when you wake.
If I have a low in the morning, it is most likely a short period of time because lows will generally wake me up in short order. I suppose it depends on how hypo-sensitive you are. My hypo sensitivity is not what it used to be, but a low in the 60s will still wake me up.
That being said, I do notice that I feel more tired if I'm waking up in the 70s versus waking up in the 80s, 90s, or above. I think it might have something to do with residual hypo-sensitivity that doesn't quite wake me up, but doesn't allow me to sleep as soundly. I've always just figured that I'd been lingering in the 70s for a few hours before waking up.
As far as your honeymoon period goes, sure, you can have a longer honeymoon than 2 years.
i might suggest doing some basal testing overnight, maybe try over weekend. wake up every couple hours to see what's going on...typically, it's best to not rise or fall more then 20 or 30 points overnight. what were you after dinner, at bed time?Also, did you do any strenuous activity that day, evening, that too can effect basal rates and BG's. I've heard even day before exercise can effect next day BG's. And to add more in the 'mix', if you're still honeymooning, the more stable you keep your blood sugars (those 'good days'), the more your beta cells, what's left, will spit out insulin because you're not stressing out your pancreas.
Some people find splitting the levemir into an a.m. and p.m. dose useful. We did when my son was on shots, but for the opposite reason as he was always waking up high.
my basal must be way hot? i dont know. i take 2 units of levemir in the morning at 9.30. my I:C ratios for meals are 1:30 but now only at breakfast, im not taking any for my lowish carb lunches and dinners. lunch is usually 20 or 25 carbs and then i cycle to work after and that keeps me even. at dinner another 15 or 20, no bolus. levemir 8, today 7 units. so total im on 9 basal and 1 bolus. how could i change it? waking up in the 60s. is it okay to wake up in the 60s then?
i feel like i cant give myself any at lunch cuz i leave on the bike right after and i dont want to have any at dinner cuz i eat when i get home from work at about 11pm.
this is totally different from feb and march when i coulndt eat anything without a bolus. totally weird.
Sarah, i guess i will have to do some basal testing. no strenuous activity, just normal. i was 92 before dinner but had a full 15 carbs with no bolus for dinner so thought that would have me waking up perfect. i am positively STUFFING myself with carbs the last week without bolus and it seems to do nothing!
yeah, thats why i started splitting the levemir too! thanks for the responses. i dont bother going to my doc or nurse cuz you guys know more than them!
I'd probably add in something like cheese at bedtime to fix the 60s although, if my BG were that stable that it happened all the time, I might not worry about the 60s and figure that's where it floats and see how I get by like that although many doctors might suggest that is wildly dangerous. I don't think it is but it depends if it's 65-65-65 or if it's 75-70-65 might not be quite as good.
i would indeed worry about waking up at 60 if still honeymooning and still making insulin. i would never want to wake up at 60 or in that range.
you're for sure taking too much basal if you're going low, eating and not having to bolus. IDK what your basal regime is but I would highly suggest, too, working with a CDE, Endo and have them help you step by step, or provide suggestions. you're taking too much basal, sounds like, overnight and too much during the day if you're eating w/no insulin and going low. when i was honeymooning and could still eat about 15 grams of carbs, i started out with only 2 units of levemir, then 5, 7, etc...but 9 units is a good amount of basal for a type 1 newly diagnosed still honeymooning. are you sure you need basal, what do you wake up without insulin, maybe just a bolus right now. sounds like splitting a smaller dose up would work better but please see your doctor/endo for further advice. you didn't mention what number you were at AFTER dinner and before bed, i.e, how much you dropped overnight.
To change it, w/ 9 basal and 1 bolus, about the only option would be to further reduce the bolus until it produces very slightly higher readings. With those doses, I'd take 1U less of basal ("dealer's choice...") and see what happens. I would think it would go up somewhere, or maybe even more than one spot. If it goes where you want it, without going too high, you found it. If it went to high, I'd see about 1/2 unit syringe, since I recall you don't have pumps.
thanks acidrock, youre a star! i did 7 units last night and woke up to a beautiful 84-thats how i like it-and feeling AWAKE! gonna see what this does for the next couple of days with this. of course, haha, as soon as i feel like its all settled down.... :)
Sarah, thanks for your response. i am not newly diagnosed (11/2011) and i like to think im honeymooning-so im just a LITTLE diabetic. however, i believe i must be LADA-ing. i upped my basal a couple of months ago little by little because i was waking up in the 120s and even 140s and i like waking up under 100. all of a sudden in the beginning of april, my wake up numbers got lower and lower. no reason, maybe youre right, my páncreas is kicking arse right now!
last night i was 92 before dinner, had salad with some turkey and cheese on it and went to bed at 138. after the 138 i had 7 grams of chocolate and a cup of chamomile tea. woke up at 84. too much basal there. i hate to give myself a bolus for dinner so late-11pm or midnight, when i get home from work, for one, because of the time, and also because then i have to eat thirty carbs. by the time i eat my salad at dinner, i dont have room for 30 carbs at midnight. the joys of mdi....
i go to my endinosaur in june so ill mention it to her...
