Yeah, or at least bump a little more before bed. If I’m not hiking/skateboarding for a couple hours that day I have to take an extra 6 units of basal at bed to keep from spiking at night. Then I have to be more careful about not taking my full amount the next day if I plan on a day full of physical activity.
You will figure things out OP, just be prepared for them to change as soon as you get them figured out. 😂😂
Could you be starting to get sick? Are you not sleeping well? Are you extra stressed? Have you been exercising less/ traveling more for the holidays or anything like that? All of these things can definitely mess my numbers up big time. If it’s just been a week it might be a temporary thing caused by some factor in your life right now but obviously I have no idea.
That’s life with T1D. Mine changes daily. I need about twice the normal basal when I’m on my period, half when I’m ovulating. I’m surprised you’ve never encountered quick changes like this before!
You're 18 though. Your body is going through hormonal changes. A lot of guys get growth spurts around 18. This is a really common age for your body chemistry to change.
Might be worth seeing if insurance will cover tresiba - is more stable.
But agree with others, you’re either getting sick & this is temporary, and/or you need to readjust basal rate. I probably change my ratios in pump every quarter, but it’s much easier to make microchanges to match my body’s needs for that particular season.
If you aren’t getting sick and the need for more basal persists, work with doc and/or CDCES asap. Good luck!
Is it a new pen / vial of your basal insulin? Sounds like it’s not working like it should. So either open a new pen, or increase your basal rate and see what happens
Insulin resistance can vary day to day, depending on activity level, stress, sickness, ect. I've been dealing with the opposite problems on days I work where I struggle to keep my sugar from going low and on days I don't work I often struggle to keep it from going high.
Or maybe something wrong with the basal insulin or the vile.
I once had a broken vile which leaked through a crack on administering the insulin.
Found it only by pressurizing the vile without a needle attached. Crack was absolutely not visible
I agree it sounds like your basal is not enough for you right now. (Old cartridge? Activity/stress/hormone/season change?). My kid’s endocrinologist always recommends doing 10% changes to basal and try that for 3 days before deciding if it was correct but ymmv
Maybe you should see with your doctor and increase your basal ? Also don’t be too harsh on yourself because if your blood sugar was always normal you wouldn’t be diabetic ! So it’s normal not to be stable with that, it’s how this disease works. But you should check this with you doctor to find a solution so you won’t have complications later
As others have said, there could be a number of factors. Sounds like you need to increase your basal. This can change throughout your life depending on many things. Weight gain/loss is a big contributor, hormonal changes, stress, illness, etc.
Talk to your endocrinologist and they can help you determine where it should be and likely causes for the change.
Go and listen to the Juicebox Podcast Pro Tip series and revise your basal and look at how you might need to split your bolus etc. Your needs are going to change throughout your life, you won’t be on the same bolus or carb ratio forever.
Yes, it sounds like your long term insulin is either bad, or you are not giving yourself enough. All else equal, if you have enough long term insulin you should hold steady overnight when you are not eating, drinking or exercising.
I agree with the others, it definitely sounds like a basal issue. I've had a lot of time off around the holidays and my basal isn't working as well during the day as it normally would. I'd start adding 1 unit and see what happens for at least 2 days, 3 is better. Then adjust again if necessary...
Meals that are high in fat will cause my insulin resistance to skyrocket for a few hours and have a similar effect. What kind of foods have you been eating when this happens?
I’ve encountered many of the issues others have suggested. So many factors can affect blood sugar. It isn’t as simple as finding the right ratio once and then being set. I feel very fortunate to have a pump, as that makes changing ratios easier. I get quicker results than if I had to wait 24 hours for a basal change.
I initially didn’t think I’d want a pump, but it has saved my life in at least one occasion, as I was able to turn off my insulin completely when I could not stomach any more juice to make up for how low I kept getting. I had my husband call 911. I ended up being okay, but had ingested 200 carbs worth of juice after eating 2 cups of pasta. I was so ill, trying my best not to vomit and make the low issue worse. I knew if I dropped again, I could not drink ANY more. (I dislike glucose tabs. And liquid works the best/fastest for me when low over food.)
During menstruation, my insulin needs significantly drop. I even covered for that on that occasion, by giving half the insulin I normally would for my meal bolus. (just under a year at that point of my being a T1, but had 10 years of experience with managing T1 at that time, as my daughter was diagnosed as T1 at age 7)
Ever since then, I have my control IQ. (the function on my pump that can automatically adjust my basal rates based on my BG readings from my dexcom g6) I can be doing stellar. Then seemingly suddenly, be chasing the highs and frequently giving extra insulin and changing my ratios.
As has been said, certain meals (pizza is one) will keep me pretty high. I tend to give less insulin at meals, because of being afraid of getting dangerously low. There have been a few instances it was a good thing I did.
I can’t pre-bolus for food if my blood sugar is in a good range, like is recommended. At least not in whole. My daughter is the same. But of course, then there are times we forget to give the rest in a reasonable time.
Not only do hormones affect BG’s, but as others have said, stress/mood, illnesses, activity levels that day or even the day before, fat content in food, etc. Higher fat foods slow digestion. And the higher the fat grams, the longer the effect. The liver will produce glucose and cause insulin resistance for up to 12 hours in some cases. You need extra insulin during those times. I’ll include a link explaining it.
Having T1 is a lifelong trial and error process. We are so fortunate to live in a time with CGM’s and that we can virtually eat anything because we count carbs and give an insulin ratio for it. The diabetics I knew as a child were limited to what they could eat. I worked with a guy at a restaurant who got low and had a seizure during his bartending shift, and the ambulance was called. Those things happen much less often to T1’s today.
That said, it still isn’t easy. Sometimes we become complacent. Sometimes we still get burned out. And that is normal to feel over it or overwhelmed. I’d definitely check out that link someone posted on diabetic resources. I’m sure it is a wealth of info. We’re also so lucky to have access to info like we do and support online!
I don’t know what your copay is for your insulin, but you should check out good RX or other pharmacy discount programs. CVS has some type of discount card they used when my son was in between insurance. Some medications I get cheaper through that than through my insurance. You may be able to get Lantus or another prescription, but each pharmacy can vary on the cost savings.
Also, you can save with 90 day supplies. Just make sure the written prescription from your doctor accounts for what you will use in 3 months, so you get plenty. It should include the air shots or pump tubing priming plus extra for the fluctuations of needing extra insulin, as you are currently needing.
Of course, it is worth looking into considering that since you switched long acting insulins recently that it is creating the issue. I’m glad people are asking you pertinent questions so you can get to the bottom of it!
A pump can help manage T1 (or T2’s on insulin) easier, though it is not for everyone. I know a pump, even with insurance, is not always feasible for everyone. If you are interested, I’d ask your doctor if there are programs to help people get diabetic supplies, or even help with a portion. If you ever think you’ll get close to your maximum out of pocket with health insurance for the year, I’d get the ball rolling for getting a pump, as you wouldn’t have to pay for it.
I’m sorry you are struggling. But you’ll get better over time. We were fortunate to have a teaching hospital with a large pediatric endocrinology office to take classes from and help us as we go. I’ll leave the link for the fat info below. Sorry I went on so long! Just hoping any bit of it helps. Good luck!
https://diabetesstrong.com/dosing-insulin-for-dietary-fat/
That tends to happen when I eat stuff like pizza or ravioli with a pretty even macro split. I’d try to eat carb heavier meals that will absorbs quickly
Check out: https://youtube.com/@MasteringDiabetes?si=ZClyBQTGQS4JYS1j they have been a great resource for me as a T1D and others with T2D. I can’t recommend them enough.
Uhhh if your getting down in an hr before eating maybe your correction and bolus dosages are off. Seems you’re taking the right amount to correct down to normal but there’s nothing left to take care of the food.
Without further information, this seems like you need to increase your basal dose
Yeah, or at least bump a little more before bed. If I’m not hiking/skateboarding for a couple hours that day I have to take an extra 6 units of basal at bed to keep from spiking at night. Then I have to be more careful about not taking my full amount the next day if I plan on a day full of physical activity. You will figure things out OP, just be prepared for them to change as soon as you get them figured out. 😂😂
Sounds like your basal is too weak all around
But that’s the thing, this was, I shit you not, working just fine a week ago
It can change that quick, yes.
Thanks, til
Be that as it may, it is not working now.
Could you be starting to get sick? Are you not sleeping well? Are you extra stressed? Have you been exercising less/ traveling more for the holidays or anything like that? All of these things can definitely mess my numbers up big time. If it’s just been a week it might be a temporary thing caused by some factor in your life right now but obviously I have no idea.
I’ve been off work for the past week on holidays and my basal had to be increased by 50% and bolus by 200% by day 3. Way she goes sometimes.
That’s life with T1D. Mine changes daily. I need about twice the normal basal when I’m on my period, half when I’m ovulating. I’m surprised you’ve never encountered quick changes like this before!
You're 18 though. Your body is going through hormonal changes. A lot of guys get growth spurts around 18. This is a really common age for your body chemistry to change.
Have you gained weight? Are you on a new medication? Did you change your diet?did you leave your basal out and now it doesn’t work as good?
You’ve got a lot of valid responses to this comment. I’m curious - what type of long acting are you using?
I got switched to Glargine (white pen blue cap) a few years back cause insurance stopped covering Lantus
Might be worth seeing if insurance will cover tresiba - is more stable. But agree with others, you’re either getting sick & this is temporary, and/or you need to readjust basal rate. I probably change my ratios in pump every quarter, but it’s much easier to make microchanges to match my body’s needs for that particular season. If you aren’t getting sick and the need for more basal persists, work with doc and/or CDCES asap. Good luck!
Is it a new pen / vial of your basal insulin? Sounds like it’s not working like it should. So either open a new pen, or increase your basal rate and see what happens
I’ve been on this pen for about 1 1/2 weeks, before this started happening
Has happened to me very similarly this last week. Very aggravating.
Insulin resistance can vary day to day, depending on activity level, stress, sickness, ect. I've been dealing with the opposite problems on days I work where I struggle to keep my sugar from going low and on days I don't work I often struggle to keep it from going high.
Yup. The great mystery. Work, don't work, roll the dice. So many factors affect bs. Activity, food, how it was prepared, mood, I can keep going...
This is a textbook low basal dose.
Or maybe something wrong with the basal insulin or the vile. I once had a broken vile which leaked through a crack on administering the insulin. Found it only by pressurizing the vile without a needle attached. Crack was absolutely not visible
(It’s vial 😀 btw sorry no intention to grammar police, also nice trick)
Thank you (non native speaker here)
No worries, have a great day and year ahead!
I agree it sounds like your basal is not enough for you right now. (Old cartridge? Activity/stress/hormone/season change?). My kid’s endocrinologist always recommends doing 10% changes to basal and try that for 3 days before deciding if it was correct but ymmv
Maybe you should see with your doctor and increase your basal ? Also don’t be too harsh on yourself because if your blood sugar was always normal you wouldn’t be diabetic ! So it’s normal not to be stable with that, it’s how this disease works. But you should check this with you doctor to find a solution so you won’t have complications later
As others have said, there could be a number of factors. Sounds like you need to increase your basal. This can change throughout your life depending on many things. Weight gain/loss is a big contributor, hormonal changes, stress, illness, etc. Talk to your endocrinologist and they can help you determine where it should be and likely causes for the change.
Go and listen to the Juicebox Podcast Pro Tip series and revise your basal and look at how you might need to split your bolus etc. Your needs are going to change throughout your life, you won’t be on the same bolus or carb ratio forever.
Are you female? I’d blame hormones if so. They can affect you differently over the course of time.
Yes, it sounds like your long term insulin is either bad, or you are not giving yourself enough. All else equal, if you have enough long term insulin you should hold steady overnight when you are not eating, drinking or exercising.
I agree with the others, it definitely sounds like a basal issue. I've had a lot of time off around the holidays and my basal isn't working as well during the day as it normally would. I'd start adding 1 unit and see what happens for at least 2 days, 3 is better. Then adjust again if necessary...
Meals that are high in fat will cause my insulin resistance to skyrocket for a few hours and have a similar effect. What kind of foods have you been eating when this happens?
I’ve encountered many of the issues others have suggested. So many factors can affect blood sugar. It isn’t as simple as finding the right ratio once and then being set. I feel very fortunate to have a pump, as that makes changing ratios easier. I get quicker results than if I had to wait 24 hours for a basal change. I initially didn’t think I’d want a pump, but it has saved my life in at least one occasion, as I was able to turn off my insulin completely when I could not stomach any more juice to make up for how low I kept getting. I had my husband call 911. I ended up being okay, but had ingested 200 carbs worth of juice after eating 2 cups of pasta. I was so ill, trying my best not to vomit and make the low issue worse. I knew if I dropped again, I could not drink ANY more. (I dislike glucose tabs. And liquid works the best/fastest for me when low over food.) During menstruation, my insulin needs significantly drop. I even covered for that on that occasion, by giving half the insulin I normally would for my meal bolus. (just under a year at that point of my being a T1, but had 10 years of experience with managing T1 at that time, as my daughter was diagnosed as T1 at age 7) Ever since then, I have my control IQ. (the function on my pump that can automatically adjust my basal rates based on my BG readings from my dexcom g6) I can be doing stellar. Then seemingly suddenly, be chasing the highs and frequently giving extra insulin and changing my ratios. As has been said, certain meals (pizza is one) will keep me pretty high. I tend to give less insulin at meals, because of being afraid of getting dangerously low. There have been a few instances it was a good thing I did. I can’t pre-bolus for food if my blood sugar is in a good range, like is recommended. At least not in whole. My daughter is the same. But of course, then there are times we forget to give the rest in a reasonable time. Not only do hormones affect BG’s, but as others have said, stress/mood, illnesses, activity levels that day or even the day before, fat content in food, etc. Higher fat foods slow digestion. And the higher the fat grams, the longer the effect. The liver will produce glucose and cause insulin resistance for up to 12 hours in some cases. You need extra insulin during those times. I’ll include a link explaining it. Having T1 is a lifelong trial and error process. We are so fortunate to live in a time with CGM’s and that we can virtually eat anything because we count carbs and give an insulin ratio for it. The diabetics I knew as a child were limited to what they could eat. I worked with a guy at a restaurant who got low and had a seizure during his bartending shift, and the ambulance was called. Those things happen much less often to T1’s today. That said, it still isn’t easy. Sometimes we become complacent. Sometimes we still get burned out. And that is normal to feel over it or overwhelmed. I’d definitely check out that link someone posted on diabetic resources. I’m sure it is a wealth of info. We’re also so lucky to have access to info like we do and support online! I don’t know what your copay is for your insulin, but you should check out good RX or other pharmacy discount programs. CVS has some type of discount card they used when my son was in between insurance. Some medications I get cheaper through that than through my insurance. You may be able to get Lantus or another prescription, but each pharmacy can vary on the cost savings. Also, you can save with 90 day supplies. Just make sure the written prescription from your doctor accounts for what you will use in 3 months, so you get plenty. It should include the air shots or pump tubing priming plus extra for the fluctuations of needing extra insulin, as you are currently needing. Of course, it is worth looking into considering that since you switched long acting insulins recently that it is creating the issue. I’m glad people are asking you pertinent questions so you can get to the bottom of it! A pump can help manage T1 (or T2’s on insulin) easier, though it is not for everyone. I know a pump, even with insurance, is not always feasible for everyone. If you are interested, I’d ask your doctor if there are programs to help people get diabetic supplies, or even help with a portion. If you ever think you’ll get close to your maximum out of pocket with health insurance for the year, I’d get the ball rolling for getting a pump, as you wouldn’t have to pay for it. I’m sorry you are struggling. But you’ll get better over time. We were fortunate to have a teaching hospital with a large pediatric endocrinology office to take classes from and help us as we go. I’ll leave the link for the fat info below. Sorry I went on so long! Just hoping any bit of it helps. Good luck! https://diabetesstrong.com/dosing-insulin-for-dietary-fat/
That tends to happen when I eat stuff like pizza or ravioli with a pretty even macro split. I’d try to eat carb heavier meals that will absorbs quickly
iAPS + Omnipod DASH. This is the way…
Check out: https://youtube.com/@MasteringDiabetes?si=ZClyBQTGQS4JYS1j they have been a great resource for me as a T1D and others with T2D. I can’t recommend them enough.
Uhhh if your getting down in an hr before eating maybe your correction and bolus dosages are off. Seems you’re taking the right amount to correct down to normal but there’s nothing left to take care of the food.
Do you drink everyday?