Insulin changes

Hello, very frustrated right now. I had very good control over my daughters BG up until she had her 1st cold being diagnosed T1D. I got her A1C to 6.6. I’ve learned that I have to set a temp basal for colds. But since then for a week now, I’m constantly doing corrections especially at night. I thought it could be the pod site, but when I did an injection it was the same. I’m struggling getting her to her target BG. I’m going to change her basal rates after school today. Is it normal to have to change basal rates when activity levels & carb consumption is the same? Any other suggestions would be appreciated.
Thank you

Sadly, yes. Totally normal, especially for a teenager, especially overnight. Growth spurts and hormone surges require more insulin, but never bother to tell us when they’re going to happen or how long they’ll last. :confused:

And long-time posters can tell you their experiences, but I’ve read many say it’s just a fact of life with T1D at any age: basal insulin needs change over time, period, for all kinds of reasons.

Stress (is it exam season?) and fighting off an illness can make her run higher, just like she does when she has a cold. For lots of women, where they are in their menstrual cycle can make a significant difference. Weather matters, believe it or not (generally, heat makes insulin more effective, so if she’s hot she’ll need less and if she’s cold she’ll need more). Etc., etc., etc.

All you can do is follow the numbers, and try to keep up with whatever the current needs are as best as you can.

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@srozelle thanks. This is our 1st year, so it’s still new. I think the hardest part is guessing how much insulin to put in the pod. It would be nice to be able to use the unused insulin when it’s time to change it, but then that would be too easy. LOL I need some kind of humor

A sense of humor helps, for sure! 🥸

Hello,
My sister is on the same bus. Like you, we barely have a year of experience with diabetes type one. I completely understand how you feel. My sister constantly has high blood sugars during the night. She will have her dinner and her blood glucose won’t rise, and then a couple of hours later during the night her glucose will spike with no reason. We have found that what helped her was increasing the amount of Lantus that she takes at night. Her endocrinologist also increased the amount of insulin that she receives at dinner. I highly recommend that you talk to her endocrinologist about increasing the amount of Lantis that she takes and possibly increasing the amount of insulin that she takes at dinner. Definitely keep us updated. Like I said my sister is going through the exact same thing right now.

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Hello Jeannine!! @jfrancise

Yes, there are so many different things that affect blood sugar. You named some of the big ones [activity levels and carb consumption]. Insulin level needs can increase or decrease, depending on what is going on. Having a cold sends your blood sugars higher and the medication they take to help with symptoms can increase blood sugar too. Sometimes it can be the things we don’t think about. Maybe after her cold, she is a little dehydrated. I know that when I am dehydrated my blood sugars sit a little higher than usual. Maybe not though. Again, it could be changed in schedule, stress, residual cold symptoms, allergies, weather, you name it.

You are still new to this. One year in is when things could be changing. Is she out of her honeymoon period? Sometimes honeymoon periods last for a while. They are not as dramatic as some people’s, but you continue to produce this little bit of insulin. Mine lasted that way for a year and a half or so. Then, I needed more insulin. Slowly, I had to increase my basal and bolus rates. Maybe consider talking to your endocrinologist if you are having trouble. Some people always ask their endocrinologist before making medication changes, but I don’t always. I follow trends. The only thing is that if you do increase basal rates, then you may need to watch her more overnight for lows.

Good luck. I am coming up on my four years “Diaversary” on June 4th, I turn 19 on June 3rd and so I don’t have too much more experience in this, trust me, I understand how frustrating it can be. Unfortunately, there is no perfect science for insulin levels. Everyone is different and everyone needs something different. Take it one step at a time. I don’t always like making a bunch of medication changes at once and sometimes I only need a little extra basal and not a whole 10 percent more as doctors recommend. Take your time. I mean obviously try to kick that high blood sugar, but realize that she is human and you are human and this all takes a long time to get used to.

Good luck and always feel free to post on here. We will help as much as we can!!

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Hi Jeannine @jfrancise , the answer to your questions is “YES”, most probably. And your feeling of “frustration” is normal, but keep in mind that in spite of what your daughter’s numbers read you are still doing everything correctly. just feature of life when living with diabetes. Over time, and without any apparent reason, insulin basal rates will change along with carb ratios and insulin sensitivity factors - just need go with the flow and use your “acquired diabetes knowledge” to make careful adjustments.

@srozelle posted a thoughtful perspective from a mother’s viewpoint which will provide you with direction you and your daughter may take. There are many factors, beyond food and activity, that may cause variations in our body glucose levels. If you do an internet search looking for "42 Factors That Affect BG’ you will find a posting from diaTribe.org that may help you.

Alexa @arodric5002 Thanks. I’ll keep you posted. I just changed her meal bolus & basal rates yesterday afternoon. Fingers crossed

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You’ve already had wonderful replies…and I just wanted to offer my thoughts. A 6.6 A1C is wonderful! As a type 1 for 35 yrs and now a parent of a t1D, who is 11, there is no perfect and not always an answer. Patterns are a sign to make adjustments and that’s our goal in overall control. As a female, I can say that I noticed insulin resistance in the few days leading up to my cycle, and then it would drop once that started. Hormones play a big role in control.
Hang in there! You are doing a great job!

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@srozelle @Dennis @arodric5002 @fieldiez @T1Dx2 Thank you everyone for replying to me. I apologize for not responding back in a timely fashion.
My husband and I changed my daughter’s basal for the overnight hours and we changed her bolus.
So far so good. BG #'s have been really good. All of your insight & experiences are truly helpful & much appreciated. You have all made it much more easier to deal with. :grinning:

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Glad her numbers settled back down!
Post anytime. :sunglasses: