I need help. I feel like all the sudden I’m crazy sensitive to my insulin. I’ve adjusted it to 1.6 for basal (instead of 1.75) and have changed my insulin to carb ratio from 1 to 5 to1 to 8. For lunch I ate 40 grams of carbs and literally half way through my iob I dropped down to the high 60s. I treated with a half a piece of chocolate cake. 45 minutes later I was down to the high 70s so I ate 4 lifesavers. Shortly after that I need a regular can of Coke to get me out of the 60s. I’ve never had this much sensitivity before. Anyone have any advice or ever dealt with anything similar. I did just have an appointment with my endo to adjust doses but it doesn’t seem to have helped much based off of today. I wouldn’t say my activity levels have changed much. Diabetes is so frustrating sometimes!
@Tee25 This happens to me every couple years. It can mean you are making a little insulin. It’ll last for 1-7 days and then it’ll go back to the way it was. Test adjust rinse repeat. Good luck
Hi @Tee25 . So sorry for your frustration. Candy and soda may give you a quick rise but they won’t last long so you need something with some staying power. I was having frequent nighttime lows a while back and my nutritionist recommended yogurt as an option for bedtime - it did tide me over until the morning. Cheese and crackers might be good to keep at your desk and more practical to carry with you. I find it helpful to get a refresher with my nutritionist now and then. You might want to check out the glycemic index to see which foods cause a quick rise followed by a fall, and which ones sick with you. It can take a few days for changes to stabilize so hang in there.
Take care, and keep us posted.
Interesting. For me this is week 2. Hoping it levels out soon!
Definitely will try adding a snack before bed. I was able to stable out at 180 last night but made the mistake of taking correction. That lowered me to 69 in the morning. Good news is the crash wasn’t fast at all so adjusting some numbers and hoping it all evens out soon. Do you only eat a snack if you’re at a certain number or below?
I use a Dexcom pump with Control IQ which keeps me pretty stable overnight as well as during the day. While it adjusts for potential lows and highs I do have to take matters into my own hands sometimes and have a snack. I don’t have a “magic number” for when I take one - a lot depends on what I may have recently eaten that is “catching up” to the insulin on board. When I took shots a long time ago (I’ve been on a pump for 30+ years) I was told to have a bedtime snack if I was below a certain number - what it was, I don’t remember now, but much has changed since then and each person’s body reacts differently. Much depends on trial and error. You could see what happens if you don’t correct at 180, or take a smaller correction: I see you spoke with your endo about your basal insulin - asking about corrections might help too. Do you use a CGM? It will help you see your patterns so you can work with your doctor to see if you need to adjust more and how, although you should see how things level out over the next few days - keeping safety in mind.
Hi Taylor @Tee25 , I can understand your concern having been in similar situation myself too many times. Know that your body is constantly changing, and that your “diabetes regimen” will need to also change - sometimes significant change. Basically, for the food you are usually eating, and your activity level, you are taking too much insulin - remember the delicate balance needed between the three elements, Food, Activity, Insulin.
It appears to me that you are using an insulin infusion pump, so; two questions: Do you also use a CGM? How many “timed periods” do you have set in your Profile or Pattern? You mention only one apparent setting where you have an Insulin: Carb Ratio of 1:5 , and a Basal uph of 1.75 [1.5]. If you have only one such setting for the entire day, this should be changed; pumps allow for at least 12 changes per day - I use 8. Another thought, although the chocolate cake and the coke are good ways to quickly boost your BGL, too much of those supper sugar fixes may be causing you body glucose level [BGL] to drop quickly - your body recognizes the glucose and will do everything it can to make it drop. A better way to treat severe lows is to take some of these wicked-fast acting carbs combined with longer-acting carbs such as a peanut butter sandwich made with full-grain bread, or a plate of pasta.
It may help if you share the “2021 ADA [American Diabetes Association diabetes.org ]Standard of Care” with you doctor before discussing with her/him changes in your pump Bolus, Basal, Correction rate settings. Just for a little piece of the Standard, I’ll paste below an excerpt from DiaTribe concerning “Over Banalization”, a topic I’ve expressed on this site many times to be “the cause” of excessive hypoglycemic events.
Healthcare professionals are warned of potential “overbasalization” for people on insulin.
Too much insulin, referred to as “overbasalization,” occurs when basal insulin doses are too high (mainly to target fasting glucose levels and often to compensate for insufficient bolus insulin with meals). In this year’s Standards of Care, ADA included some warning signs and complications associated with overbasilization. ADA’s new clinical signals of overbasalization include basal doses of more than 0.5 IU/kg, large differences in bedtime and morning glucose levels, large differences in glucose levels before and after meals, hypoglycemia, and high glucose variability.
These updates are posted in chapter 9 of the 2021 ADA Standards of Care.
The same has happened to me. Usually when I’m more active than normal. And it’s particularly frustrating when using a pump. The only advice I can give you is to keep sharing as much data as possible with your endo. I’ve been doing this for years. Sometimes it seems like I’ve found the right ratios, settings, etc only to have to change them again.
If you are on a pump, you can set multiple profiles. I have used different ones for warm and cool weather. And my basals are in the .35 to .6 range. Alternatively, you could set a temporary basal rate of 50% for 24 hours and go from there - up or down depending on what happens. The small adjustment you made was clearly not enough.
You may need to do further basal testing or keep adjusting insulin to carb factor. Usually when that is happening to my 7 year old it’s her basal that needs adjusting, if it’s only happening after meals and not all night, I count how many carbs she needed total for the insulin I gave her and use it to get a more accurate insulin/carb ratio. Being young and growing her’s change frequently
This happened to me recently as well! It felt like I had either somehow magically self-cured my T1D or my insulin was super-concentrated. I started to adjust my dosage to half because the lows were really frustrating. Eventually everything went back to normal after about 10 days.
I am very sorry you are going through a hard time right now. We all deal with this frustration so I know exactly what you are going through. I have been adjusting my basal as I wasn’t getting enough and it was leading to high ketones. Have you checked your basal rate? I know that usually if you fall low within 2 hours of eating it is most likely your carb ratio. I get very sensitive in the warmer months. I hope you can come to a resolution. Good luck. Take care.
This happens to me occasionally but it has nothing to do with insulin production. Sometimes when I install my pump, I’ll hit a “sweet spot” where the insulin just works really, really well for the time I wear that set. Then when I change to a new site, it goes back to the old sluggish ways. I wish my endo could tell me more about this and how to more reliably find well-absorbing sites, but nobody’s really got any insight on this. It’s one of the many mysteries of having diabetes.
@schleima , for me, go deep and go very near muscle. a little too close and I have to rip it out due to pain. when it’s just right I get very fast absorption and my humalog clears out in 2-1/2 hours.
the way I know (for me) when it’s insulin production over a set location is I don’t need any insulin for x number of days where x has been 14 days max for me in the last 40 years, enjoyed a little beer and pizza last time it happened… never when above 80 mg/dl zero basal, zero bolus. brilliant when it works right even if for only a little while.
Hi Adam, finding tje well absorbing “sweeet spots” is, in a way, kind of hit-or-miss - that has been my observation. The different places that you insert infusion-sets will tell you a story, not tell it to your doctor.
To address this, several decades ago (I began MDI in the mid-1970s before the term MDI came about) and assigned all my injection areas with a number or letter. When I identify an area that doesn’t work well, I make a note on my tracking calendar. - do the same for really effective absorption. Two days ago, I placed an infusion-set in a “very good area”, so I activated “Profile Minus 10” which supplies about 10% less insulin than “Basic Profile” - I just looked at Dexcom phone app and see that I have been 99% TIR for two days.
I also have a couple of “Plus” Profiles that I use, both for poorer performing sites and for when I’m feeling off. Setting these pump Profiles involved much WAGing, but it is a solution - the recommended insulin needles in the 1950s were 24 gage and 1 1/4 inches long, used hundreds of times, and caused me much damaged tissue.
Mine is definitely from insulin imbalance. I adjusted down my basal a little more and it’s a lot better. I definitely have found those “sweet spots before” but I think I just needed to adjust slightly since I’ve lost almost 10 pounds(on purpose.) overnight I’m staying within 20 points which is great. I do have one more question though. I ate lunch about 4.5 hours ago. My blood sugar is decreasing still but slowly. Example about an hour ago I was at 139 and now my cgm shows me at 121. I seem to decrease one or two points every five minutes or so. Does that mean I should adjust my basal another .05 or leave it and that’s normal? I guess I’m perplexed because overnight I barely lower at all unless I take a bolus but when awake I still drop a little which is a little confusing- all though I suppose your body uses more energy when awake and even a little movement can lower bs a little bit.
It just feels good to know your not alone! I think I genuinely needed a basal decrease because I lost about 10 pounds and less weight means less insulin but at the same time I was surprised how much I needed to drop it by. I have a quick telehealth appointment on Monday to discuss further adjustment but for the most part, things have seemed to level out a lot. I was able to exercise for the first time in weeks yesterday which felt great!
Hi Taylor, your basal decreases of little bits of 0.05 uph are what I do too.
I don’t know how your “timed periods” are set up in your pump, so it is difficult for me to make an adjustment suggestion for what is in the quoted passage. But keep in mind that basal infusion just like bolus infusion can have an active lifespan of 4 or 5 hours. When I’m trying to improve my basal rates, I make certain that I have enough, or more than enough timed periods, so I can account for the lag time for insulin to fade away. For example:
I recently [and still working on it] had a very similar experience to what you are experiencing 4.5 hours after lunch - I was dropping into the 80s around 5 PM. I had “timed periods” in my Profile for 11:30 AM, 1:30 PM, 3:30 PM, 4:30 PM, 6:30 PM - some of the periods started off as duplicates of the preceding period. It turns out now, that my supper-time BGL [5:30 PM] is just about where I want it at 100 mg/dl since I decreased my 3:30 basal rate. As an aside, after many years using an insulin pump, I have found that making adjustments in either basal or bolus settings, that more timed-periods are more efficient than having fewer options - yes, a lot of experimentation on my part, but the result has ben worth the effort.
Crazy question, are you male or female? I can’t tell by your name and I’ve known Taylor’s of both genders. If you are a female, how is this tracking with your cycles? I notice changes based on the calendar - remember, insulin is a hormone.
I’m a female. I honestly am lucky and don’t really get affected by my cycle and usually if I do my bs runs slightly higher a couple days before but that’s it