Hi everyone,
I have really been trying to cut out my lows recently. I generally have 1 a day so it's really an area I could improve in. I'm finding it very difficult - it's as if I know how to prevent the low (e.g., not bolusing too early before meals, reducing bolus if I'll be active after), but I can't bring myself to do it on a regular, consistent basis. Is anyone else struggling to get their lows under control, or have any general advice for me (I've tried lowering my TDD thus far)? Any help/insight would be appreciated! Thanks,
Dylan
I don't have any advice you haven't heard - check your basal doses, ISF, and I:C ratio. See if you can find any patterns, in types of food, types of exercize, etc.
How low are your lows? Lows suck - good luck cutting them down!
hmmm, one a day..thats quite a lot...have you found a pattern for the times/specific reason that you tend to go low during the day? e.g. You find the pattern is because you didn't reduce your bolus enough knowing you'd be active later?...you know how to prevent it, so if you pinpoint the reason, then it might be easier for you to acknowledge that this is the time where you are going low and actually bring yourself to correct it...so if you do realize that you tend to go low because you didn't reduce your bolus enough, then the next time you are going to be active, you will be able to say "last time i went low, i better reduce my bolus this time" ...you might find it easier to force yourself to reduce the bolus this way and prevent the low!
hmm, i hope this made sense dylan haha, if not we'll talk later. ..i have a question for you too.
I'm in a similar situation - it's hard because at least for me lows are really dependent on specific instances. I don't have any other advice except to be careful with not over-bolusing, especially before exercise or anything else that generally triggers lows for you.
If you haven't tried to evaluate your basal dosage by fasting for some longer time periods. I have found that when things are out of whack, I have to eliminate the variables and deal with only one at a time to ID the real reason for the unpredictable events. The fast need to last a fair amount of time to see if the basal is right with any food or bolus insulin that may impact BGs. I have also found the for me a few lbs, up or down, can have a huge impact on my basal. And, as you have found out, the exercise will change the insulin receptor effectiveness, during exercise and post exercise.
Another factor I still struggle with is background insulin. For example, if I try an run 4+ miles within four hours of my last bolus, all BG predictability is out the window. But if it has been >four hours, the BGs are predictable.
I learned even more after reading "Think like a pancreas: A Practical Guide to Managing Diabetes with Insulin"
I'm usually low about twice a day, so I've been aiming to be higher than the suggested range, more like 160-180, for the last couple of weeks to get this more under control. That way, I figure I'll be snacking less if I'm not low between meals...
Thanks Ajax, I think (know now) my TDD is too high, so I'm trying that out for size to start. The lows are generally around 3.5 (about 60)
Yea Virginia, too many! I actually think a lot of the time it is because I don't reduce my bolus when I know I'll be active afterwards, I really have to start doing that consistently. Thank you for the advice!
Thanks sjwprod,
It might have something to with my weight. It has definitely dropped in the past couple months or so - I think I'll try weighing myself and trying to stay at that weight. I've been through the basal test routine numerous times and to be honest find it too sporatic - one seems to work on day but not the next so I haven't spent much effort testing them by fasting. I definitely know what your saying about exercise with background insulin though, I've been trying to time it so I'm 5 or 4 hrs since last bolus before exercise.
Thanks for the advice!
do you take a 24 hr insulin? if so lower it 1 unit. thts wht i had 2 do. i used 2 have about 4-5 lows a day. then i lowered my lantus and now im fine.