Thanks to the many who commented & sent e-mails in response to the very practical survey. I'm grateful for all the help.
I'm observing the progression of my diabetes from a sometimes clinical and detached, sometimes hyperemotional (as you guys know) stance. Today's post shall tend toward the clinical and detached, Violet style.
When I started on the pump last February as a happy honeymooner (ahem), my basal rates were 0.25-0.30/hour all day long. Crazily small numbers for an adult, I know. But without those teeny droplets of insulin I'd go up and up.
I enjoyed six months of stability and numerical happiness, relatively speaking. In August, I began to need to raise the basals. They leveled off for a while, then needed another small bump in October. They're now on the move again. Tweak, tweak, tweak. Yet I'm still spending fully half of each day at 0.25. This is in contrast to the average post-honeymoon type 1. Check out Skytor's December 16 post about basal rates over at DIA...gonal, a newish blog Kerri highlighted recently.
Based on Skytor's supercool graph, I may still have a long way to go before I'm entirely done honeymooning. The average adult T1 has basal rates of roughly 0.6-1.0. Here's where I am (sorry, I'm not graph capable yet):
5 PM-5 AM 0.25
5:00 AM-6:30 AM 0.60
6:30 AM-9:00 AM 0.65
9:00 AM-10:00 AM 0.50
10:00 AM-3:00 PM 0.40
3:00 PM-5:00 PM 0.35
...for a grand total of 8.60 units per day of basal insulin.
The other new aspect of this period is a change in some of my carb ratios, which has never happened thus far other than changes caused by estrogen. I need more insulin with lunch and dinner than before--about 15% more at lunch and 10% more at dinner. Err, I think. I'm not getting consistent results yet (sometimes going low, sometimes still too high, sometimes just right), so this remains a work in progress.
It's not the numbers themselves that I'm fixated on, actually. My preoccupation is this: How long will the instability continue? Since everyone needs different amounts of insulin, it's impossible to know where I'll end up. I won't be able to tell until things level off and stay leveled, I guess. This unpredictability is so very...diabetesish, if you will. Mercurial. Ephemeral. Etc. Which makes it, really, just another face on a figure we all know well.
Count on me to be sort of a downer.
ReplyDeleteThe unpredictability will likely last the duration of the disease (you know, forever)... My insulin rates tend to change a lot -- sometimes seasonally, sometimes based on my work scheduling, sometimes for no reason whatsoever. My max insulin dose for the last week (basal + bolus) was 29 units; compare this to the week before, with the same eating patterns, when my max dose was 35. It's quite a difference... And it's frustrating.
You seem like you've got a handle on it though, and that you're willing to try some experimentation -- this will serve you very, very well.
PS... I very much enjoyed reading other folks' survey responses -- more information = more power...
Egads, Nicole. But no, you're not a downer. I agree: information = power = cause for optimism. Or at least cause for reduced pessimism ;)
ReplyDeleteOkay, tell me more about the 35 week vs. the 29 week. During the former, did you simply have to correct over and over each time you went high? Or were you able to key into a certain trend over the course of the week and respond accordingly? (Hmm, I guess that would entail predictability, which is just what you said you lack. Rats.)
I think you actually caught me at a sort of pessimistic time. I had a tough week this week -- accounting for some of the difference in total daily dosages from last week. I had to lower all of my basal rates because of a few days of unexpected lows. And then I had a day of unexpected highs -- which seemed to require a lower correction bolus than usual. The whole week has just been strange and it has me pretty frustrated. I've had two very good days now, though, so maybe I'm at a turning point...
ReplyDeleteI find with my body that sometimes I CAN predict; sometimes I can track and look at trends and make adjustments -- and my bloodsugars respond as I would expect them to. But other times, I think, "Oh, I know what this is, I know how to handle it..." And I make an adjustment and I get bit right in the ass.
Again, just keep an open mind about experimenting and you'll be excellent...
Hello, I'm a type 1..diagnosed sept 04 at 21. I have been experiencing similar fluctuations in my insulin needs these last few months. My basal used to be pretty simple, .3 throughout the day and .15 throughout the night, and that worked out great, but these last few months i've had increase it to .45-.60 and reduce my bolus ratios from 1:8 to 1:5 for a few weeks and then switch back to my regular rates and ratios again once i start getting consistently low readings. This past week or so I've been running high throughout the day and hitting low in the middle of the night, and then waking up high again. It took me a few days to catch on to this bizarre trend, but after a few days of tweaking, I have gotten my blood sugars stabilized... for the most part, but I now have 4 different basal rates
ReplyDelete12:00 am .50
3:00 am .20
9:30 am .45
9:00 pm .55
and am back to the 1:5 bolus ratio. Still needs fine tuning, but I'm tired of going through the hassle of fasting, testing, waiting, testing, etc...if my insulin needs will just change again in a week or so as it has been, so i'm just testing and adjusting as needed while waiting for things to return to normal.
I have been looking around online to find out what could possibly be causing my new insulin regime, but haven't had any luck, so I was excited to stumble on your page and read about your situation. I have also considered the possibility that perhaps I was honeymooning and it is coming to an end, but that doesn't seem to explain the varying basal rates I now need. I have an apt with the endo next week, so hopefully I'll get an answer from him, although i don't count on it...
Oh and I was on the pill 2 months ago in attempt to stabilize my hormones/insulin needs, but it caused insulin resistance in me and was a hassle to take so i ended up discontinuing it after a month. From what i understand, insulin resistance witht he pill is not very common though possible. My doc didnt mention it as a possibility when she prescribed it and was suprised when i let her know how it affected my blood sugars.
Anyway, just wanted to let you know you're not alone in this game =)
my basal rates are sooo high ...
ReplyDelete12 am - 2.10
3 am - 2.30
7 am - 2.30
12 pm - 2.50
5 pm - 2.40
my carb ratios are
12:00 am - 1/10
6:30 am - 1/7
11:00 am - 1/10
my correction factor is
1/15
all in all my body hates me - i go through anywhere between 60 and 110 units of insulin ... A DAY!!!
it's horrible - but i have good blood sugars ... most of the time, ok you caught me ... like 65 % of the time ...
bah ... alrighty i'm gonna get going now ... good luck!