Alright…my fun and games have started early. Looking down the barrel at a +15% increase three days earlier than expected…and by “expected” I mean the days that might need more basal depending on which cycle it is and what my body decides to do or not do to me. I haven’t needed too much extra at all the last few months. Time for a change! I thought the last pod site might be getting dull and that was driving the increased basal needs…but the subsequent pod is yielding the same results. Looks like ovulation is happening early this time.
Good thing I’m full-on Extroverted or else all of this TMI might embarrass me. For the good of science and sisterhood, I say!
Hey, I’m super introverted and participating here.
Can’t report anything as of late because my cycle has been totally out of whack and so I’m not sure any patterns or lack of patterns mean anything. I’ve had zero energy to do anything beyond just eat, work, sleep; and often just doing that is a struggle. I think my thyroid is still super low (I’ll get blood work today if I can muster the energy), so I can’t wait to see my endocrinologist next week. Some other things are low, too, so I also have to see my GP next week. I suspect all this stuff is putting my cycle completely out of whack.
Up to +20% now. +15% worked well until late afternoon and then my needs seemed to have eeked up higher. I’m stuck at 164 now and the correction bolus from 3 hours ago has yet to impress me. I’m going into bedtime with the new +20% and no further correction dose. My theory is that I’ll drift down 20-30 points in a few hours with the extra basal. Let’s see what happens! (I dislike basal changes going into bedtime but it’s time to guess and check so here I go.)
Today’s one of those day where it’s ALL I can do to keep it between 100-250. This is ridiculous. Ran a +20% overnight, had to treat a high at 1AM, then I spiked from 150 to 240 starting at 5AM. Then at 9AM it started to break loose and I’ve had downward trends all day. I went to +0% at 10AM but my boluses have been wayyyyy too effective even without extra basal. But now I’m back at 245 and am doing a pod change during this mess. Grrrrrrrrrrr.
How embarrassing. I’m posting too many consecutive times on my Basal Rates and Hormones thread to be allowed to post anymore. So I’m putting this post here, for now.
"Playing hormone detective here…as with everything diabetes related, it seems for me.
I’m probably two days out from ovulation. (TMI, what what!)
I’m trying +5% basal today. I used to start with +10% extra basal, but I’m going to start small and start early this time around and see how that plays out for me.
The reasons that I suspect my hormones are causing insulin resistance right now are:
I added 10% to my dinner bolus for a tried and true dinner last night. My bg never came back down below 140 despite being super active all evening long. It just stuck at 150-140 when it normally would have tanked in there somewhere due to my activity level and bolus last night.
I chose a smarter snack last night than what I actually wanted (inspired by @Nickyghaleb’s exercise last night c/o Yoda @Eric) in order to keep my overnight observations cleaner (my snack of choice, nachos, would not have helped that overnight).
My blood sugar climbed from 127 to 183 between 1AM and 3AM. 1AM was roughly one hour after my snack bolus would have been done working, and I had bolused an extra 10% for my snack after seeing how dinner went. This was a routine snack that doesn’t cause late spikes, so I suspect the hormones instead of the food.
My basal rates do a good job overnight when hormones aren’t in play. Once hormones start ramping up, I see early morning spikes like this one.
I’ve said elsewhere that I used my meal doses as a barometer for when I needed to increase my Lantus on MDI due to hormones. This is also my strategy of choice for pumping now. Still working on fine tuning what thresholds I use to start adding basal based on increased meal needs. "
UPDATE: +5% (a day or two prior to ovulation) held me steady in the 120’s all night with no early morning spike.
I never put much stock in that small of a basal adjustment, but drifting down and staying at 120 as opposed to spiking to 180 is a pretty stark difference. Obviously I’ll keep observing and tweaking, but this is the sort of improved control I’ve been searching for for a very long time.
Day 15: +5% was not enough last night. It worked all day, but last night I drifted up to 190 at 3AM. I took a correction dose. I came down to 160 and it drifted right back up to 190. Now I’ll try +10% as I get closer to ovulation.
We’re back in full swing here with hormones and blood sugar.
This time around, there was a +20-30% rise and fall in basal needs (and insulin needs all around). I just experienced “the drop” about two days ago.
My Fitbit predicted the timing within one day. Having that is very useful for confirmation of my suspicions and helps me make faster decisions to raise or lower basal rates or other settings.
My BG is very sensitive to activity, and when I started podding, I remember how thrilling it was to discover how a 5% reduction might be all it took to spare me hours of running low. I’d love to see what happens with even a 1% or 2% drop (not that it’s possible).
My thing recently has been doing a “poor man’s low suspend” where I suspend my pump if I’m, say, under 6 mmol/L and have a lot of IOB. It’s surprisingly effective at preventing lows as long as I catch it in time. I can’t wait till it’s automated—I think it will work incredibly well for me!
Just last night I was 5.7 mmol/L heading to bed with I believe 1.25 units of insulin on board (or maybe it was 0.75 units, can’t remember). Either way, it was enough that I knew I’d end up low in an hour if I left it. I suspended my pump for (I think) an hour and a half (using a 0% temporary basal, so I didn’t have to worry about turning the pump back on). My blood sugar dipped and brushed my low limit, but then rose to 7.0 mmol/L and stayed perfetly flat at that level for the rest of the night.
It doesn’t always work that well, sometimes I still go low and sometimes I skyrocket. But overall, I’d say I have about a 75% success rate.
(For exercise, if I exercise hard during the day or more moderately during the late afternoon or evening, I do a -10 to -20% basal rate for eight to ten hours overnight, which really helps to prevent lows. Again, sometimes I use this when it’s not needed and end up high. But overall, it’s quite helpful.)
Further proof that we were separated at birth. Last night I was 4.2 and dropping slowly at bedtime with 4.60 on board, so I temped 0% for 30 minutes and had a couple of cookies. Dipped to 3.3 by an hour later and then slowly climbed to 7.8 over the next 2 hours and hovered around there till I got up. I’ve done -75% or -50% before, but I actually wanted to be slightly higher this time.
Ok, @T1Allison, I made it! And I’ve read through all 250 comments, phew.
I’ll use Nicky’s little setup:
Number of years with diabetes: 16
MDI or pumper: pumper, 670g
CGM? medtronic guardian and dexcom g6
Diabetic during reproductive phase of life? perimenopause? menopause? Reproductive - I’m 22
Did you notice any insulin resistance or sensitivity due to hormonal changes? Yes! more so sensitivity during period
How did it impact your bg control? Your diet? How did you manage it (or not manage it)? I just didn’t manage it and ate more treats
Do you use hormonal birth control? What kind? Yes. Mirena IUD
Do you experience insulin resistance or sensitivity due to hormonal changes while using birth control? Not sure. I wasn’t really monitoring my diabetes before and I’ve had it for years so I believe my insulin needs are way different now I assume
Ok, I have so many questions and points of confusion I don’t even know how to organize and get it all out there. Nevertheless, she persisted.
I’m assuming there’s another thread for birth control separately but I’m running a little low now and don’t have brain power to go searching and reading…
However, even though I’m on Mirena, I still think I sort of “qualify” for tracking hormonal changes and insulin needs over the cycle (and thus I think it makes sense for me to be in this thread (if you want to move me that’s fine ). 1. because I am ovulating (even with Mirena, women ovulate). 2. I have noticed insulin sensitivity (not sure about insulin resistance) across the cycle
I’m planning to write up some stuff on the Mirena and how I believe my hormonal basal needs may differ since I am on it (again please feel free to be like "Larissa you’re late to the party - we’ve already done that!) and I’m planning on tracking basal needs and using temp basals across the cycle, founded on the framework in Allison’s original post
I’ve downloaded the app Clue because I’m really terrible about writing down and remembering when I start my cycle.
I am planning on doing this and tracking with the app !
Dropping this picture down here mainly for my own reference but also if anyone’s curious of body temp over the cycle (which I plan to write a blurb on - again direct me to someone’s post if it’s been done here before!)
Ok with all that, and because I’m low and whiny - can I just say it’s SO annoying that us ladies have to worry about this?!?!? And that our needs change nearly every day and that every month it’s not the same like really?!?
ALSO it’s so insane to me that there can be fluctuations of basal needs from-15% to +40% and this isn’t a thoroughly researched aspect of blood glucose management??? If I get to set up and conduct my own research study in med school I’ll do it on this and you’re all invited to participate
Interesting! My experience is the exact opposite of yours. I have a basal need increase about 1-2 days before my period that lasts throughout my period.
My most insulin sensitive week begins 1 week after my period has ended.
You are not late to the party! This party will go on forever and we’re glad to have more women to party with us!!
Awesome. About persisting.
There is…but we’re always in search of more info on this topic. Since you’re on Mirena, here’s the only other experience on FUD that I’ve seen related to Mirena. You may have a totally different experience.
I would guess so! It will be interesting to see what you find. Mirena uses a second generation progestin locally released in small quantities. My general understanding from my CDE is that it may dampen your insulin sensitivity fluctuations as compared to if you were not using Mirena, but it might introduce the tiniest amount of resistance overall (due to progesterone usually causing a bit of resistance). So, hopefully this means that your cyclical insulin sensitivity fluctuations will not be huge!
I really hope this helps you! Hopefully you will not see large fluctuations, and hopefully if there are moderate to small ones you can track them and adjust for them without too much issue. For me, scaling my basal up and down throughout the cycle with flat percentages is the way to go…but it only started helping me once I had my basals all set to work cohesively according to my Week 2 needs. Since that took me YEARS to figure out from a problem solving perspective, the percentage increases and decreases exacerbated problems that existed within my basal profile. All of which is to say, watch out for any trouble spots. Something that is a noticeable spike or dip in Week 2 for me became much larger when I added a percentage change to it in Weeks 3 and 4.
Great idea. I use the Fitbit app for this same thing.
Yup! Preach. I wish mine only changed during PMS or during my period, but that is simply not the case for me. And maybe we’re all different. And maybe I’m an extreme example. But sharing our experiences together will help continue to answer those questions since we’re getting no help from the medical experts.
[my hand is shooting up to join this project in any capacity you need at a future date]
