Epic “Drop” day yesterday. Standard lunch and standard hormone resistant bolus calculation used for lunch. Bounced ridiculously. Waited it out. Eventually took a small correction dose three hours later. Then my hormones shifted and I waded through The Drop for the next 18 hours. I ended up completely turning my basal off four times throughout the evening and overnight timeframe…which I never do! Of course, all of this was while trying to live life and get kids through extracurriculars. I wasn’t sure how to bolus for dinner and went on the low side of dosing, and thank goodness I did! 45 minutes later I’m dropping and throwing tabs at it!
I turned off my basal again from 11PM-1AM. Then I woke up and changed it to just -20% overnight and that worked. Now I’m bouncing from breakfast.
People throw shade about A1C’s over 5.9% on here all they want…I’m soooooo proud to be sub-7 given these conditions!!!
Wow! That’s a pretty substantial time without basal. Did you end up high from that?? Sounds like a crazy drop this time!! And of course it always coincides when we’re busiest already
I’m so proud of you too! It’s hard to hit a target when it’s always moving
Ugh! I hate how suddenly these changes hit. That is one of the hardest parts. I really can’t think of many other diabetes circumstances where someone with years of experience and knowledge would have no idea how much to estimate for a bolus. But I totally understand what that’s like. It’s truly guesswork at times.
Yeah…I hate to say it, but I’ve largely given up on ever getting to be sub-6%. Maybe when I’m 60 and all the hormonal stuff is over. But with my basal and bolus doses constantly in flux, I just don’t know if it’s possible without wrapping my entire life around diabetes.
wow that’s intense! and the concept of the drop swinging from resistance to sensitivity like that … very scary. Amazing work with being on top of it and documenting it all
I think I may be having drop day as well. Sustained low all night, awoke in range (after I finally got up and treated with 24 grams of glucose), but then bolused for breakfast and obviously didn’t need any bolus as I went low in the middle of eating. Ingested about 30 grams of glucose and set a -30% basal rate for the next 24 hours. Crashed again an hour later, 20 more grams of glucose, crashed again an hour later, another 20 grams of glucose. Now I’ve been dropping again but am not yet low… Just ate another 15 grams of glucose plus lunch without a bolus.
I think these extreme changes in insulin sensitivity are really hard for anyone who doesn’t experience it to understand. How can someone go from running high one day to needing more than 100 grams of glucose during one morning (even with a basal rate reduced by 30%!) without any changes in therapy or other noticeable precipitating factor. I wouldn’t believe it if I didn’t experience it every month.
I had a drop occur this week. 5 days ago I was taking 12 units 2x/day which seemed to cover my basal needs well but I seemed less sensitive to my bolus insulin than I’d prefer. That dose is generally the highest of my monthly cycle. The timing isn’t exact, but I generally need this dose during the beginning of my period. That is when I’m most insulin resistant.
Well, that ended a couple of days ago when my trends just blew up. Yesterday I dropped my dose by 2 units to 10 units in the morning and 9 units in the evening (after dropping it the two days prior as well), and my trends seem alright now. Most months my basal needs drop more slowly throughout the month, so this was a very unpleasant experience with a lot of glucose gels and gatorade during the nights as I tried to lower my dose without dropping it so much that I’d end up with highs all the time!
I’m still super insulin sensitive at a basal dose 5 units lower (20%) than what I was taking a few days ago, but I only dropped low once during the night last night, and it was a very mild meandering low.
The last few nights make the Control IQ system very appealing to me. Maybe some day I’ll consider a pump again.
This is my challenge every month. The changes are unexpected in terms of timing (never exactly the same day) and degree, and sometimes they are extremely fast. Think 25% change in insulin needs overnight. It’s really difficult to keep up with.
Right now I’m also dealing with the seasonal changes I experience (more insulin in the fall and winter, less insulin in the spring and summer), which is making things even more interested, but in a way easier to manage so far.
I’ve heard that some of the automated systems (specifically the 670G) can’t keep up with hormonal changes. I’ll be curious to know if Control-IQ does a good job with such sharp adjustments. If it does, I’d be sold. I don’t care about the super tight control that some are worrying about…I’d just like to be able to deal with hormonal changes without so much mental effort and chaos every month.
I was trying to get pregnant for a year, maintaining pregnancy control, while experiencing these swings for the first time ever since I’d always been on birth control as a diabetic prior to that.
It. Was. Hell. And no doctors knew anything about it and just made me feel like I was generally sucking when it shouldn’t be hard.
So during Coronatine I’ve been walking two miles every morning. And then playing sports with my boys all afternoon. I’m an active person but I’m way more active now. And consistently. I’m in Week 6 of being home with my boys.
I can say based on these 6 weeks…exercise for Me at this point in my reproductive maturity does nothing to help with hormone driven insulin resistance. I’ve been needing even more basal for my most resistant days. I’ve swapped out pods just to ensure it wasn’t a bad site. I’ve been insanely carb sensitive. I’ve been pre-bolusing (via shot) by an hour with no effect and still spiking to 200-300 with low carb meals.
And then my hormones switched gears. And the thunderclouds parted and drifted away. And now I’m on reduced basal stemming lows.
So yeah. Exercise hasn’t radically helped hormone driven insulin resistance. Carb sensitivity, prebolus times, basal needs were same or even “worse” this cycle.
I agree, exercise doesn’t seem to make any difference in hormone-related insulin resistance to me. I still spend weeks out of range if I’m not on top of it (and half the time even when I am). If anything, exercise actually just makes things even more confusing, because you’ve got the combination of increasing insulin for hormones but potentially having to decrease it for exercise, but not too much or you’ll skyrocket, but enough so that you don’t crash.
This is what I find so frustrating. If my diabetes behaved like my low-hormone weeks all the time, I’m sure I’d have hit an A1c in the 5% range many times by now. But add in the two to three weeks of persistent highs (except when they’re crashing lows), and my A1c tends to hang out in the upper 6% range. I know that’s still good, but considering the effort I put into my diabetes, it just frustrates me that at this point, I don’t think I’m ever going to do better. Maybe things will be easier when I come out the other side of menopause; although, ugh, certainly not looking forward to that whole process and effects on diabetes…
Today has been one of those frustrating hormone days. I woke up this morning at 15.6 mmol/L, despite taking a correction before bed (caused a very small dent, then my blood sugar went right back up).
I was exhausted at just the thought of changing all my basal rates, which I’ve been trying to fine-tune the past week (I can never actually seem to get any fine-tuning done, because hormones interrupt, but I try). So, instead, I decided that this time I’m going to try using temporary basal rates and setting them each morning (since they only last 24 hours on my pump).
I’ve been running a 130% temporary rate all day, have been correcting every couple of hours, and have still been above 10 mmol/L for most of the day. So frustrating. If I’m still high tomorrow, I’ll try a 150% temporary rate tomorrow. I’m hoping this will work and maybe be less annoying than having to go in and change every single individual segment every couple of days for the next two or three weeks.
Those are the worst. Just got over weeks of that using temporary basal rates on and off.
In the past three hours I’ve shot from ~125 to ~470 thanks to a pump occlusion. It’s the eight occlusion I’ve had in the past two weeks. Seriously considering a short pump vacation.
Nothing wrong with a pump vacation. Sorry about the trouble. That is why my son uses Lantus for 50% of his basal needs and then uses the pump for the rest.
This is what I’m considering, except with Levemir. Or I may just do a week with no pump, since I’m just staying at home and am off for summer vacation.
