What I’ve noticed this month about basal and hormones:
I increased my I:C ratio and ISF at about day 16 of my cycle. I changed my I:C ratio from 1:12 to 1:10 and my ISF from 2.5 mmol/L to 2.0 mmol/L, so not huge changes.
I upped my basal rate by about 0.2 units an hour around day 16. But what I’ve found with basal is that I’ve had to continue to gradually increease it ever since (currently on day 30 of what what my Fitbit predicst is a 32 day cycle). At first, as I suspected, in week three my hormones seem to have a bit of inconsistency where I have to fight with rollercoaster highs and lows. Maybe it’s that I’m trying to raise my basal rates before it’s time, but I get more of the impression that my body’s insulin sensitivity is increased at some times but not others, before getting into a state of being increasingly resistant.
And, this past week has been particularly intense, with me needing to bump my basal rates up almost daily and spending several days mostly out of range (high). This morning I woke up to find I’d risen to 15 mmol/L and been there most of the night, and it’s now 2:00 in the afternoon adn and I’m still cruising above 11 mmol/L, despite 25 units of insulin between meal boluses and corrections. So I’ll adjust my basal rate again later today if I’m still running high.
The difficulty, of course, is that I know the drop will come in the next few days. And I’m doing summer work some days but not others, so activity and stress levels are quite variable. So my plan is as soon as I have any hints of the drop (such as a persistent low or two lows in close succession), I’m going to drop my basal by a ton. In total I’ve raised it by about 47% this cycle (assuming I don’t raise it any further), so I’ll likely start running a -60% temporary basal at the first sign of the drop, back my basal off by perhaps 20 units (I’ve raised my basal from ~34 to ~52 units). I know a couple days after the drop my basal goes back up slightly, so I’ll aim for that to be 34 or 36 units again and see how I do from there.
I am looking forward to the week two blissful stability already…
Oh @Jen, I hate those swings for you. I love your careful tracking and reporting. I wish you a safe hormonal drop! Week 3 going into Week 4 is typically all over the place for me…high resistance, then it drops off some, creeps back in, drops again. I’ll post more as I track the next one. I’m also going to watch I:C as much as I can.
For me, some months I don´t need to increase anything, and there is no change. Other months, I increase my usual 11 units of basal (am and pm) by 1-3 units. Sometimes I need 2 days of this, others, 7. my cycle is between 25 and 30 days so i never really know whether or not I should actually bother increasing it, as my period might just start earlier than predicted, so it means fighting highs for five days that are ridiculously stubborn or fight lows cuz my upped basal was too much. it is all just so much fun. and ive heard menopause is just as fun! yippee!
Actually, this month has not been too bad, I think because I’ve been paying such close attention. Except for today, where I hvaen’t been able to get below 11 mmol/L all day. Currently sitting at 18 mmol/L. Gave a three unit correction (as well as 25+ units of bolus/correction insulin throughout the day) and raised my basal rates by 0.3 units an hour so far today. No ketones, so I’m going to go for a short swim and see if that helps. I’m wondering if my insulin has somehow overheated or gone bad…
Ugh. I didn’t end up exercising at all, but I think perhaps the drop might be starting. I finally came down into range, but then just continued dropping. I just dropped from 6.2 to 4.7 mmol/L (111 to 84 mg/dl) in eight minutes with no insulin on board.
Happy I just bought three containers of glucose tablets today…
no, not on any hormones or anything. The first couple of years with diabetes i had zero ups and downs, rode a long honeymoon. now, its a crapshoot every month.
That’s been my experience as well - diagnosed two years ago in April, and, outside of pregnancy, everything was pretty stable until March of this year.
This was my night last night. I gave a three unit correction when I was 18 mmol/L, which is pretty conservative (about half of what I’d normally take). That brought me down to around 8 mmol/L, but then with no further correction I drop to 2.7 mmol/L. I suspended my pump for an hour at around midnight, which usually helps bring me up but had no effect. Between about midnight and 2:30 AM I ate about 25 grams in glucose tablets. Finally, when I was still low at 2:30 AM, I suspended my pump for an hour and a half and went to sleep as soon as I saw that I was rising. You can see that the combination of 25 grams of carbs plus 2.5 hours without insulin eventually cause me to rise to around 13 mmol/L, but then with NO correction I drop steadily down again until I’m at LOW. (Incidentally, this is why I wish there were such things as dual temporary basal rates. I would have loved to be able to set a 1.5 hour -100% basal followed by an eight hour -50% basal, as I knew I’d probably drop low again.) I had already lowerd my basal by 0.2 units an hour around midnight, but at 7:30 AM I further lowered them by 0.3 units an hour.
I’ve now had breakfast, cereal in fact, which usually spikes me. Considering the lack of a spike, I strongly suspect I’ll be dealing with more lows this morning. I’m glad, at least, that all this hormonal chaos kicked in on a weekend and not during the work week.
I guess I was wrong about my need to turn down basal. I’ve been high for the past four hours and currently sitting at 16 mmol/L. I haven’t been doing anything crazy today. It’s exactly this type of guessing-game with such extreme highs and lows if I’m wrong that I wish so much for a way to figure out!!
I have that happen, too. Once the rollercoaster gets going for me, it’s hard to nail down any theory I might have about what my body needs in that moment. Hope it does something recognizable soon!
So far still running high (12.9 mmol/L). Upped my basal rates by 0.2 units an hour. Hoping that doesn’t plunge me low.
Hard to believe looking at yesterday and today that the very day before I was running flatlines, especially overnight. If only this hormone business was something I could figure some sort of pattern out of…
For the past two days I’ve been constantly ping-ponging between high and low. Only 36% of readings in range, according to Diasend; 10% low, and 54% high.
I had bumped my basal rates back up a bit over the previosu few days, but that seemed to have minimal effects to the rollercoaster except it did diminish the lows, and I’d made no further changes last night.
Last night I had a flatline that lasted from midnight until 8:00 AM. I’ve now drifted a bit low before breakfast.
I suspect that this is the real drop, and I was two days early in anticipating it. Either that, or maybe just like the few days before the rise, I get a few days where my hormones are wonky and I’m sometimes insulin resistant and sometimes insulin sensitive.
I’ve bumped my basals down a notch and will bolus a little less for breakfast (using a 1:12 ratio instead of 1:10), and I’ll go from there.
@Jen, can you tell me more about what indications signal to you that it’s time to make a basal change and by how much? Is there anything specific you are looking for?
This is what I’m trying to figure out. If I could figure out what indications tell me that I should make a basal change, and could estimate by how much I need to change things, that would help me a lot!
Right now, I go by guessowrk and intuition. Neither of which are very quantifiable. I lowered my basal rates a bit today because last night was “too perfect” without making any type of change, and I was nervous that if activity were added on top of that, it would result in lows.
So far, after breakfast (oatmeal and strawberries), I’ve spiked to 8.0 mmol/L, which is quite within the realm of what I’d expect (yesterday, same breakfast with 1.5 units more insulin, I spiked to 13 mmol/L).
Also, as my experience from two days ago illustrates, sometimes I have the timing totally wrong. I backed way off my basal rates two nights ago because I had a three-hour low followed by another very severe drop (from ~13 mmol/L to LOW on my Dexcom with no correction). Turns out that night was some type of weird fluke, probably the type of low that would normally have been a nine-hour low for me had I not suspended my pump for 2.5 hours and eaten a bunch of carbs.
I ended up having to raise basal rates back up slightly, and even with that stayed mostly high (with random lows) the past two days.
I so wish sometimes that we had meters that could measure other hormones. I often feel like the external factors are the simple ones. It’s everything that’s going on inside my body that I have no control over and can’t see that is utter guesswork.
Also, when I use terms like “slightly” in the context of basal changes and hormones, I’m talking about 0.1 to 0.3 units an hour.
I’m basically super jealous of people who just need to “tweak” their basal rates twice a year, or on certain types of days, by 0.05 units an hour or a unit or two total.
No such thing as tweaking in my life. I’m just perpetually trying to figure out the basics.
@Jen, I realized today (I’m making a lot of realizations through self-examination after joining FUD, go figure), that when I let a CDE change my personal logsheet format by removing my “Correction Dose” column, that’s when I stopped logging anything for four years because it was the most important piece of information on my entire logsheet.
When I was on MDI (and on Nuvaring, coincidentally), I tracked Time/BG/Carbs/Insulin Dose/Correction Dose. I ate the same breakfast everyday. I would keep tabs on when I started needing to take a correction dose to make up for when my breakfast dose was insufficient. When I needed to consistently take correction doses for breakfast (and probably throughout the day), that would tell me it was time to increase my Lantus for my hormones. (I still do the same thing on pumping, now.)
When I switched to pumping, the CDE I worked with told me to remove the correction dose column because he said it’s not used that much. After extensive basal testing and getting up and running on the pump, my new and “improved” personal logsheets did nothing for me without the correction dose column and I stopped logging altogether. I’ve been back on my original logsheets for three months now and the correction dose column continues to be my most crucial information. It is the key to my basal adjustments for hormones. I really need to add an “Extra carbs consumed” column to help track when the lows creep in.
But this is the most effective method I’ve found to track it for myself. It may not work for other women, but it helps me quite a bit. But dialing in the “how much” to change things is still super challenging. This is where I rely on my cycle tracking sheets where I note what I used and if it worked well and if not, what I think would have been better.
I, too, have wished for a hormone meter to go with my glucometer.
I complained to my endocrinologist about this once. We were talking about lows, and I said, “Sometimes i have a lot more lows than it shows, but I correct them before they happen with carbs, but there’s no real way to see that with the pump/Dexcom even if it’s tracked.”
There’s also no easy way to see boluses versus correction boluses, at least not with Diasend or the Dexcom software.
This month I’ve found easier than most because I’ve been tracking with my Fitbit. So if I find I’m running high or low, I can look at that and go, “Oh, it’s day 14, I probably need to raise my basal if these highs keep up.” The days that thorw me for a loop are the half-week during week 3 and week 5 where I just ping-pong between high and low and can’t figure out what my body wants.
