Well, I’ve spent the last 10 days at a workshop where I’ve spent the entire day sitting. So my average for the past week is a pathetic 2,800 or so per day. More typically it’ll be 6,000-8,000 per day, and I hit 10,000 if I work in an extra evening walk. (But I also use my stationary bike almost daily, including yesterday although I didn’t use it when I was away, obviously. The bike or swimming that I do doesn’t get included in Fitbit’s step counts, one major weakness of the Fitbit platform.)
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I don’t know if this is a sound conclusion or not, but for the last few months I’ve been needing more temp basal on high hormone days during the daytime hours (i.e. eating hours), and definitely less temp basal on high hormone days during the sleeping hours (i.e. non-eating hours). Since my basal rates do a pretty good job for me during neutral hormones (week 2). I’m thinking that this isn’t just an incorrect basal rate phenomenon. For example, temp +15% worked well for me yesterday during the day so I went ahead and tried it overnight to see what would happen, and it was crash city (53 at 3:00AM). I usually run at least 5% less temp basal overnight than whatever I use during the daytime. I used temp +15% during the day today with good results…so I’ll try temp +10% tonight overnight.
I was going to post about exactly this same thing this morning! I spent a good chunk of the day yesterday at 17 mmol/L (300 mg/dl), even with corrections and cartridge and site changes. I finally did an IM injection before bed, and that dropped me to 2.7 mmol/L (48 mg/dl), where I pretty much stayed for the next eight hours, despite eating a total of about 50 grams of carbohydrates and suspending my pump for a total of two hours throughout the night. This morning I lowered my basal rates slightly (by perhaps 8%) and have spent all day hoverinign at 10-14 mmol/L (180-250 mg/dl). This is not the first time this has happened, and it definitely makes me wonder if there’s a difference between day and night.
I’ve also come to the reluctant conclusion that I really need to get back to eating a low-carb diet. I really don’t want to, but I think I have to if I want to get off the rollercoaster enough that I can get a real sense of what’s happening. So come tomorrow I’m planning on going back to that way of eating, though I’ll have to force myself to do it because it’s become such a chore since I had to give up eggs (I enjoyed it a lot before that, even without dairy).
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That’s super interesting! I hate that you were stuck in the ditch for so long. That’s not enjoyable at all.
Anytime I’ve had a good night on a certain temp basal, and then I try it for the next day (thinking that I’ve cracked the code!), it’s typically ended up being a disastrous day…either stuck high all day or rollercoasting like crazy. And similarly, when I’ve had a good thing going during the day and try it overnight, it tends to make me crash overnight.
I’m eating differently during my high hormone weeks than when I’m in low and neutral hormone weeks. I am working to diligently get enough calories everyday, but I’m choosing safe/lower carb foods over and over and over (and the same dinner over and over and over) to try to get a handle on these moving basal targets. I’m still figuring out how bolus dosing factors into all of the resistance stuff. But with more conservative eating, at least I am bolder with pre-bolusing because there’s less overall risk with eating lower carb bc if it crashes on me, there’s less to dig out of than how I’d be bolusing during low/neutral weeks with relatively higher carb meals.
Using +10% overnight seemed to be basically “correct”. It wasn’t a perfectly clean test run (had an active correction dose going into bedtime), but it did pretty well overall. I started with a 30 point drop, then a 30 point rise, then a 15 point drop and it held steady. The timing of the swings seemed to line up with when I see bobbles in my bg during Week 2, but the bobbles were amplified. I keep thinking that hormone induced insulin resistance will amplify any typical climbs I see and the extra temp basal will amplify any typical drops I see.
So I was going to post the below picture from yesterday but ultimately didn’t finish the post. This was taken about an hour and a half after an IM correction. I ended up giving another IM correction before bed, which did bring me down into range.
The overnight? Perfect flatline. Drifted a bit low towards morning, but otherwise perfect.
Everything else was identical about the night before last (eight hours low despite lots of carbs and suspending pump) and last night. The only difference was the infusion set and insulin. Which makes me wonder if they’re paying a role. But how do you sort all this out? Why does a 0.05 unit an hour change (lowering) in basal rates make such a huge difference, and how can one possibly keep on top of that when basal rates are changing most of the time?!?!
Hopefully today will be more in-range than the previous few have been…
EXACTLY. EXACTLY THIS. And I can understand skepticism from people not experiencing what we are experiencing, but here it is. “Basal Surfing” is the most relate-able term I can imagine to explain to outsiders what we’re experiencing with hormone induced insulin resistance.
EXACTLY THIS, TOO. For me, I start every morning the same way with the same breakfast to give me a fighting chance at that day’s scenario. Everyday is different. Totally different. General patterns? Sure. But when + or - 5% basal is the difference between stuck highs, or flat line-ish, or tanking lows…it all has to be handled like dynamite in my life. Not to scare anyone else figuring this out…but I myself am never allowed to assume anything. And understanding the gap between what boluses can do (not much) and what basal can do (a ton) is crucial for my safety and success.
I figure if one or two correction doses do nothing and I am in a higher hormone time, I turn to basals and give each change 2 or 3 hours to do something before I tinker again. Basal changes usually kick in pretty quickly for me. Not sure what you experience on that front.
Yup. I went four years thinking this was the problem. And maybe some of the times it was. I tried Novolog. I tried alternate sites. I tried injections for meals to take quantity pressure off of the site in case of leaks. But basal changes have been my largest answer at this point. Since Basal Surfing for hormones, I’ve in actuality had very few site issues compared to what I was suspecting before. Unless I’m climbing and I keep going up, it’s usually insulin resistance due to hormones for me. At least that’s my most sound conclusion at this point. All of my data supports that conclusion right now.
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I think I’m gong to try your strategy of using temp basals every 12 hours, @T1Allison, and see if that works better for me. At least it would give me a stable base to fall back on during these periods where it seems my body switches between insulin resistance and insulin sensitivity.
For breakfast this morning I ate the last of some bread I had. I weighed it to make sure the carbohydrate count was exact. I pre-bolused. Then I totally tanked to LOW on my Dexcom and am still waiting for the numbness in my face and mouth and visual artifacts to go away. I think that is my final straw in trying to make carbohydrates work. Enjoying food isn’t worth almost dying every day because I’m guessing at all these variables. I’ll start eating low-carb come lunch and hopefully will find ways to enjoy it more and find travel solutions.
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That sounds like a good book title, or at least a monograph. The work all you folks are doing here looks hugely valuable and important, and I hope as the conclusions settle in that it becomes widely known. Kudos.
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Thank you for saying that. Thank goodness for FUD bc that is the only thing making this possible, IMO. I’ve tried other routes and venues on this topic. I’ve come up empty everywhere but here. The open-mindedness and critical thinking at FUD is such a gift.
I have gotten so much help at FUD from both women and men that has helped me personally in huge ways. Hopefully we can make strides for these hormone specific issues via continued FUD collaboration.
And when the hormones dissipate, the storm subsides for a little while…I’ll enjoy getting to take a breath before another round.
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Did you have a huge crash?
The past two days have not been bad for me. I’m sticking with the +35% increase and putting up with blood sugars that are spiking to 10 mmol/L regularly, but I’m also eating carbs, so I can’t complain too much. Keeping an eye out for the secondary rise that I’m sure will come in the next couple of weeks.
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I didn’t crash this time. As soon as I got the indication that things were shifting, I cut to +0% basal (down from +15% that I had been running)…and I allowed myself an extra cup of coffee in case -10% was actually needed. I tend to do better w hormone transitions on weekends when I’m more relaxed and active. Work days make everything 10x worse.
I was able to do a fasting basal rate test today to check my 4P-7P work day basal rates. This was my most important time frame to test during low hormone days because it’s been when I’ve been crashing worst during high hormone days.
Rock solid. I really expected to see a drop.
So…this makes me theorize that when I’m running temp basals to offset insulin resistance from hormones, the amount of temp extra that I need is heavily influenced by my activity level. I.E. When I’m at work and pretty sedentary, hormones might necessitate +20-+30%. But I better turn that down an hour or two before I leave for home where I’m super active…bc those same temp basals are overkill in an active environment. That’s my theory for now. Can’t do much more testing on that right now. Hoping to basal test some other time frames tomorrow at work. Fingers crossed. (And, btw, I’m terrible at fasting. So. Hangry.)
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Great work.
My overnights have looked like yours the past few nights. I’m currently running a basal that’s 35% higher than my usual. Seems to be holding steady. Some spikiness during the day, but that’s mostly from eating high-carb meals.
The other day I got sick of using steel needles because I’m in the “it hurts!” phase where my skin just feels really sensitive and insertion is painful. Someone suggested that this is related to cycles, and so I’m going to start tracking it as well. I inserted an Inset II and was quite happy because it actually lasted for three days, although after the first day it felt pretty irritated, and it was pretty red when I removed it. Last night I inserted another Inset but by this evening it was so itchy and irritated feeling that I had to rip it out, and it was red although not horribly bad. Pretty sure I’m still allergic to plastic infusion sets. I’ll insert another steel needle set tonight, and I bought some EMLA cream that I’ll test out to see if it helps the pain issue. 
(Someone on the forum asked me to keep them updated about this, maybe @daisymae?)
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Last night after being stuck at around 13 mmol/L for several hours, I went to bed at 10 mmol/L. I woke up this morning at 17 mmol/L. I think this means I need to up my basals again (second round), but I’ll wait to see how the day progresses before doing so.
So strange how I can go from overnight flatlines to such steep rises with no warning.
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I ended up not adjusting my basal rates yesterday because I stayed lowish all day. It was a great day control-wise.
Then last night I again rose from 4.5 mmol/L at bedtime to 11.5 mmol/L when I woke up. So something about my overnight basal has changed. How to deal with this… If I get a repeat tonight, I’ll use a temporary basal rate overnight to help out. But I really don’t understand how my overnight can go from flatline to such a dramatic rise with no warning. Does that happen to anyone else? I don’t think it’s hormones, because I’d think if it were it would affect the daytime as well. And if I use a temporary basal overnight, of course at some point it will end just as suddenly as it began, and then I’ll be running way too much basal…
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I have a really tough time w my overnight to waking bg’s. I’ve seen lots of other diabetics talk about how this is their best time of day, but it’s very variable for me. And 50% of the time I get a 40 point spike just from falling asleep. My CDE says that’s my body releasing stress from the day but I’m skeptical of that explanation. I also don’t have a better explanation so who knows.
I get some kind of spike right after I fall asleep too. My theory is that my body goes into digestion overdrive as soon as I fall asleep. It’s pretty annoying because I can be running a flat line the hour before I sleep and then end up with a 30-100 point spike (rise rate alert).
If I don’t have any food on board, then the spike is more gradual over 2-3 hours, then either flattens or turns into a slow descent for the rest of the night (depending on my current basal needs/dose). That means I can go to bed at 100 and wake up at 100, but I’ve gotten as high as 150-160 during the night. It’s not uncommon for me to drop low when I wake up (totally opposite of dawn phenomenon).
I’ve seen it a bunch of times, but I still have trouble dosing for it. I worry about going low at the beginning of the night because I have a really hard time waking up to alarms first 2-3 hours after falling asleep.
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The weird part is that both yesterday and today a correction brought my blood sugar down into range very quickly (within 30-60 minutes) and after that I seem to run almost low all day. Maybe I’m having bad dreams that are stressing me out overnight and just not remembering or something?! 
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