I definitely feel that both basal and bolus need to be adjusted. In fact, lately I have only been adjusting basal, and I think it’s in part why my basal needs rise by 50%.
I just find all this hormone stuff SO frustrating. I mean, T1D is hard enough when all you need to deal with is figuring out basal and bolus needs and how to compensate for food, exercise, stress, and illness. Doing all of that on top of constantly shifting hormones that are never quite the same is just so frustrating. I don’t know that I will ever get it figured out.
The past couple weeks I’ve been raising my basal significantly due to prolonged overnight highs and have made a few other tweaks. I was really happy that my overnight numbers were relatively flat (by no means perfect for those with a super low A1c, but good enough for me). Then the past couple of days my blood sugar has been behaving oddly, so I lowered my basal a touch. Last night I suddenly spiked to 17 mmol/L (300 mg/dl) as I was going to bed and just had no energy to deal with it. I figured I’d correct if I woke up in a few hours and was still high. Well, I woke up in the morning with a blood sugar of 5.5 mmol/L (100 mg/dl) and proceeded to drop low before eating breakfast. I mean…what? That kind of drop literally never happens to me unless I have done a correction or my basal rate is way too high. But the past four or five nights have been flat, indicating that basal is apparently not too high…so, huh?
So anyway, now I’m thinking I need to lower my basal significantly and up my bolus significantly. Or maybe my Fitbit period prediction is off by a few days (though it’s usually pretty spot on) and I’m getting an early drop. I just … ARGH! It is never ending. NEVER ENDING!!!
And yet you get people saying they manage super tight control with “little effort.” HOW?!?! I mean I have been doing this for over 27 years and still feel like the sand is shifting beneath my feet and I’m struggling just to keep my balance most of the time. The only time I can manage tight control with little effort is one week each month. I can do practically anything and as long as I check my CGM and dose insulin I stay in range. IT’S BLISSFUL! If diabetes were like that all time time it would be a non-issue. Instead I get to spend my entire life trying to figure out baseline doses. Never mind any tweaking or fancy stuff. Maybe when I’m 65 and not dealing with this craziness I’ll have time for that. But that’s still almost 30 years off.
Anyway, clearly I’m hormonal since I’m grouchy. I’ll stop ranting now…