Do Women Need to Change their Meal Boluses During High Hormone (Insulin Resistant) Weeks?

We have to celebrate the good days to have something to look back on during the bad days! :slight_smile:

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ABSOLUTELY. Mine’s all good in this moment. And it will shift little by little up and down and around for the next 10 days. And then it will shift lot by lot for the two to three weeks after that. What I define as “good” in the first 10 days is COMPLETELY different from how I define “good” for the last two to three weeks of the cycle.

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Last night I purposefully ate some cereal and only took a half bolus to cover it so that I could go to bed high, thinking I’d have another big drop and lower my basal. But I just stayed high all night. So I guess my basal is correct, and who knows why I dropped by about 14 mmol/L (250 mg/dl) the night before last! Since this morning I’ve been having a “can do no wrong” day like you had, @T1Allison. No rhyme nor reason. Hopefully it will continue for the next few days till the big drop comes…

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I just “liked” every single comment in this thread.

I get one week, then it turns to crap. Then back to second guessing everything. My male endo just retired, and I have an appt with a female endo. I hope she is ready

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Last night after work I had a blood sugar of LOW that came out of nowhere. I didn’t clue in to anything because it was only one low and because my Fitbit said not to expect the big drop for another three days.

Then I had a three-hour low overnight. Woke up this morning to find that Fitbit was wrong. Dropped my basal rates by 25% and will back off another 10% if needed.

This is the type of thing I think those who don’t experience hormonal shifts just can’t fully understand. It’s not a matter of just making tweaks to insulin and it’s not a matter of just tracking it on a calendar. It’s a matter of massive changes in insulin that come on very suddenly and that even fancy Fitbit algorithms can’t always predict accurately!

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I had dinner. And now 1 hour to 2.5 hours after my dinner bolus I’ve needed 2 large juice boxes, 3 chocolate chip cookies, and 2 dove chocolates. Still eating to stay in the 60’s. If this keeps up I’ll lower my basal for overnight but that’s a dicey guessing game, too.

And this in no way matches how the rest of the day went.

That’s what makes this so difficult. You never know if you’re making the right choice. A lot of times I’ll put my basal rate up or down and it’ll be the wrong choice. But if I don’t react fast enough when I should make that choice, I end up running high or low for days.

At least with food, exercise, stress, and illness you either make those choices or you feel those choices. With hormones, the timing is so inconsistent that even when you feel changes, your amount or timing could still be off.

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Agree 1 million percent.

If I back off my basal by 5% tonight, that’s almost a guarantee I’ll run high tomorrow morning.

But if I don’t, 2AM lows will probably creep in.

I wonder what good sleep feels like…it’s been a while…

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To be honest, I usually put my phone on Do Not Disturb when I’m sleeping and therefore sleep through my Dexcom alarms. It’s not ideal, but my body lately seems to demand eight hours of sleep, which means nine hours in bed. So I’m putting up with out-of-range blood sugar most nights so that I can get some quality sleep and get my fatigue and daily routine issues sorted out.

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It’s amazing how good I feel the one night a month I manage to stay around 100 all night. No interruptions…feeling good just via being in range for that long…it’s a STARK contrast to how I feel the rest of the time.

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And despite cutting my basal by 25%, I find myself with a blood sugar of 3.7 mmol/L and 4.8 units of insulin on board at 11:10 pm. And that was with what I thought was a reduced bolus. Cut basal by another 10% and will reduce boluses even further. Time to go find about 60 grams of carbohydrates to consume. :unamused:

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I got myself steady at 106 going into sleep last night. No carbs, no corrections two hours before bed. (I know digestion can take longer, etc etc but let’s be real here.)

Got the fall asleep instant spike last night.

Awesome. At least I never lowered my basal bc that would have made matters worse.

I ended up drinking 60 grams of carbohydrates and continuing to drop, so suspended my pump for two hours. That made me rise to 9.5 mmol/L, where I flatlined all night. So it appears my basal is good, I just need to bolus a lot less. Although the fun part is this whole drop thing only lasts a couple days, so any time now my basal rates and boluses will go back up a bit, and then I’ll get the week of bliss before it starts all over again.

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I’m currently in week 1 and have been trying out switching up my boluses to be less upfront insulin and more of the insulin being extended and extended for a longer period of time. This seems to be helping with the sensitivity so it’s not so much insulin upfront, avoiding going low then rebounding from treating/suspending, but I’m still covering the carbs. Obvi YDMV but extending the boluses more is going into my toolkit for insulin sensitivity days

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:woman_facepalming:Prime example of not heading my own advice

Week 1, day 4: -25% basal in the morning. No breakfast. 9am-10m: Coffee black with two Splenda (no bolus whereas I normally bolus 15g for caffeine and splenda). All fine. Have an eggo waffle around 11:45am, prebolused for 10g (each waffle is 14g) all upfront because they’re carby and fast acting (I thought and I’ve done all upfront for the full 14g before and it was fine). Started feelin low 12:15, tested at 50 (EDIT: at 12:30, dex is caught up and has me reading at 54, dropping)


Because of the insulin sensitivity, I probably should’ve extended the bolus even for the fast acting eggo waffle I think

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Definitely needing more basal and more meal bolus today. Thank goodness for @LarissaW’s observations to “normalize” the strategies required for a day like today. I was cruising near 95 all night with no extra basal, but OMG the “get out of bed spike” was formidable today. I went ahead and added +10% basal for the daytime and have been adding a unit to all of my meal boluses and giving them an extra head start of prebolus time before eating. So far I’ve kept it respectable after dealing with that initial spike to 200 in the blink of an eye this morning.

Anyway…I feel less precarious adding basal and bolus on a day like today since I’ve seen that others need it, too. It does defy the logic that is presented in the leading T1D books out there (re: if your basal keeps you flat then you’re all good and your I:C ratios will work).

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It may defy the logic of these books, but I think it makes sense saying “I’m more resistant to insulin today so a larger mealtime bolus sounds like a good idea.” (And this is TOTAL retrospective thinking :sweat_smile:)

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I was reminded of this topic this week…prior to now, I’ve seen some affects on my insulin needs during my period, but not anything dramatic. Just a “huh, guess I’ll dose a little more” and done thing.

Well. I can say with certainty that has changed. :grimacing: The last few months, I’ve noticed hints of mealtime insulin resistance during my period. This month, I had a what the heck moment watching my BG rise and rise with almost no impact from what I was tossing at it (I ended up throwing an entire normal day’s worth of insulin at that one meal’s rise). I then had an ah-ha moment, remembering that this happened last month, too.

I’m always tempted to just blame my bad food choices (I have slipped off my paleo-ish diet a few times, but especially around my period…), but this week has proven beyond a doubt that it is not just bad food choices. I have some major (for me) insulin resistance going on at this stage in my cycle.

Part of me is tempted to just adjust my diet - lower carb, cut sugar, etc - but…I like good food, including treats and, ha, sweet potatoes. :blush: So I guess I’ll be tracking my cycle and BG levels, etc, etc for the next few months to see if there’s any specific pattern (oh, please, let there be a fairly predictable pattern). In the meantime…you ladies who have been going through this every month for years…my hat is off to you. It is incredibly frustrating.

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Just adding this here for general reference since it is relevant: