Not sure exactly where to put this. I’m not on basal insulin yet, as I have previously been waking in the 70s/80s and fairly easily get back to that between meals. The past 10 days or so, however, hormone shifts have made me run a little higher - waking in 90s/100s, not really going back below 100 all day, even with adding correctional doses to my boluses at times. I know those are still pretty decent numbers, but I don’t really like staying there, especially since corrections don’t even budge it back down at all at times.
All that to say, if this continues every month, would you consider that a need for a tiny amount of basal during these periods of higher numbers, or would you just deal with being a little higher ~10/30 days of the month? The main problem I see is that I don’t always stay up around 100 - sometimes during the day I do drop back down to 80s/90s, so I’m fearful any basal would just lead to random, unpredictable lows.
And just a note - I am planning to talk to my doc about this, too.
@Pianoplayer7008, JM2C, but I would be super ok with those numbers , even for 10/30 days. Basal is going to drag the numbers even lower, and potentially make you hypo if the dose is too large. IMHO, I would just take bumps of bolus to nudge the bgs when needed.
I would definitely consult with your doc and take his recommendation into strong consideration.
Your drops to the 80s and 90s would be a bit worrisome if you had basal running on top of that. I probably would not run the risk. Averaging 110 across still gives you about 5.5 A1c. The problem is the lows.
Thanks, @elver and @Michel. I know it’s probably best to just leave it be (with bolus corrections as needed of course); it’s just really annoying after having such good control to see things run higher like this. Ha, I’m very type a/goal oriented, so having gotten down to a 4.9 A1c at last check has me frustrated knowing it’s going to be back up again at the next check.
Well, it all depends upon your low incursions, I would feel the same way too! Besides, without trying you won’t know.
So you could see if you can convince your doctor to let you try, then very carefully and gingerly dial it up super slightly. Without experimenting you won’t know, but be really careful, Emily!
Now I am speaking out of both sides if the mouth… You’d have to be really careful.
[EDIT] btw, I am only suggesting you try because I know how well managed and active in BG management you are. I would never suggest that an average PWD do so: too dangerous for not enough return. I am adding this paragraph after the fact because I would not want to encourage risky behavior
Going on at least week 3 of consistently higher fasting numbers (had a screwy sensor just before this, so not sure when exactly it started). I have been relying on Afrezza more and more the past month or two, and I’m wondering if the shorter action time is just revealing my current beta cell function - wondering if the longer DIA of Novolog helped keep my fasting levels lower, and now that my boluses only last 1-2 hrs as opposed to 5-6…hmm. I think I’m going to try a week of using primarily Novolog and see if I notice any difference, then contact the doc.
That seems like a good course. My 2 cents, is if you aren’t living above 130, I wouldn’t even think of adding basal. You seem to be doing great with your current treatment, even if it isn’t perfect.
I can honestly say that once this disease progresses, perfect isn’t possible all of the time. my additional 2 cents is that I would be careful about adding treatments that might make your disease progress faster.
If you do decide to use basal, maybe use some syringes with 1/2 unit markings so you can do 1/2 unit or even 1/4 unit as needed? Seems less risky than dosing in whole units.
But I tend to agree with others…coming from the full-fledged T1 perspective, the higher numbers you’re talking about are dead centre within my target range and I wouldn’t consider them a problem.
I have seen and heard that perfection isn’t possible, but I’ve been trying my best to keep as perfect as I can while control is “easy.” I also have heard that early insulin treatment, keeping numbers lower/in a tighter range, actually preserves beta cell function, extending the honeymoon period. That certainly seemed to be the case for me, as my tightest control weeks resulted in days I didn’t even need to bolus at all.
That’s a good idea. I use the Echo pen in order to do 1/2 units of bolus as it is…makes sense to start with that for basal, whenever I do start.
Switching to Novolog (and upping my ratio a bit) hasn’t made any difference whatsoever - I’m able to manage rises from food, but don’t come back down to pre-meal, even. I just talked to my docs office and my labs came back still hypothyroid - have been for a year and a half now (got worse during pregnancy) - so now I’m wondering if that’s what’s behind my higher numbers, considering I’ve been more symptomatic from the thyroid stuff the past month, which is when my numbers started inching up.
Do you take thyroid meds? If not, is that a discussion you have had with your Doc?
Yes, I’ve been diagnosed/on meds for Hashimoto’s since I was 14 (that was my first autoimmune disease). Was on NDT before/during pregnancy, finally decided to switch to Synthroid, now about to add cytomel. Every med change has boosted things temporarily (or made no change), and then back down again.
What level Synthroid? Maybe you just need a bump up?
The other thing you can do with Synthroid is change the time of day you take it.
For some people, it makes a difference if they take it first thing in the morning as opposed to right before bed.
Easy enough thing to try for a couple weeks to see if it has an impact.
I’m right now at double the dose I started at - I think 112mcg. I started out on synthroid when first diagnosed and have always had a problem on t4 only meds (don’t convert to t3 well), so I’m hopeful adding cytomel will help.