I should add that I watched him fill out this form and pull numbers out of his rear end! 
I assure you that there was no logic. He looked at the ceiling and said, “You’re sometimes high after breakfast, right? Let’s do 1.2 units per hour then.”
Not sure what medical school was for. His basal rates would have killed me. Not even joking about that. Can you imagine if I had bolused for meals and had that much basal in my system? Unrecoverable, IMO.
Getting my house ready to sell has kept me hopping. I’ve gotten 16000 steps in my house/yard for the last three days. I kept my basal the same and reduced boluses to about 25-40% of what I’d normally take. I transitioned from needing less bolus just during activity to needing less bolus no matter what after the first day. I’m transitioning back to my normal bolus amounts tonight since I’m closer to my usual 8000-10000 steps today with more sitting. It’s been interesting to watch the sensitivity changes…and another bright reminder of how everything is relative with insulin dosing. I’m convinced I:C ratios are just the loosest of starting points for dosing for food.
So…some other things I’m figuring out/rediscovering:
#3 above has been my most important realization. Most of my fear has come from startling and deep drops when I’ve gotten home from work and was in the thick of solo parenting my boys. That’s a bad time for a deep drop. So it lead me to be suspicious of all boluses and all basal rates…and that lead me to higher bg’s across the board…and much more knee-jerk low treatments. I’m like Lieutenant Dan in Forrest Gump who’s always suspecting that Charlie is around the corner. I’m exactly like that with lows. But since getting a handle on the work-day-to-home-night dosing transition, my fear is getting under better control. I just hate that “rug ripped out from under you” feeling…mentally, that is, since I still can’t feel lows. It really bothers me that I can’t feel lows. My endo suspects it’s due to neuropathy (autonomic?), but I don’t know. My A1C’s have always been really really good compared to the general diabetic population…which doesn’t matter for individual complications, but it’s not like I’ve neglected my self-care at any point in this 13 year journey so far.
Is it all lows you can’t feel? How about when it is a fast drop?
While hypo-unawareness can be caused by neuropathy, it doesn’t sound like you have had really poor control.
For many T1D’s, when they can’t feel a low, it is because they have had a lot of lows. It dulls their senses to lows. Maintaining normal BG’s for a while can return the feelings of lows.
Not many lows at all. I avoid them like the plague.
I don’t feel fast drops at all.
I was 57 the other day, first time I’ve been that low in a long time, and didn’t feel it at all. I had trouble thinking but that was it.
I used to go low all the time on Lantus, but that’s been nearly five years ago.
I’m glad you’re working hard at moderation and patience with letting your treatment carbs go to work. It was a revelation to me, when I got my CGM, how little carb I actually needed to recover. (The old recommendation of 15 g often feels like overkill.)
I also used to try to avert lows at all costs, and if I was approaching my low alert level (4, or 70ish), I’d treat and then eat something to sustain the treatment. But often that would make me go higher than I wanted to be. So it was interesting to discover that I could go below my low alert level and then level out and stay there, rather than continue to drop. And be perfectly functional. I can sit at my desk for hours with a flatline of red dots (60 - 70 range), and not need treatment. Getting up to have one glucose tab or a swig of juice wouldn’t hurt, but it also isn’t necessary. Something to keep in mind when you’re avoiding lows like the plague.
Yep, there is nothing physically damaging about a flat 60. For T1’s of significant years there is no hormonal response like a T2 might have. I can hang in that range all day too.
Non-D’s and T2’s generally have hormonal responses to BG’s below 70.
See reference ===> Glucose Counterregulatory Responses to Hypoglycemia)
The endo argument though, is that it reduces your awareness.
Once a CGM can get closer to my BG number than my guesses, I will entertain that thought as a possibility for myself. It may affect others, but it has not affected me yet.
A post was merged into an existing topic: Basal Rates and Hormones
I’m proud of my graph today. Sedentary office day but still consumed a healthy amount of food (160g of carbs by this point in the day on the graph) without sticking highs.
So I have finally gained five pounds after eight months of working on that goal. 
Tunneling seems to be my biggest current issue. I’m utilizing extra basal to get the most out of my insulin from a consumption standpoint. I’m back to using shots for some meals to take load off of my site. The shots leave welts which is annoying but they don’t seem to be causing any real problem. I wish I knew why my skin was reacting that way since that’s new as of this year.
FUD, you’ve been good to me all last year. Looking forward to another year of progress. 
Gratz on all your successes and here’s to many more in 2019!
So I’ve been basal testing my work mornings (2AM to 10AM timeframe) since switching to Novolog last week. I can’t get the rhythm of my work day eating and bolusing correct and thought it was time to do legit basal testing again. I’m putting this in my overall podding thread since my findings really aren’t Novolog specific.
This whole process is showing me how much I got off track by following specialized advice for the masses when I started podding in 2013 (my second try at it). Diabetes is a funny thing. There are certain universal truths in it…but then there are things that are incredibly person-specific about it. And when you let others into your management habits when you’re looking for help, they may inadvertently remove your most helpful and necessary habits. But, switching from MDI to pumping, there was enough gray area about what my Lantus was really doing and what my Humalog was really doing that I thought, “Hey, maybe they’re right. Maybe this part really is different on pumping bc I’ve established a pretty level basal playing field. Maybe I can relax this habit, and that habit, and be more flexible and trust the equations and my Dexcom more.”
Nope. Not in my body. Nope. Nope. Nope.
I’m back to my old MDI truths, but applying them to pumping my way now.
Seen this both days. Made an adjustment for it on this morning’s basal with no change. I’m guessing this is the “feet on the floor” effect that I read about in some threads on FUD. I don’t get this spike at this time if I keep sleeping.
What do your basal profiles look like on your PDM?
Do they look like this?
Or more like this?
Tresiba might work for you, depending on what your basal needs are.
But with the things you’ve posted about your hormone variability, changes from one week to the next, or changes from one day to the next, good luck managing that with Tresiba.
It’s almost like my mock-up picture was your actual profile…
You have different profiles for workdays and weekends, and variable rates during the day and night. Not sure how that would square with Tresiba, honestly.
@T1Allison, I don’t think 40 minutes is slow! @Eric, who is the least diabetic of the PWDs I know, once wrote he activates in 25 minutes. We activate in 45 minutes. Our NP, who is a T1, and appears to be a 20s something in fairly good physical shape, activates in 1 hour 45mns. So I think 40 minutes is pretty good!
One thought, though: we often have slow carb dinners, for instance a bean stew with mostly veggies and some meat, with a small fruit desert, or a split pea soup. These are pretty slow carbs, and we find that sometimes we need a partial extended bolus for those. Also, hard to dial meals, such as pizza, may warrant an extra extended bolus on top of the regular bolus?
YDMV is a strong theme in many of our collective posts, so I will mention this but assume everyone will take it with a huge grain of salt—this is exactly what our school days used to look like. Eventually, we were able to take out the whole afternoon dip, which, for us, was due to large amounts of IOB from the morning.
In fact, our basal profile, from looking very much like yours a year ago, is now a flat line. We now dial up manually in the morning at breakfast time (+35%), then turn the temp basal off by hand. Our basal curve is a single number for 24 hours. We were somewhat inspired by the author of “Sugar Surfing” in going in this direction. He recommended it on the basis that it was very difficult to take the curve into account when manually compensating. We did not believe it for a long time, but we have now come to his position as well. Of course, YDMV again! Even for us, we would not be religious about this: for instance, we don’t see any dawn phenomenon at this time, but we would certainly program for it if it came back (we used to see it regularly).
Very interesting and helpful, @Michel!
To be fair, manually dialing it up, and automatically dialing it up, are basically the same thing. So not exactly a flat line, but I get why you are doing it. The simple solution is almost always the correct and elegant solution.
Eating while sedentary at work still confounds me. I’m thinking I’m going to have to make that an extra long prebolus to make lunch work on work days (it’s the high at the beginning of the chart).
I have eaten quite a bit today to make up for morning fasts the last few days. I’m going to have to bolus more for the “feet on the floor” phenomenon…but otherwise I’m super pleased with today given my consumption. It feels good to eat like a healthy person again.
