Using a higher basal than we absolutely need: one more treatment option

Tips, Tech & Gear Treatment
61

This isn’t quite how I see it. I do run a little low at times, but that’s not the same as “running low on purpose”. I know you have said you don’t believe this is how it works, and it is entirely possible that our bodies handle our diseases differently (would that be a surprise?), but the reason I don’t run low is because of the intermittent carbs or coffee that I am consuming.

I was trying to describe the difference for me… that with less basal, I have a tendency to jump with a lot of what I eat and with caffeine. My coffee spike can be ridiculous. So I’m still not sure why choosing an alternative path, and this is running a higher basal rate with the tendency to push downward, is not a legitimate choice if one is aware of the cons of it. One choice means I have to wait for things, and the other makes me feel more like a person without diabetes. In no way am I encouraging others to do it, I was only discussing what I have found to be true today for my own disease. It might all be different tomorrow.

I also saw you mentioned exercise up there in a previous comment. I’ve been a very active person since my early childhood. I love exercise, and I would use it to fix my diabetes if I could. In fact, I really hoped I could and have tried at various points to use it in a much bigger capacity than it deserves… for my disease. It is wonderful for me, both mentally and physically, but I need to be able to control my numbers through insulin first. Exercise, for me, is really more about the long term benefit as well as the mental and emotional outlet it provides. I always thought it was for immediate blood sugar control, but that has not turned out to be the case. It has been a very important idea for me to embrace that to be able to exercise is a gift, but to be able to use insulin effectively is a mandatory skill. I don’t know if there will come a day where I can no longer perform physically the things I enjoy, but if it should be before me, it should not be detrimental to my diabetes management.

I’m really pretty happy with this extra basal, and I don’t say that in the hopes you will try it. There’s a lot in here that is interesting to me but also not for me. I just hope you are able to keep an open enough mind to allow for the idea it might not be the feeding insulin of old. I make good use of all that technology you speak of in order to make changes when I see fit. I think flexibility is what this technology has given us, and it puts some of these decisions in our hands— truly where the decisions belong.

You and I agree on a lot though… especially about how much effing work it all is (every day, like it or not) and especially about this disease forcing us to keep an open mind. It’s how I came to be here, and it amazes me how many ways we can achieve desired numbers.

Anyway, here’s to a disease that has more possible paths than an international airline. :coffee:

5 Likes
62

Excellent post and Im really happy it’s working for you!

There’s so many variables and equations with all the different technologies, it’s a challenge for everyone to bring more to the table. People’s various homegrown techniques may in fact be very helpful, but if they’re not Doctors, or describe them as “advanced” techniques with no scientific data, I’m a bit more sceptical as I’ve said a few times already.

And the description of glucose mimicking glucagon makes no sense without data to back it up. To suggest that glucose is taking the place of glucagon really needs to be studied, otherwise it just looks like feeding insulin, and this supposed metabolic description seems like a made up justification for eating without bolusing, and possibly a potentially dangerous basal rate in some cases as others have described.

Sure hypos are no big deal. Injecting insulin when already hypo no big deal. For us diabetics anyway. Have we lost sight of the forest through the trees? Hypos are a serious emergency for the rest of the world, and I think we need to understand that not only is about ourselves and our numbers, but also how this disease effects others and the risks involved.

Furthermore I think techniques outside of the prescribed ones are in fact “experimental” and not “advanced,” and should be described as such. How are Doctors and Insurance companies supposed to prescribe things if we don’t use them as prescribed?

If I go to the Doc and they ask me to explain some numbers am I going to say “I read this on the internet”? Even if it works!

For so many years I’ve had to learn and re-learn new technologies and terminologies over and over, and things haven’t always worked as advertised.

I think that tight control and the “freedom” that comes with it is more certainly a bit more doable these days, if only for those people who are “lucky” enough so to speak.

The fact that many aren’t is still a real problem for me. It hurts me to think that people are being forced to use inferior insulin regimens, ones that can cause possible complications and pain and suffering or death even when used as prescribed. I know this from personal experience. And all of my diabetic friends from childhood died a long time ago!

So then I think wow first world problems right? “Must be nice” others without the same access might imagine!

Yet perhaps we are doing the ground work for the greater good of the medical community and those that are suffering from this disease without access to the same technologies we have?

Yea right! Keep dreaming I tell myself! This is a big multi billion dollar business and that’s pretty much all that counts, the bottom line!

Isn’t it?

63

Wow! All this deep discussion for the simple technique of raising your basal. I mean basal insulin is novolog. Bolus insulin is novolog. Isn’t novolog well, novolog?

Why don’t you look at it like this: a higher basal is just an extended bolus for grazing. Sure, if I’m going to eat 30g carb I’m going to bolus, that’s well beyond my .25u/HR basal increase. But my usual grazing of 5g here 3g there would result in more lows, considering that I have a 5 hour tail, if I bolused for that.

The only thing I have to do is graze, which I do and have done every day for 60 or more years.

6 Likes
64

Doctor’s orders. :grin:

2 Likes
65

How can we argue with so much experience :slight_smile:

3 Likes
66

Couldn’t have said it any better.

4 Likes
67

Maybe we can agree on this.

A higher than needed basal is appropriate for those who can track their BG closely to prevent lows and highs, and who like to supplement their meals with between meal snacking. For a T1 this will require a CGM or very frequent BG monitoring and continual access to carbs. It is not appropriate for those who want to avoid the need to eat between meals, and for those who want to minimize the amount of time they need to think about and test their BG.

Though some here are in the former group, I am definitely in the latter group.

Personally, I typically like to eat my meals, and then forget about food until my next meal. My company supplies a kitchen full of free packaged processed foods - snack bars (Kind and other), granola bars and cereals (Quaker and other), snack chips (potato, corn, popcorn, Doritos, Cheezit, Bugles, Goldfish, etc. ad nauseam), Rice Krispy treats, candy, etc. Some of this has been given a “Healthy” glow in the media; some of it has not. But to me this is all junk food. If I was interested in snacking there is always a ready supply of this junk food available. But I avoid snacking on all of this junk food because eating it would cause me to consume more calories than I need and would likely contribute to weight gain. My weight is great and I don’t have any issues with my weight - but I am convinced I would if I turned up my basal rate and started relying on junk food throughout the day.

Since I don’t currently use a GCM, I test BG a lot, but mostly around my meals because those are the times that my BG is going to be changing most dramatically. I test before and three or four times after every meal to correct with carb (typically fruit) or insulin as needed. Once my meals are balanced, I like to have quiet times between meals when my BG is stable. I think this will continue to be true even when I use a CGM.

The only food my work supplies that I routinely eat is packaged nuts, which I can eat if I’m hungry during my quiet BG times with little impact on my BG.

Everyone has a different definition of unlimited. Part of being unlimited for me is trying to minimize the need to check my BG and eat or bolus to return to normal. The more time of the day I am in that between meal stable mode, the better. So for me, a properly tuned basal rate is an important and critical part of being unlimited. I’ve eaten Bugles and Cheezits and Kind bars and all the rest, and I’m sure I’ll continue to eat it occasionally in the future as well. Sometimes I’ll incorporate junk food into a meal or even make a whole meal out of it. But including it as part of my daily diet is not a part of being unlimited for me.

7 Likes