Bother MY bloomin' basal now...

[Munjeeta]

Hello all. I'm after some advice! I'm throughly confused by my basal insulin dose in the day... I'm hoping one of you clever souls can shed some light on it for me...

Basically. I split my levemir into two doses; am and pm. Am I am currently taking 8 units (when cycling, 12 when not) and pm 12 units (14 when not cycling) At the moment, my am basal dose is keeping me perfectly steady in the mornings to the point of being almost exactly the same before breakfast, mid-morning and then before lunch. But in the afternoon it seems to be completely diffferent. I eat lunch about half 12, then usually test 3-3.5 hours later, straight after school. The last 2 days I've been 10-11 at this point then literally an hour later I've hypoed. I have no idea why Yesterday I tested before cycling and was 10, so didn't eat anything and was hypo when I got in (could be the cycling, but usually when I'm 11 I'll go up or be absolutely fine). Today I was 11 then an hour later (BEFORE cycling) I was 3.2 (obv I sorted myself out before cycling 😛) but I'm thoroughly confused: how can my basal keep me completely steady all morning then make me drop like a stone in the afternoon?!

 

[lilredhairbow]

Hey hun, I can't exactly help you too much sorry , but I'm having a similar problem, not necessarily with basal but with cycling! I've started using a stationary exercise bike (pink i might add which is why i originally bought it hehe) and for example today i cycled for 50 minutes whilst watching some tv and a couple of hours afterwards before dinner i was 9.9 and then about 30 minutes after eating dinner i was 3.4 it all seems a little bit odd. So basically, I'm sorry that this reply hasnt been very much use but i wonder if your cycling is contributing a little bit to your erratic levels?is there any variation in the intensity or durations of your sessions ? because exercise can cause u to hypo or affect levels for up to 36 hours after doing it so i have been told. sorry i can't be more use. hope someone comes along soon to sort you out hun 🙂all the very best xxx

 

[MCH]

Glad to have you back, Munjeeta. 😉

This is not much help, but I find something similar when cycling home from school. It's only about 15 minutes and reasonably flat, but I often find that I can be a decent level when I leave and down at 3 or 4 when I get home. (Mind you the same is true if I walk the same route). I think probably I should think of getting home as proper exercise -like at the gym- but feel it isn't because I don't get hot and sweaty and therefore I tend not to eat jelly babies though I suspect I should!

 

[rossi_mac]

Hi Munjeeta

Sorry your having issues, again no real answers from me. My days vary in physical intensity but I don't vary my basal at all, I sometimes worry that some people vary theirs too much always combating it, nursey told me it takes 3 days to adjust to any change in dose. I know I don't have wild swings and have relatively good control so probably no help I just wish you luck in sorting it out and understanding it soon.

Take care

Rossi

 

[aymes]

Can you have a couple of days without cycling and do the same tests? Then you should be able to determine whether it is the cycling dropping you or something else. If it’s the cycling then you may need to look at having some sort of snack before the cycling or reducing your lunchtime insulin (although depending on timings that could leave you high for a while in the afternoon so maybe not the best option).
If it’s not the cycling and you’re dropping anyway my next move would be to do some day time basal testing to identify if that’s the problem or not. If it does still drop then I’d probably consider dropping the day time dose slightly but maybe increasing bolus ratios during the day time too (although obviously only changing one thing at a time. If when basal testing it doesn’t seem to be that either then maybe a tweaking of the lunchtime ratio (and then after that maybe timing too) could be needed.
There’s so many factors here that I think it may take some time to work out exactly where the problem is, it’s a case of trying to isolate each variable to work out what’s causing the problem. And of course the above is just what I would consider doing, not advice so do chat to your DSN about changing doses etc!

 

[Copepod]

I find cycling has so many variables - wind direction (cycling into wind can be considerably harder work, but a tailwind makes things much quicker & easier), idiot motor vehicle users (not just drivers, but also passengers who open their doors without looking as you cycle up a cycle lane approaching traffic lights, for example) increase stress levels, air temperature, amount of clothing (good if I get it right, but if I wear too much, get too hot and use more energy; virtually never wear too little to affect levels, but it could happen). But, I really miss cycling when I don't do it and couldn't imagine goign more than a day without cycling. Today I went to conference in London, so only walked about 2 miles, instead of cycling at 1 1/2 miles each way for one commuting journey / 1/2 mile then train, then 1 1/2 mile each way on a different commute or 3 1/2 miles including a steep hill going to work on a third commute. Plus extra distances for supermarket shopping, evening class, visiting friends, going canoeing etc. I reckon if I explained my variables to diabetes team, they wouldn't understand, even living in the city with the highest cycling rates in the UK!
Can you adjust times of levemir doses? Are they currently 12 hours apart? Personally, I find it easier to have my long acting doses (not levemir, by the way) at approx 0645 - 0700 when I wake up and approx 2230 before getting into bed, as around 1900 I'm busy doing other things, so would probably forget. Anyway, hope your diabetes team can help you when you ask.