Insulin drop

[spiritfree]

I've not been on here for a while
Just been so down in the dumps. I have recently been taken off tibalone, hrt meds, and I am having trouble keeping my bg's up. I have dropped insulin by 10% but still keep going low. Has anyone got any idea's? It's driving me mad.

 

[trophywench]

Can you reduce your basal a tiddly bit more? Can't recall if you have a pump or not - but anyway, do a basal test and see if you can afford to reduce it more - cos presumably if you're off HRT by now, you won't be going back on it anytime soon.....

 

[Pumper_Sue]

Sounds as if you need to drop your insulin more than 10%.
There's no law that says you can't lower it as much as you need 🙂

 

[trophywench]

Dunno about you, Sue - but I've always been told, when either increasing or reducing, to do no more than 10% in one go, to assess how it pans out each time. If not enough - increase/reduce again as many times as I need to.

 

[Thebearcametoo]

Yeah a 10% change is a good rule of thumb to see what happens but it’s not the only possible change. It sounds like you need to drop it more. My daughter is currently through the first burst of puberty and her insulin needs have dropped dramatically. We did a first reduction of 10% basal but needed to drop it again and also drop some of the boluses. It will settle again but it’s not surprising that a change in hormones has resulted in a change in insulin needs. It’s also perfectly normal to feel fed up with it all.

 

[spiritfree]

Yeah a 10% change is a good rule of thumb to see what happens but it’s not the only possible change. It sounds like you need to drop it more. My daughter is currently through the first burst of puberty and her insulin needs have dropped dramatically. We did a first reduction of 10% basal but needed to drop it again and also drop some of the boluses. It will settle again but it’s not surprising that a change in hormones has resulted in a change in insulin needs. It’s also perfectly normal to feel fed up with it all.

 

[spiritfree]

Thank you for your replies. I will stick with the 10% drop and see how things go.

 

[Pumper_Sue]

Dunno about you, Sue - but I've always been told, when either increasing or reducing, to do no more than 10% in one go, to assess how it pans out each time. If not enough - increase/reduce again as many times as I need to.

Yep that's fine and sensible, but obviously if still going low then it needs to be dropped again which is what I was trying to say 🙂

 

[Sally71]

Yeah a 10% change is a good rule of thumb to see what happens but it’s not the only possible change. It sounds like you need to drop it more. My daughter is currently through the first burst of puberty and her insulin needs have dropped dramatically. We did a first reduction of 10% basal but needed to drop it again and also drop some of the boluses. It will settle again but it’s not surprising that a change in hormones has resulted in a change in insulin needs. It’s also perfectly normal to feel fed up with it all.

That’s interesting, when my daughter was going through puberty her insulin needs went up by about 30%, and have never really come down again! I’d heard of the 10% rule so was reluctant to change the main basal pattern by that much at once, but I found I was running +30% temp basals most days just to try and keep her in range, so checked with the DSN and she said “yes, if she needs that much extra just change it!”

 

[helli]

Yeah a 10% change is a good rule of thumb to see what happens but it’s not the only possible change.

My understanding of this guidance is to only make changes of 10% at a time.
If 10% reduction (or increase) is not enough, then make another 10% change until levels are where you want them.
I have no fear of making total changes of more than 10% but I would edge down by 30%, for example, rather than a sudden drop.

Since having my second jab, my basal needs have dropped 20% and stayed there for a couple of months despite an injury which has curtailed my usual exercise.

 

[Thebearcametoo]

That’s interesting, when my daughter was going through puberty her insulin needs went up by about 30%, and have never really come down again! I’d heard of the 10% rule so was reluctant to change the main basal pattern by that much at once, but I found I was running +30% temp basals most days just to try and keep her in range, so checked with the DSN and she said “yes, if she needs that much extra just change it!”

10% changes each time is a good ‘let’s try it and see’ but within a couple of days you can tell if it’s enough and do another 10% (or less) until you get good numbers. If you’ve already been running temporary basal then you’ve essentially proven the principle though so it’s likely safe to do that much in one go.

She definitely needed more insulin before puberty fully hit but seems really sensitive to it now so we’ve had to drop it loads. But then she’s also lost some weight so that may be as much a factor as puberty ‍♀️ A lot of it is just about adapting to the needs and sometimes we won’t ever fully understand why changes happen.

 

[spiritfree]

Thank you all for your help.

 

[trophywench]

We all said exactly the same thing - 10% and test, if not enough another 10% and test and do that as many times as you need to until you're happy with the tests!