Dropping Low?

I moved up to Portland, OR to attend Portland State University. There is a TON of walking and different eating times for me. I’m on the pump and have adjusted my basal rates to half a unit lower at all my times. However, I still drop low about three times a day. I actually don’t even bolus half the time. I know I should lower my basal… but then I’m worried I’ll go high and won’t be able to go back down. Any advice?

Hi @katiepurry,

From my experience I’d say you are doing the right thing - at least headed in the right direction. A couple of questions first:

  1. are your three lows a day usually at the same tine each day?
  2. have you also considered adjusting carb ratios?
  3. do you do after meal blood tests to make sure you are not staying too high?

You have been on insulin for 10 years and your body may become less sensitive to it - mine has, and instead of beginning its action 5 to 10 minutes after bolus and leaving your body within a couple of hours, it may be hanging around and “stacking”. For my 4 mile midmorning walk I’ll set a temporary basal at 25% an hour before I plan to set out and have the temp run for at least 3.5 hours. When I return from walking I’ll usually have a BG around 100 have lunch with a bolus and often go low mid afternoon - I’ve fixed that by creating a “summer-time” pattern that has my 1 PM to 4:30 PM basal very low - strange because my lows are 4 hours after my exercise. Experiment some and see what happens - I know it is difficult to find time in your new schedule.

And not knowing your class schedule, I presume that you may need to set different pimp patterns; that is, one pattern for Monday, Wednesday, Friday - and another for Tuesday and Thursday.

I hear your concern about going too high when you skip meal bolus and not being able to get back down. Certainly you can get back down by taking a correction bolus, BUT BE VERY CAREFUL that you don’t drive yourself too low. Have you checked your insulin sensitivity lately - how much 1 unit will, under normal circumstances, drop your blood sugar?

Good luck to you in adjusting and especially with your new university life.

hi @katiepurry, sorry about posting in here - it’s been a long time since I was in college! yea it’s always tricky suggesting you change a setting - you should be very comfortable changing your settings before you do so.

that said, I think your basal rate and maybe your meal ratios are cranked too high for your current level of activity. When I am very active my insulin requirements drop to half or less than half my regular. 50 units a day become less than 25 and I have gone all day on 10 units (meals plus basal) when I am going like crazy.

if you back off the insulin and you find yourself high, a correction will bring you back down. the other thing is to add carbs but the extra calories could put weight on you. “Pumping Insulin” has great tips and explanations for pump tuning when your days are not always the same. Good news is you already pump so IMO this is really just that - better tuning.

best of luck in school and I hope you do well.