Extreme Basal Changes after 13 years

Coping & Support
#1

Hey guys! First post as I am desperate for help.

I (F,22) have had type one for the last 13 years with relatively no hiccups.

This October my basal insulin (Lantus, 28u) started causing insane lows. I would need about 100g of carbs to fix a low from 1-2 u of insulin. I’m talking like 60 with 2 down arrows.

Ok so i started dialing back the basal. I ended up at 12 u of lantus that would crash me during the day and leave me high overnight. After 3 weeks of the i went to the ER, did telehealth visits with my doc. The hospital basically said we are unqualified for this my doctor kept saying put the lantus back where it was.

I decided to change to tresiba 14u At first it was amazing!! Normal life again! But now about every 2 weeks i have to add an additional unit to the basal due to constant high glucose. like eating nothing and trending up. I am now at 15u and up trending again.

Is it possible my basal is slowly returning to normal? My doctor is useless and I am trying to find a new one.

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#2

I have been able to stabilize my sugars by injecting a .5 u every hour if that’s helpful

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#3

hi @ashlyn901, welcome to Type One Nation! in my 40+ years experience, there are periods of time when I make a little of my own insulin for a little while. I think it’s happened 4 times. sometimes it’s just a lot of lows. sometimes it’s crushing lows, for example I bolused for 60g carbs and almost died. I had to treat with 60 grams of carbs to get all the way up to normal. this went on and I literally didn’t neeed insulin for about 6 days… then it went back to normal.

the bottom line is s**t happens. you test more and you take enough insulin to keep your numbers as good as you can. if that means 2 days, or 2 weeks of half insulin, or 2x insulin or no insulin, then so be it.

also, in general. I need to adjust my basal every spring and every fall something about the weather gets me.

hope this helps! good luck

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#4

Oh man. The weather thing my be spot on! My whole life I lived in South Florida and recently moved to Colorado.

This is my first winter and maybe that’s what causing it!?

I also thought about producing my own insulin

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#5

@ashlyn901, don’t know for sure, but the weather affects me.

#6

@ashlyn901,

Ashlyn, throw altitude into the mix. If this does not resolve when summer comes, it may be altitude. I know 6 months is a long time. May be interesting to watch what happens when things warm up.

Hope this helps. Please share what you discover. It is how we learn.

#7

Hi @ashlyn901. First of all, congratulations on your move to CO. I’ve never been there but from pictures I’ve seen it seems like one of the most beautiful states. I’m a brainstorner so a few thoughts come to mind:

  1. Moving is one of the most stressful activities in life and that can affect our numbers. You can’t simply wish stress away but learning management tools might help as things come together and you adjust (consider that a global "you":blush: if you wish).
  2. You didn’t say anything about bolus insulin. Lantus and Tresiba are both long acting. Although you said you’ve been increasing your Tresiba slightly because you were trending up even without eating, I’m wondering if your meals are causing the rise (even if you’re not eating anything else) and you need to adjust your meal bolus - sorry, let me say “injection” since it sounds like you’re on shots. Basal (or background) insulin won’t help much with the carbs we take in so unless we take sufficient assuming we’re not making any insulin on our own we need some rapid-acting insulin to cover the carbs or highs. I have used a pump for 20+ years and only take injections occasionally; and the various basal insulins out there have their own patterns and quirks (apologies for the word but it’s the only one that comes to mind at the moment). I went many years on injections using only long-acting insulin (NPH if that one rings a bell) before I needed to add some short acting (Regular) with meals. For me that was up through the 1980s. So looking at what are now known as rapid acting might help if you’re not already using any.

You said you were unhappy with your doctor - is that one in CO or the one you had a tele visit with? If the tele visit doctor is good I would definitely continue to get their input - I am not a medical professional and can only suggest things you might consider. Working things out with your doctor is the best way to get started. On the forum you may read the term “be your own doctor” but it’s good to work with people who have knowledge about the ins and outs of the various options.
Just out of curiosity, how did you come to try Tresiba? Different formulations of insulin have different durations and peak times, and from what I’ve read some work best taken at a particular time of day. It may be it takes a few days for the body to adjust to a different one - that could account for why it worked well at first but not so much now. I’m not saying Tresiba is wrong fit you - or right - just asking out of curiosity.
I’m sure you are working on finding an endo in CO and I wish you the best. There is now an inhaled firm of Glucagon available - I think it just came out a few months ago, and should be much easier to administer than the injected version.