Background Insulin

auroralapetite · Apr 27, 2017

Hi there,

I was diagnosed a month ago with Type 1 diabetes and I just have a question regarding Levemir. I train in the gym (lifting weights) 5 times a week, and cycle and walk everywhere. I carb count and match my insulin with ratios (ranging from 1:50 for breakfast, 1:30 for lunch and pre-training meal, and 1:20 for dinner), and take 3 units of Levemir at 9pm.

I am finding that before my lunch at 12:30pm and pre-training meal at 4.30pm, that my blood sugars are starting to go low. When I check 2 - 2.5 hours after breakfast (where I was between 6 and 7mmol/l), I'm at 6.7mmol/l but after another 1.5 hours, my blood sugars are continuing to drop to 4.5 and below, and somedays I go hypo just before lunchtime.

Is this coming from my breakfast ratio being incorrect or is it coming from too much background insulin?

maria030660 · Apr 27, 2017

hi as you were only diagnosed a month ago you might still be in what we call the 'honeymoon' period were still some insulin is made in your body but will die down, here is a link with information

http://www.diabetes.co.uk/blood-glucose/honeymoon-phase.html

auroralapetite · Apr 27, 2017

maria030660 said:
hi as you were only diagnosed a month ago you might still be in what we call the 'honeymoon' period were still some insulin is made in your body but will die down, here is a link with information

My endo is unsure of whether I am actually in a genuine honeymoon or if I'm quite insulin sensitive due to the amount of training/ sport that I do. I train 10 hours a week for my sport and then another 3 hours a week commuting by bicycle. I guess what I am wondering is how best to deal with the decline in blood glucose levels from 2 hours post meal to my next meals - whether a reduction in basal is warranted or if my ratios need to be adjusted.

tim2000s · Apr 28, 2017

auroralapetite said:
My endo is unsure of whether I am actually in a genuine honeymoon or if I'm quite insulin sensitive due to the amount of training/ sport that I do. I train 10 hours a week for my sport and then another 3 hours a week commuting by bicycle. I guess what I am wondering is how best to deal with the decline in blood glucose levels from 2 hours post meal to my next meals - whether a reduction in basal is warranted or if my ratios need to be adjusted.

Hi there Aurora, I suspect that you are still in the honeymoon period, as even when I trained stupid amounts, both weight training and aerobically, my insulin sensitivity was nowhere near as sensitive as that as someone who has been T1 for 28 years.

The only way that you're going to know what is causing it is to undertake some testing. Basal testing is done as this link describes: https://mysugr.com/basal-rate-testing/

If that shows everything is alright, then you can look at the IC ratios.

TorqPenderloin · Apr 28, 2017

When you say that you sometimes go "Hypo" exactly how low are we talking?

I ask because while I agree that a reading of 4.5mmol/l is "low" I disagree that it's necessarily a problem (in fact it's just about perfect).

Like you, I was diagnosed later in life. Why is that relevant? People who are diagnosed younger in life seem to also have inhibited glucagon responses while people who are diagnosed later in life are more likely to have that bodily function preserved (note: that is an observation and not based on facts or statistics).

In layman's terms, what that means it that I have to worry about going high just like any other type 1 diabetic, but I seem to be at slightly less of a risk of going low as my liver is ready to dump the equivalent of 125g of glucose into my blood at the sign of hypoglycemia.

Also like you, I am very active and run about 25-30 miles a week in addition to lifting weights and living an active lifestyle. I also eat relatively low-carb.

What that equates to: My fasting levels on most days stays between 3.8mmol/l-6mmol/l. That's the healthy range that my body functions with minimal risk of hypos and without other factors to consider (namely carbs and insulin). If I hit 3.7 I chalk it up to meter error or I may do a small correction depending on how I feel. At 3.6 I start to feel the symptoms of a hypo 90% of the time and at 3.5 I feel it probably 99% of the time. I'm fortunate that it's that precise.

My point (tl;dr): you may be dealing with too much insulin, a combination of insulin/exercise/honeymoon, or you may just have naturally low (but otherwise healthy) blood glucose levels like many athletes sometimes do.

auroralapetite · Apr 28, 2017

tim2000s said:
Hi there Aurora, I suspect that you are still in the honeymoon period, as even when I trained stupid amounts, both weight training and aerobically, my insulin sensitivity was nowhere near as sensitive as that as someone who has been T1 for 28 years.

The only way that you're going to know what is causing it is to undertake some testing. Basal testing is done as this link describes:

If that shows everything is alright, then you can look at the IC ratios.

Thanks, I think I am going to do some basal testing over the next few weeks on rest days. The diabetes nurse called me this afternoon after I emailed her and suggested dropping to 2 units of Levemir each evening.

auroralapetite · Apr 28, 2017

TorqPenderloin said:
When you say that you sometimes go "Hypo" exactly how low are we talking?

I ask because while I agree that a reading of 4.5mmol/l is "low" I disagree that it's necessarily a problem (in fact it's just about perfect).

Like you, I was diagnosed later in life. Why is that relevant? People who are diagnosed younger in life seem to also have inhibited glucagon responses while people who are diagnosed later in life are more likely to have that bodily function preserved (note: that is an observation and not based on facts or statistics).

In layman's terms, what that means it that I have to worry about going high just like any other type 1 diabetic, but I seem to be at slightly less of a risk of going low as my liver is ready to dump the equivalent of 125g of glucose into my blood at the sign of hypoglycemia.

Also like you, I am very active and run about 25-30 miles a week in addition to lifting weights and living an active lifestyle. I also eat relatively low-carb.

What that equates to: My fasting levels on most days stays between 3.8mmol/l-6mmol/l. That's the healthy range that my body functions with minimal risk of hypos and without other factors to consider (namely carbs and insulin). If I hit 3.7 I chalk it up to meter error or I may do a small correction depending on how I feel. At 3.6 I start to feel the symptoms of a hypo 90% of the time and at 3.5 I feel it probably 99% of the time. I'm fortunate that it's that precise.

My point (tl;dr): you may be dealing with too much insulin, a combination of insulin/exercise/honeymoon, or you may just have naturally low (but otherwise healthy) blood glucose levels like many athletes sometimes do.

Thanks Torq for your advice - when I say hypo - below 4.0. Why it's a worry for me is that if my lunch ends up being delayed due to meetings or work calls and I can't eat it at 12:30pm, I end up having a hypo within the next 30 minutes and from my reading of how Novorapid works, it shouldn't be causing hypos 4-5 hours after being injected.

I work on my own for 50% of the week, so I am a little nervous about having hypos in the office just in case I don't catch it on time.

Background Insulin

auroralapetite

Active Member

maria030660

Well-Known Member

auroralapetite

Active Member

tim2000s

Expert

TorqPenderloin

Well-Known Member

auroralapetite

Active Member

auroralapetite

Active Member

Background Insulin

auroralapetite

Active Member

maria030660

Well-Known Member

auroralapetite

Active Member

tim2000s

Expert

TorqPenderloin

Well-Known Member

auroralapetite

Active Member

auroralapetite

Active Member

Privacy & Transparency

Privacy & Transparency