Sudden increase in insulin needs?

[victry77]

Hiya I've been T1 nearly 6yrs and I must admit to relatively easy control. Always tended more towards hypos than highs (I know hypos aren't good but usually needed to manage them more than highs). This past couple of weeks, though, I've had what I personally would consider for me, a bit of a dramatic increase in insulin needs.

Since I started carb-counting (not far off 2yrs ago) my basal rate has been 6 units and my bolus ratio has been 1:8. These more or less stayed the same with nowand again needing to adjust based on circumstance. Couple of months ago, I increased my breakfast dose from 3.5 units of Novorapid to 4 (I have the same breakfast each morning but noticed I started to need an increase). This past couple of weeks I've needed to increase to 4.5 units, which I think now works out to a 1:6 ratio.

In the past month, I've needed to go from my regular 6 units of Levemir to 7 units and this week I have now needed to increase it to 8. I suspected I might have been experiencing the DP as my waking levels have suddenly been in the range of 10-13, although I haven't actually run any tests to determine this yet. However, a couple of months back I would not have dreamed of taking 8 units of basal as I would have been in hypo land all day, but now my levels are, at their best, 6-7s.

My ratio has also changed from 1:8 to 1:7. I think I may possibly need to use 1:6 for lunch as 4hrs later and I'm in double figures.I know the predicable thing about diabetes is its unpredictability, but just wondered if these sound like reasonable changes in my needs, because it has seemed very sudden.

One more thing, as a female, I have been lucky to never have any changes in levels during my time of the month. But over about the past 4 months I noticed my insulin requirements did need an increase. I started to up my basal from 6 to 7 and add 0.5-1 unit onto my bolus. Then decrease back to normal once it was over. However, during my last period at the start of Dec, I had worse than usual PMS (usually only get it very mild) but I felt really rotten and down in the mouth for a good couple of weeks which lasted the duration of my period (PMS symptoms will usually vanish as soon as your period starts, but these didn't). M insulin needs increased again, but it seems it has been since then that they just haven't settled back down.

Don't know if it's connected, but seems a bit strange.

 

[noblehead]

Just adjust as necessary Victry, those insulin doses look perfectly acceptable and I wouldn't worry too much about the small increases you have made, insulin ratio's and basal doses are not set in stone and often they can change throughout the year; sorry being a male I can't help with the time of month query.

 

[Daibell]

As your number of Levemir units is still quite low, I wouldn't worry. Many posters inject far more units than you. Obviously they may be heavier and have some insulin resistance. I'm 62Kg and inject 9 units which I thought was quite low. It may be that when you started the insulin you still had reasonable pancreatic function but it has decreased since then? I'm only guessing of course.

 

[victry77]

Thank you, folks.

noblehead ~ Yes, I agree. These are acceptable doses. It was just the sudden increase in a matter of week is something new for me and wasn't sure if it was too much of a rise in a short period of time. Things have settled a bit, although, I'm still seing higher than usual levels at certain times. But for now I'm just recording numbers and seeing how I go.

Daibell ~ Again, I agree my Levemir do is pretty low. It was just the sudden need to increase it by 2 units within a week which took me by surprise. I'm 53kg and have taken 6 units for nar far off 2yrs, so up to 8 now. I think you make a good point, though, Even though been diabetic for almost 6yrs, I have always felt that I've had reasonable decent pancreatic function as can't say I've had the kind of trouble many people have with high numbers. You might be right, and it is now started to wane.

Ah, well, better late than never

 

[abs]

Stress can cause higher levels and illness also.

 

[SamJB]

Some people on here report seasonal changes in insulin requirements. In the summer it's warmer, heat can bring on hypos so some people report that they need less insulin in the summer and more in the winter.

Also, my insulin requirements change a lot, but this is mostly down to how much exercise I've done recently. Have you had any change in activity recently?

Finally, I know I've been eating more at this time of year, which we all know means more insulin!

 

[victry77]

Thanks. TBH, there has really been nothing different going on to suddenly demand an increase. Even when I'll with colds, etc, I never seem to get high sugars. Had a really bad cold in November, but levels stayed fine. I did start experiencing mild PMS symptoms on the 28th Dec, so that might be a contibuting factor.

 

[donnellysdogs]

If you eat more at Xmas your ratio of bolus to basal May go out of sync.... If you having to change one, then sometimes you may need to change the other. Personally I wouldn't worry too much about having to do changes- but do make a note of them, I case you need to change back....