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[IPk] Re: sudden changes in insulin requirements

> Have others experienced sudden, substantial, long-term changes in
> basal and 
> bolus insulin requirements for no apparent reason?  

In brief, yes,  yes - how nice to read someone else writing this!

In my case it is sometimes adrenalin related, as Pat (I think) wrote,
and I definitely can have lots of adrenalin or other hormones - enough
to have major effects on my insulin requirements - when I suddenly get
involved in a new project at work, or plans for a vacation, or people
visiting, or you name it!!! On one occasion it was related to
medication, but in general I do not take any medications whatsoever at
present thankfully, so there is no connection.

And sometimes there is no obvious relation to anything that I can find
- just suddenly find that I need increase or decrease in insulin either
throughout the 24 hours or for part of it (with possible different
changes at other parts of the day). Changes of 20-30%, or more - it
sounds as if the changes you experience are probably often greater.
And sometimes the changes persist and become longterm, and sometimes
they return after some days or a couple of weeks to the previous state.

At some stage I discussed this with my endocrinologist, and he was not
that suprised - had seen this happen to other people before, though he
thought my situation was perhaps more variable than most. He suggested
that the best way to deal with it was simply to notice carefully what
was going on, take advantage of the flexibility of the pump, to set
temporary basal rates first, and then as soon as it is apparent that a
change is not just a one-day phenomenon, or due to illness or something
obvious, to change basal rates. But as you say, of course these things
always happen at the worst time, when you most want diabetes to take
care of itself, and least want to give it time and attention.

(at this moment feeling not very well and rather stupid because it was
only 2 hours after breakfast when I started feeling terrible that I
checked on my pump and found that I must have dreamt taking my
breakfast bolus and not done it, and instead of concentrating hard on
work to be completed urgently for a deadline, am working on getting my
blood glucose back to something half way reasonable)

This happened to
> me 
> pre-pump, but I thought it was related to factors such as site
> absorption.  
> My requirements used to "reset" once a year or so and caused a lot of
> hassle! 
>  I've just had the same experience with the pump. It's true that I've
> been 
> under some stress at work, but that's been a regular feature of my
> working 
> life for 20 years.  Otherwise, nothing has changed.  Suddenly my
> basals have 
> totally altered (right in the middle of an important time, as chance
> would 
> have it), I need far less at night (lots of hypos, but at least not
> at work) 
> and a bit more during the morning (I can still think with a bg of
> 20+, but 
> not the best time for decision making...).  (Fortunately a colleague
> with 
> whom I work closely is always dashing to the loo in the middle of
> meetings - 
> not diabetic! - I paid visits at the same time, so no disruption
> caused :-) ).
> I'd appreciate thoughts/advice.

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