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RE: [IPk] Unexpected lows



Allis asked <snip>Over the last few days I've noticed that my insulin
requirements have been getting less...After 30 years of diabetes I can't
work out why this is happening</snip>

Well, a number of things can be happening. 

Are you perhaps less stressed than usual? 

Are you doing more invisible exercise? For example, cleaning the house is
exercise (especially hoovering), but people don't think of it that way. Long
stretches of gentle gardening, perhaps?

I'm not sure if you're male or female. Could you be starting or finishing a
period or entering the menopause? 

If your total daily insulin dose has dropped since MDI, you'll be getting
more value for a bolus. So if your basal needs seem to be dropping after
lunch, it could actually be that you're getting more value for a meal bolus
and you actually need to take less insulin for the meal but keep the basal
the same. 

Finally, one of the benefits and hassles of pumping is we can discover
exactly how complex our diabetes actually is. For example, I was having
problems with morning BGs. They seemed completely unpredictable. Eventually,
after about a year of tracking results, I worked out that my overnight
insulin needs vary depending on how much insulin I've used the previous day.
So, if I use 35 units in a day, I currently need 17.4 as my total daily
dose. If I use 30 units, I need 17 units as my total daily dose. The
fluctuation of .4 happens when I sleep. And if, say, I exercise a lot in a
day but still use 35 units because I also eat a lot, I need to be really
careful around 4-6am, when I'm likely to drop. I haven't worked out a tweak
for this, so after a day like that I'll go down to the 17 units and set my
alarm for a test around 4am.

Does anyone have any other suggestions?

elizabeth
.
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