Insulin intake decreasing...

[maya0606]

Hi everyone!

I have been going on a low carbohydrate diet and working out everyday, I have lost 4 lbs already!! Which i am very happy about it! BUT I wanted to ask you guys something.

I have been taking Lantus 16 units every night before bed, since i started working out more than usual, my Lantus went down from 16 units to 9 units in one week, and this morning I woke up again with BG level 4.3 !! Does this mean I have to reduce more of my Lantus? I just think that in a week I have decreased my insulin to much! Also my Homologue intake changed, for example, when i have those Tuna sandwich that are already packed I always put 3 to 4 units of Homologue, but yesterday I had that and about 3z of broccoli raw and i only put 2 units of insulin!!! I was shocked! after, I checked my BG and it was 6.1!! I couldn't believe it!!

I just seem to be more sensitive to insulin since I started working out A LOT!!

Honestly I can't complain!!! if anything I am very happy!!! hehe!

But I just wanted to see if anyone had that experience or see people's opinion about my experience. If I can get any more tips from you guys, that would be greatly appreciate it

[BlueSky]

... I just seem to be more sensitive to insulin since I started working out A LOT!! ...
That is what usually happens. Well done :) . Being more sensitive to insulin makes controlling blood sugar easier. But it can take some getting used to. Decrease the Lantus slowly until you are going high, either in the morning or later in the day. You may need to have a snack before bed to stop you going low during the night.

[maya0606]

Thanks Bluesky! right now I am not having any lows at night I have low when I wake up in the morning, for example last night i went down from 11 units to 9 units, and I woke up with a 4.3 this morning. now is 4.3 to low for a diabetic?

[conguitos]

maya, that's great, the low for a diabetic, is the low for a normal person, but that varies as well, we're different, but 4.3 is excellent. Keep the good work! If you're able to go through the night without hypos and waking up with 4 to 5.5, then you're controlling your night time very well. IMHO

:)

[maya0606]

Conguitos Thank you very much, and yes I am having 4 to 6.1 in the morning I do not get lows in the middle of the night and I also noticed I sleep so much better too now :D I love it hehe

[Subby]

Hi Maya, this all sounds very encouraging, well done.

As for the morning levels and whether you should modify your basal, it depends to a big degree what BG level you are going to bed with.

Basal therapy always has one primary function to strive for: and that is to keep BG's consistently level as much as possible. This may seem like a fine distinction to make between "just arriving at good levels"... but it's not. Problems occur if your basal insulin is compensating for other issues, you fix those issues, and then you may have major problems with the basals causing lows and highs.

So, if you are going to bed (a couple hours away from a meal) with levels around 5, and waking up with levels around 5, perfect. If you are going to bed higher, say, at 9, and waking up at 4, then you know the basal is compensating for other issues, and it's better to iron the source of the problem out.

As for is around 4 too low, well, 4 certainly could be on the low side, and the way I would approach it is, how natural does it feel for you? Do you wake feeling shaky, a bit strange in the head? Extra hungry? If not, it may not be enough to be a hypo for you - but it's still not leaving much of an error margin.

If it was me I'd probably reduce my dose a little until I didn't get 4.5 under. that's both an official "low point" and the point I personally start feelling affected. Listening really closely to your body and mind is the key with working out what your natural thresholds are. Good luck.

[maya0606]

Well see today! I woke up with 11.1 when it was 6.2 before bed, but could it be because I had a pizza for dinner? and pizza is very slow motion carb? i went swimming for 30 min after that pizza! it felt so weird seeing my sugar that high, I was so use to one digit number lol

[Subby]

Well see today! I woke up with 11.1 when it was 6.2 before bed, but could it be because I had a pizza for dinner? and pizza is very slow motion carb? i went swimming for 30 min after that pizza! it felt so weird seeing my sugar that high, I was so use to one digit number lol

Sounds a likely reason. Pizza can indeed give a slow energy release for hours afterwards, completely at odds with the way an insulin bolus may normally work. While exercise may typically have a downward effect, it may not make up for the fact that you had energy hitting your system without enough internal insulin at the time - in fact it may have sped up the action of the insulin, leading to less in system when the pizza kept releasing energy hours later, exacerbating the problem. Lots of variables here, yep?

Getting more strict with your carb intake (both amount and GI or length of energy release for you) while you get a better handle on things, will likely give you a baseline of expectation instead of seeing a more inexplicable or random picture. Unfortunately your reaction to different foods can only really be worked out by trial and error (informed by good information, of course). Now you suspect pizza as being a problem for a normal bolus: write this suspicion down and put it to the side to test again some other time.

[conguitos]

Well see today! I woke up with 11.1 when it was 6.2 before bed, but could it be because I had a pizza for dinner? and pizza is very slow motion carb? i went swimming for 30 min after that pizza! it felt so weird seeing my sugar that high, I was so use to one digit number lol

I fear not, pizza is given a 80 GI (glucose has 100), although the things that are on it will also have an effect. And the carb load is also quite brutal on some > 200gr. Those numbers are medians, it may vary from product to product.

I would suggest you, not to eat pizza for dinner anymore, since you wont be able to correct while sleeping ;) For that instance I would try not to eat any carbs before going to bed, you can see what effects it has on you, it may help.

Keep the good work up! :) You're on the right path.

[Subby]

I fear not, pizza is given a 80 GI (glucose has 100), although the things that are on it will also have an effect. And the carb load is also quite brutal on some > 200gr. Those numbers are medians, it may vary from product to product.


Conguitos, this is somewhat irrelevant, the GI nor GL does not reveal independent time based profiles of foods, nor does it necessarily specifically correlate to an injected insulin situation.

Common experience, on the other hand, reveals time and time again that an insulin dependent diabetic will often come up against a difficulty with the timing of the release of energy from food such as pizza, due to the particular mix of high carb and high fat content. It is often a "problem food" but unlike you who suggests giving up on solutions here, there are various "methods to manage" than may well be worth trying, if so desired.

[conguitos]

Conguitos, this is somewhat irrelevant, the GI nor GL does not reveal independent time based profiles of foods, nor does it necessarily specifically correlate to an injected insulin situation.

Common experience, on the other hand, reveals time and time again that an insulin dependent diabetic will often come up against a difficulty with the timing of the release of energy from food such as pizza, due to the particular mix of high carb and high fat content. It is often a "problem food" but unlike you who suggests giving up on solutions here, there are various "methods to manage" than may well be worth trying, if so desired.

Hi Subby, that's what I would do, trying not to eat the food that apparently would cause the high morning numbers, to see if it was really the problem or there was something else involved. Perhaps the real culprit was what she was drinking with the pizza. Since she gave no information about it...

[maya0606]

I think it is teh pizza because fo teh past two weeks i havent had anything heay liek pizza and my sugars were PERFECT, but than when I had the pizza slice last night my sugars was 6.2 before bed but went up to 11.3 this morning at 9 am

[Subby]

Yep, watch out for this delayed release effect with a lot of junk foods - such as hamburgers and hot chips and some take away chinese food - which is another good reason to avoid them apart from all the other reasons :)

On the other hand, if you do want to eat them now and then, as it is your choice, there are things you can try to improve things at those times - such as splitting your bolus through the period around the meal, to allow for the longer time period of energy release. A pump can give techniques that can almost eliminate these issues too.

[maya0606]

Hi Subby!

So you're saying the best time to eat it is during teh day instead of having it at night? so that i could burn it while moving around and have more time to check my suger before my next meal?

[Subby]

Nah, approaching eating the likes of pizza from an exercise point of view is probably too tricky at this point (or maybe any point!). if you can, what I wrote above is what I would recommend:

Getting more strict with your carb intake (both amount and GI or length of energy release for you) while you get a better handle on things, will likely give you a baseline of expectation instead of seeing a more inexplicable or random picture. Unfortunately your reaction to different foods can only really be worked out by trial and error (informed by good information, of course). Now you suspect pizza as being a problem for a normal bolus: write this suspicion down and put it to the side to test again some other time.

But, if you want to eat pizza at the moment, after all that, and it's obviously your choice, (but likely to increase your insulin intake...) there are the specific techniques you can try, but which may take some experimentation to get the best result.


if you do want to eat them now and then, as it is your choice, there are things you can try to improve things at those times - such as splitting your bolus through the period around the meal, to allow for the longer time period of energy release. A pump can give techniques that can almost eliminate these issues too.

Bit strange to quote myself, but it seemed the easiest way to answer your question :)