[Notey]

At the age of 40, I was diagnosed with Type 1 4 months ago. I was put on 10 units Levemir and Novolog - generally, I took anywhere from 2 units to up to 6 units depending on how much I ate. I had this thing down. I was controlling my levels like a well oiled machine.

I let myself go a bit during this period. I was an avid runner coming off peak training for the past couple of years and needed a break. I ended up gaining 20 pounds and my ankle was injured preventing me from getting back into it.

Now that my ankle is almost 100%, I'm running again and watching my weight again. I've lost 5 pounds so far. As soon as I increased my exercise and watched my diet, my need for the levemir went away. I was getting excrutiating headaches but my testing didn't show that I was going low. I finally figured out that I was going low between 2 hours after a meal and my next meal. Reducing the levemir immediately cured my headaches. But then they came back. So I dropped the levemir to 5 units. Gone again. Then I forgot to take my Levemir one night. My blood sugar didn't increase. So I stopped taking. Now the headaches are back and I'm not taking any. I've figured out I'm still going low between 2 hours after my meals and my next meal. I've also reduced the amount of Novolog I'm taking. I'm starting to wonder if I need to take anything at all as long as I keep up the exercise and watch the diet.

Should I stop taking the log? If I do, I'll be monitoring my levels even more than I am now - I'm going through test strips like crazy night now. How high can I let my blood sugar get before I need to step in and take some insulin?

[kel4han]

I too, was placed on Levemir, and initially started with 5 units. But, I was never put on Bolus!! Becuase I was dx'd at 28 and ASSUMED type 2. So, when I started Novolog, I couldnt even take .5 with a typical meal of 40carbs becuase I would DROP. So, it took alot of learning here, to know that my Basal Levemir was too high. Eventually, I learned that I dont even need the Levemir. I can go to bed at 100 and stay at 100 or lower a bit. I dont ever go up unless I eat. I now take just a bolus for meals which I need even though I am a runner/weight lifter too. I take about half the dose on work out days though. So, a typical 1:15 ratio is for off running days, and 1:30 ratio for work out days. I also dont need to bolus for things like fruit. Just for those other carbs like breads etc. And if I spend the day working in the yard, I can eat up to about 20carbs without needing to bolus. I have the insulin production there still, but it doesn't keep up with the heavy carbs. Pretty typical in our honeymoons I guess. I will usually correct anything over 180 with about .25 novolog and it works for me. Hard to draw up on the syringe though.

[Scarlett]

wow-this sounds like insulin is used where not necessary
I've been a T1 for 34 yrs. and have never known NOT taking a needle-I can't believe Dr.s are pushing insulin instead of diet-something has to have made your BS higher than normal at that time when you saw a Dr.

[lilituc]

10 units is a lot for a starting dose in someone still making insulin. It sounds like you have LADA and not plain Type 1. I went without a basal insulin for four months (although I don't recommend this) and then was on 4 units of Lantus. I would recommend trying to take basal insulin because the idea is to allow your beta cells to rest a little in order to preserve function as long as possible. You don't have to take 5 units - you could take 4 or 3 or 1 or even a half unit. Of course, be sure to work with a doctor on this.

Scarlett, insulin is the normal treatment for a Type 1, even if they have LADA and only need a tiny amount.

[Notey]

Only 24 hours later and I'm thinking I need to go back on some basal insulin. I had three days in a row of not being so strict about my diet and one off day from exercising and my levels shot up.

lilituc, that was one of my questions, would as little as 3 or 4 units of basal insulin even make a difference. My edcuator and doctor are leaving the decisions up to me about how much to take...obviously I am in close contact with them and seeking their advice before doing anything.

[Dervish]

Originally Posted by Notey

lilituc, that was one of my questions, would as little as 3 or 4 units of basal insulin even make a difference. My edcuator and doctor are leaving the decisions up to me about how much to take...obviously I am in close contact with them and seeking their advice before doing anything.

According to Using Insulin, typical starting insulin doses for a 160lb type 2 diabetic are around a total daily dose of 7-18 units. The book also recommends (frequently...) that basal should make up about half of your daily total, so, at the low end, that would work out to 3-4 units/day.

Anecdotally, I'm a new diabetic in the process of trying to nail my basal rates down and recently tried increasing my daily basal dose from 50 to 52 units to see if that would help with some of my problems. In the few days I was using that dosage, I experienced more hypos than in the three weeks prior to the change.

So, yes, 3-4 units/day of basal can make a difference.

[NoraWI]

The duration of Levemir is dose dependent. That means the smaller the dose of Levemir you take, the shorter time it lasts in your body. That is totally unlike Lantus that may last 24 hours no matter the dose. My 6 to 8 daily units of Levemir were simply not working long enough. I would have had to inject 3 to 4 times a day to have effective basal coverage with Levemir. I ended up switching back to Lantus.

[dbc]

Originally Posted by Notey

Only 24 hours later and I'm thinking I need to go back on some basal insulin. I had three days in a row of not being so strict about my diet and one off day from exercising and my levels shot up.

lilituc, that was one of my questions, would as little as 3 or 4 units of basal insulin even make a difference. My edcuator and doctor are leaving the decisions up to me about how much to take...obviously I am in close contact with them and seeking their advice before doing anything.

How intensely do you exercise? I recently started on lantus, worked up to 6U/day, no bolus as yet, but I have been on 3x500mg metformin for over a year. I've been T1/1.5 for 3 years, initially diet & exercise only. My exercise is pretty low key - a 3 to 5 km jog no more than 4 times a week. Haven't yet noticed any significant change in glucose levels correlated with exercise.

So far (only 6 weeks on insulin), I can say emphatically yes, as little as 4U basal insulin does make a difference! my fasting levels have come down from around 6.5 - 8mmols to 4.2 - 5.8. At 6U/day I have had to change my eating plan slightly to avoid mild hypos occasionally (around 3 -3.5, once down at 2.6)

[trailrunner]

Notey, I am the same way! IF i run 50+ miles weekly, MY basal rate on my pump of .20 units an hour is too much. I don't even bolus for regular meals( not including ice cream, or booze). I sometimes think maybe they were wrong. Maybe I really don't have diabetes, But then I don't run for a day or two, and I am right back in 200s after a meal.

[owlyn]

I think you need to adjust your basal down and your bolus up (if need be).

[Notey]

Originally Posted by trailrunner

Notey, I am the same way! IF i run 50+ miles weekly, MY basal rate on my pump of .20 units an hour is too much. I don't even bolus for regular meals( not including ice cream, or booze). I sometimes think maybe they were wrong. Maybe I really don't have diabetes, But then I don't run for a day or two, and I am right back in 200s after a meal.

The same thing is happening to me. Right now I'm using 4-5 units of basal and that seems to be working for me now. I won't take any the night before a run of 10 miles or over. So far I'm experiencing fewer lows and less highs, although my levels overall after eating are still a bit higher than they were, I think they are acceptable.

One thing that I've noticed is that if I run in the morning before eating, I don't need to consume any glucose before running anymore. Not so in the afternoon because I probably have fast activing insulin still in my system.

[Funnygrl]

I went 2 months without basal insulin, then i started 8 units of Lantus. I moved to 10 of Lantus, then started my pump. My initial basal on my pump was 11 units, but moved up rapidly. I used 19.4 units of basal now.