Learned again -- highs need less, not more, basal

[Lisa P.]

For a very long time we had toggled back and forth from one day to another 3 and 3 1/2 units of Lantus (since Lantus persists in the system for up to three days, we found the back and forth got us just the right amount). Then she started running a bit high at times and we wound up increasing to 4. Was good for awhile, then highs began, so increased to 4 1/2.

Long story short, after seeing a new pattern of lots of highs and lots of lows and lots of vertical-ish movement on the CGM, I harkened back to previous experiences and took her basal back down to where it had been. Sure enough, tons of even numbers.

I think when the basal is too high, you do get lows that sometimes get overtreated. But I also have truly come to believe that there is some kind of feedback mechanism in some of our kids that if they get too much basal insulin it creates some insulin resistance. I've seen this too many times to think I'm off.

So, just a note, if you see highs and they seem to just get worse as you raise the dosages over time, give a shot at actually lowering them for a day or two. Weirdly, sometimes it works.

(Also, I'll repeat that Selah's 3 1/4 units of basal for a TDD of 13 to 15 is way off the half and half basal / bolus folks will be told to use, and it really does work for us.)

[kiwikid]

I'm wondering if this is where we are. Endo (actually physically) adjusted Rachel's pumps settings up yesterday (maybe he thought I wouldn't do it) and we had a more resistant night than ever! Rachel is using around 42 units of insulin daily and her weight is 38 kg's... does that sound about right?

I think he was surprised on the the Diasend website that we were actually bolusing for all food. With the HbA1c we got I think he expected to see 1 or 2 boluses per day NOT 8 ... and all the testing we do

*crappy crappy crappy*

[Lisa P.]

Originally Posted by kiwikid

I'm wondering if this is where we are. Endo (actually physically) adjusted Rachel's pumps settings up yesterday (maybe he thought I wouldn't do it) and we had a more resistant night than ever! Rachel is using around 42 units of insulin daily and her weight is 38 kg's... does that sound about right?

I think he was surprised on the the Diasend website that we were actually bolusing for all food. With the HbA1c we got I think he expected to see 1 or 2 boluses per day NOT 8 ... and all the testing we do

*crappy crappy crappy*

Aww, I'm sorry! What a pain. Are you not seeing that adolescent thing so many here report around pre-teen time?

Wish I could advise on the weight, I know there are charts for that but it seems to me charts don't apply more often than they do apply!

I've had the endo do my changes "for me", too! It's kind of funny, in'it?

I don't know, we have seen this happen several times. In fact, once I argued with Darryl on here (not argued, but ya know) because he kept saying, "sounds like your basal is too high" over and over and I kept saying, "No, it can't be that, we've got a tiny basal already" and, sure enough, he was right. It's frustrating because I think our original raise of basal rate was right -- I think she ran across a bug and needed a higher basal for a day or two. But then when she started going up again, I think I needed to lower it instead of raise it.

We might, of course, just be outliers, or maybe I'm off on reading stuff. But much prettier numbers the last few days, and not much else changed.