As diabetics, we can see every change that our body goes through reflect on our blood sugars. So many things impact our glucose, some of which are often invisible to the eye. Too often we get caught up in the why of changes in our insulin needs. We might get stuck overthinking why things are happening, rather than simply making changes to accommodate our new needs.
The truth is that T1Ds have too many factors to account for when considering what can impact their insulin requirements. There is stress, the diet, the weather, hormonal changes, female cycles, activity levels, weight changes and so much more. Not always will it be possible for us to correctly prevent and predict our insulin needs. Sometimes needs change due to invisible factors, and the best we can do is give the new doses we need now, not the doses we used to need.
The best way to identify if things are going wrong is to look at patterns. If you are correcting all the time with short-acting insulin, then your basal is no longer sufficient. If you are seeing spikes after meals, either your pre-bolus times need to increase or your carb to insulin ratio has become too low. A CGM is the best tool to help identify trends quickly, adjust to them and do corrections to prevent the highs or lows from happening.
The key here is not to blame your body for changing. We all go through different periods of life – sometimes more stressful, sometimes it’s growth, other times it’s hormones. It is natural for the body to go through different insulin needs. We can’t blame our body for needing more or less insulin, if that is what it needs.
Stop overthinking the ‘why’ and overwhelming yourself with investigations on why your insulin needs have changed. If you need more insulin, just do more insulin. In the moment, it really does not matter why. It is useful to figure out patterns, but if your BG is already high or rising, that should not be the priority. Do yourself a favour and stop stressing about the things you don't have the power to change.
Of course, this comes with a pinch of salt. If you know that your BGs are harder to control due to less movement – move more, if it’s due to stress – try meditation or journaling, if it is the pre-bolus timings – work on figuring them out. Work with what you can control and make the changes that you need to your insulin doses. Don't wait for your next doctor’s appointment for someone else to do it for you.
No information in this article is intended as medical advice. Please, consult your diabetes team before making any changes to your diabetes care.