Sarah Howard
Sarah Howard has worked in the diabetes research field ever since she was diagnosed with T1D while in college in May 2013. Since then, she has worked for various diabetes organizations, focusing on research, advocacy, and community-building efforts for people with T1D and their loved ones. Sarah is currently the Senior Marketing Manager at T1D Exchange.
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With your current T1D management tools, do you notice that your blood glucose levels are impacted if you do not eat on a certain schedule every day? Cancel reply
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I chose other as I do not need to eat at scheduled times, but I cannot go for extended times without eating, say more than five hours unless I want hypoglycemia. The longer I have T1D, I am becoming more and more sensitive to insulin. I need to change my basals, ratios and sensitivites often.
I never eat on a prescribed schedule. My BS may certainly be affected by that as it does make things more difficult to manage probably. But I do have my own general rhythm and foods that I eat that keep me on track. I have a pretty good TIR and A1c. I would like less ups and downs within that range.
No. A 24-houe fast I would recommend for the tSlim control IQ in order to see how good / accurate the basal rate is. I can literally and actually eat any time of the day or night. Control IQ seems to sense small amounts of carb intake. Big amounts, of course, must be bolused for. ⚡ 🤳
My basals are dialed in perfectly and control IQ on my tslim seems to correct any extra I might have. Can eat or not if I want to without a problem.
No. With Control IQ I generally eat three time a day when I my body signals I am hungry and it needs replenishment. While engaged in work, household, or creative projects I often do not need to eat for several hours until I do feel hungry. When I do eat, I chose healthy food sources that provide balanced nutrition for energy and well-being.
And some days I do not eat at all – just drink water – and I do fine with that.
I think a lot of this scheduled eating depends on if you’re on a pump or doing MDI. I do MDI which requires a more scheduled lifestyle.
Insulin’s have gotten much better overtime and I am not as tightly bound to a clock as I once was. However, eating is more than just an action controlled by T1D. It’s also patterns and habits. If one usually eats lunch at noon, one can deviate, but doing so significantly or continually, is difficult with or without T1D.
I use the Tandem control IQ which does a good job of keeping your TIR and A1c okay.
But if you are looking for tighter control you still need to prebolus watch carbs …….
I definitely notice on weekend if I eat breakfast later my BG is higher, which is odd because when I went on the pump, one of the things they sell you on us you no longer have to eat on a prescribed time period. I haven’t noticed lunch because I am pretty consistent there. The longer I wait to eat dinner, the more risk of a hypo. That makes sense because I don’t often think to adjust the basal rate. I don’t have a CGM but have tried them twice and both times couldn’t get them calibrated, but there have been improvements so time to try again.
If I dont eat breakfast and bolus at my usual time in the morning, my bg starts to rise quickly. It has always done this, despite efforts to fine-tune my basal rate for that time.
I have never followed any set meal schedule and instead always let my blood glucose levels determine when or if I eat so I had to say “OTHER” since I have never had any set meal schedule.
Only if I eat a large meal very late in the evening.
The question is basically about basal insulin management, which has undergone a sea change during the 38 yrs I’ve had T1. The single most fundamental and life-altering change I’ve experienced in that time was the introduction of a true (or close enough) basal insulin, Lantus, and the advent of basal-bolus MDI using Lantus and Novolog. Previously we’d used the R/NPH regimen, which was maybe a step in the right direction from the old one-shot-per-day Lente, but NPH was not a basal insulin as such and doing MDI that way was, well, kind of nuts. A dx of T1 was a sentence to being shackled to a medication and the routine IT imposed on you. You could find yourself in danger if for some reason you couldn’t eat at the right time, and it’s hard to communicate what that was like, 24/7, if you didn’t live through it. I called it the Eat Now Or DIE regimen. Those of us who use a CGM to do pre-bolusing can think of R/NPH as the blind-folded Russian roulette version of pre-bolusing. You knew when the effect was SUPPOSED to come on, and you hoped like heck it more or less did what it was supposed to and you were sitting down with your plateful in front of you when it did. The first real flat-effect (close enough anyway) basal insulin was like being let out of prison after 20 years of that. I could eat a late lunch and not die! WOW! Pumps were a step up from that, allowing you to set different basal rates during the day rather than just a single shot, and closed-loop systems (when they work right, which is not a given) are an advance over standard pumps, but it was really Lantus that was the threshold moment. Before then, “Eat what you want and bolus for it” would have been incomprehensible advice. Everything since then–pumps, CGM, looping–has just been a refinement, allowing us to modify our medication to fit our lives and not the other way around.
I realize this is a little long, but “eating to your insulin schedule” is a bit of a trigger for me!
I totally relate, having lived with type 1 for 45 years! Thanks for saying it so well. I now use the tslim with CIQ and it gives me a lot of freedom!
Yes, and I like to have the tools to track it better, like a CGM. I like the new tools and insulin that allows me to adjust my eating pattern as needed. I really dislike being on insulin that required me to eat on a specific schedule to meet its peaks. Like if I didn’t eat a snack before bed I would experience a low during the night and have to get up to correct it. Now I can eat, or not, as know where I stand.
I hear you and agree with everything you said. In the days before the use of T1D tech tools & new insulins we always had to “feed the insulin” whether we were hungry or wanted to eat or not.
Once upon a time I worked in an office with an 8 to 5 daily routine. On my pump it was easy to set the basal rates to fit that routine. Since I retired, my daily schedule changes with the wind (I now cook in a small restaurant for fun) and my meals are often different and sometimes unique, which makes estimating carbs challenging. As such it’s difficult to set a basal rate that works with my flexible schedule. My pump needs a wind sock to try and keep up!
I have experienced increasing blood sugar readings if I skip breakfast. Overall it is my activity schedule that influences my blood sugar more than diet. I usually am very active during most of the day. If I have an unusually low activity morning or day- even with less carb intake- I run in more difficult management staying non a desired range of blood sugar levels.
When I was on daily injections, the answer would have been ‘yes’, but since going on the pump, I no longer have an issue – Thus the current answer of ‘No’.
Not sure. Changed schedule is usually associated with dietary change so whilst levels are usually impacted not sure if it is the diet or schedule change which is the cause.
When I go long extended periods of time without eating is when I can tell a big difference in my blood glucose levels. The tools come in handy so I have something to go back and reference my days against.
Since I have been on a pump and have my basal rates set right I am no longer a slave to the clock for eating.
With summer here I seemingly tend to eat less cooked/heavy food, more cool fresh salads, and much less at dinner time which has certainly impacted my basal need at night. Had a few mild lows and corrected with a bit less basal insulin in my evening MDI shot.
If I do not eat at all, I can achieve 95-100% in range. Sporadic eating does not seem to cause any difficulties, it is just eating in general. Carb Ratios, Insulin Sensitivity, etc are correct. Major causes are site absorption (most due to 54 yrs of scar tissue) and stress.