Needing less insulin and not sure why

[kieronw96]

Hi there

I am 17 years old and have been T1 for just over 4 years now, and through most of that time i have been on the basal bolus routine, in the last year i moved from lantus to levemir, and for the entire time i have had ongoing high blood sugars levels, at my last clinic appointment i was on 2:10g novorapid and 90 units of levemir split into morning and evening doses of 45u. however in the last month i have had severely low blood levels, almost consistently below 4.0, and my insulin levels have dropped so far that as of yesterday i am on no levemir at all and when i injected 2 units of novorapid this morning on a high blood level (15.3) i was reading a 3.6 within 30 minutes.

I am waiting on some blood test results and am due to see some more doctors soon, but i was just wondering if anyone else had experience anything like this, or even heard of a reason for it?

Thanks
Kieron

 

[mrman]

Been hotter lately so could be the heat. Other things may be weight loss (if you've had any) or just more active in this nice weather.

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[kieronw96]

thank for the ideas, they are something we thought aswell, but its not something that has happened before in the hot and nice weather, and i think I've gained a bit of weight if anything
thanks though

 

[Daibell]

Have you been losing weight recently or just come off any steroids etc?

 

[kieronw96]

no weight loss, put a couple of kg on if anything, and not been on steroids or any other medication besides the insulin

 

[Spiker]

90 units/day of levemir is pretty intense and to drop that to zero is incredible. As is a drop of 12 mmol/L in 30 minutes with ANY amount of quick acting insulin, let alone 2u of Novorapid. I doubt you would see a loss that rapid in a non-diabetic. I am at a loss to explain any of it.

Have you been feeling any better since this change, or feeling worse? Is there any chance your meter is malfunctioning?

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[Spiker]

Just to add: if you are T1 you should never be on no basal. Even if you just inject 1u. Unless you are having the biggest, latest onset honeymoon period ever, you don't make insulin and so you can't clear ketone products from your blood, which will build up and cause ketoacidosis. Very dangerous. Please keep taking a minimal amount of basal at least, even if you have to skip or drop bolus doses.

What you are reporting is very hard to come up with an explanation for.

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[Spiker]

in the last month i have had severely low blood levels, almost consistently below 4.0, and my insulin levels have dropped so far that as of yesterday i am on no levemir at all and when i injected 2 units of novorapid this morning on a high blood level (15.3) i was reading a 3.6 within 30 minutes.

This part doesn't add up. If you have morning readings of 15.3 you should not be stopping the Levemir. How quickly did you reduce the Levemir from 90u/day to nil? Hopefully you reduced gradually, and measured the effects for at least 3 days before reducing again?


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[Spiker]

Was your T1 diagnosis confirmed with c-peptide and GAD tests? One outside possibility is that you are a misdiagnosed early onset T2.

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[smidge]

Or LADA. My own insulin still comes and goes at varying intensities more than 5 years after diagnosis. Nothing as dramatic as the Op's though.

Smidge

 

[noblehead]

This part doesn't add up. If you have morning readings of 15.3 you should not be stopping the Levemir. How quickly did you reduce the Levemir from 90u/day to nil? Hopefully you reduced gradually, and measured the effects for at least 3 days before reducing again?

My thoughts entirely, the morning reading of 15.3 would suggest that you still need your basal insulin Kieron.