Type 1: No insulin for a protein meal

[GrantGam]

The theory is that people with type 1 who were diagnosed as children no only have little to no insulin production but they also have an inhibited glucagon response.

With those of us who were diagnosed as adults we may very much be type 1 (rather than type 1.5), but our glucagon response is still uninhibited.

Interesting reading there @TorqPenderloin. I do wonder though, if the glucagon producing alpha cells are eventually inhibited in adults who have had T1D for a fair while, let's say >10 years?

I have had a little look around for info regarding T1D's and glucagon response to hypoglycemia, and some studies actually suggest that alpha cells are in greater numbers with T1D's (interesting enough in itself!) - although their response is inhibited. I can't seem to find any notable differences between children's glucagon response vs that of adults. I'd hazard a guess though, that the primary factor affecting the response of the alpha cells to hypoglycemia would be down to the length of time with the disease rather than the age of the person when diagnosed?

 

[luzanmurphy_]

Hey @luzanmurphy_ Well done those levels sounds great If it works then just trust your meter and keep doing what you are doing.

Unfortunately for me this doesn't work, if I eat protein I still need insulin to manage the gluconeogenesis process, my body seems quite efficient at converting protein to glucose, gathering whatever glucose it can from anything I eat..

That's very interesting juicyj x

 

[Claudio1]

I'm T2 and this does not work well. Any carbohydrates I eat, even in vegetables or milk, for example, affects my BG.

 

[wiserkurtious]

Hi everyone

I'm Type 1. I've done very well at getting my BG under control. Some days I don't have any insulin with any of my meals all day as I don't have any carbs and I maintain my BGs at around 6.2
I do however always take my long acting insulin everyday. Is what I'm doing ok?
Thanks in advance x

Hi So my situation is I m over a year into my hooneymoon an currently on keto diet which is brilliant for my numbers I may add.What I ve noticed is if I have too much protein without exercise I would get a small rise in my blood sugars a few hours later,reasoning switching to keto diet is because I wasn t happy with my carb spikes without insulin it was hard to control and was mainly bringing it down with exercise which was maybe not a good idea.are you adding fat into your diet as a main fuel source???

 

[wiserkurtious]

We are amazingly complexed human being's,yes we've been diagnosed diabetes but we are all different and our body's will react differently to everything,peace to all and try your hardest to keep your numbers down

 

[jackois]

This is exactly what I'm doing at the moment. Lowish carb (40gm per meal) and steady exercise (walking) still shows th BG spiking up to 7 to 8 but reducing back to starting number within 2 hours.

With careful management I've dropped my basal by 4 units, have no bolus for breakfast and lunch, only taking bolus with the evening meal. Bloods still around 5 to 6 mostly and diabetic team seem quite happy with it. Last HB1AC was 38.

I'd say carry on as you are and trust to your blood testing.

 

[Jennofspades]

Hello,

I came here to ask the exact same question. I typically used to take approx. 3-4 units per meal. However after gaining a bit of weight I've been living off fruit, veg and meat for about 2 weeks and have never taken more than 2 units of fast acting insulin per day. I think even that is too much since I keep waking up with hypos? I have also started exercising which I think has replaced the insulin.

I agree its very liberating! Feel like I'm curing myself. I still take background insulin as usual.

Also with my new regime having a few problems. Waking up with hypos but going to bed with sugar at about 12 and still waking up with BM at about 2 - how can I sort this problem out? if I was to go to bed with anything less than 12 I'd be in trouble.

Any suggestions?

 

[catapillar]

Hello,

I came here to ask the exact same question. I typically used to take approx. 3-4 units per meal. However after gaining a bit of weight I've been living off fruit, veg and meat for about 2 weeks and have never taken more than 2 units of fast acting insulin per day. I think even that is too much since I keep waking up with hypos? I have also started exercising which I think has replaced the insulin.

I agree its very liberating! Feel like I'm curing myself. I still take background insulin as usual.

Also with my new regime having a few problems. Waking up with hypos but going to bed with sugar at about 12 and still waking up with BM at about 2 - how can I sort this problem out? if I was to go to bed with anything less than 12 I'd be in trouble.

Any suggestions?

If you are taking your background insulin as normal you might need to do a basal test to see if that needs to be reduced in light of increased activity/weight loss which could be increasing insulin sensitivity.

 

[Engineer88]

Hello,

I came here to ask the exact same question. I typically used to take approx. 3-4 units per meal. However after gaining a bit of weight I've been living off fruit, veg and meat for about 2 weeks and have never taken more than 2 units of fast acting insulin per day. I think even that is too much since I keep waking up with hypos? I have also started exercising which I think has replaced the insulin.

I agree its very liberating! Feel like I'm curing myself. I still take background insulin as usual.

Also with my new regime having a few problems. Waking up with hypos but going to bed with sugar at about 12 and still waking up with BM at about 2 - how can I sort this problem out? if I was to go to bed with anything less than 12 I'd be in trouble.

Any suggestions?

when are you injecting basal, what and how much? fast acting wont really have much affect on over night bg but when are you doing it?

 

[azure]

Sounds like your basal might need adjusting @Jennofspades as others have said.

 

[tim2000s]

I have had a little look around for info regarding T1D's and glucagon response to hypoglycemia, and some studies actually suggest that alpha cells are in greater numbers with T1D's (interesting enough in itself!) - although their response is inhibited. I can't seem to find any notable differences between children's glucagon response vs that of adults. I'd hazard a guess though, that the primary factor affecting the response of the alpha cells to hypoglycemia would be down to the length of time with the disease rather than the age of the person when diagnosed?

There are a lot of studies about this area. Papers going as far back as 1973 identified a lack of alpha cell response to insulin secretion in juveniles, as well as a tailing off of signalling between Alpha and Beta cells in later onset cases. Roger Unger has done a lot of research into whether Type 1 is better treated if we look at glucagon reactions to normal eating as well. If I remember correctly, one of the key points relating to the adults v children glucagon response was that the earlier the onset, the less the signalling between Alpha and Beta cells had had a chance to develop properly. I'm unable to find that though.

There are a bunch of links in this to various pieces of research that raise a number of questions related to the management of type 1 and Glucagon.

 

[GrantGam]

There are a lot of studies about this area. Papers going as far back as 1973 identified a lack of alpha cell response to insulin secretion in juveniles, as well as a tailing off of signalling between Alpha and Beta cells in later onset cases. Roger Unger has done a lot of research into whether Type 1 is better treated if we look at glucagon reactions to normal eating as well. If I remember correctly, one of the key points relating to the adults v children glucagon response was that the earlier the onset, the less the signalling between Alpha and Beta cells had had a chance to develop properly. I'm unable to find that though.

There are a bunch of links in this to various pieces of research that raise a number of questions related to the management of type 1 and Glucagon.

Thanks @tim2000s!

 

[Kristin251]

If you're going to bed around 12, why wouldn't you be taking some bolus so you're lower before bed and then you could reduce your basal. Basal is not intended to lower you or work on food. I like to go to bed at a good number and wake up at the same place. I use my bolus to keep numbers lower with food throughout the day. Keeping insulin doses low is great but not if your in the twelves. I personally would rather take more bolus than basal as I can control bolus easier and if I keep myself steady during the day I need less basal and less hypos

 

[Blackers183]

If you're going to bed around 12, why wouldn't you be taking some bolus so you're lower before bed and then you could reduce your basal. Basal is not intended to lower you or work on food. I like to go to bed at a good number and wake up at the same place. I use my bolus to keep numbers lower with food throughout the day. Keeping insulin doses low is great but not if your in the twelves. I personally would rather take more bolus than basal as I can control bolus easier and if I keep myself steady during the day I need less basal and less hypos

Interesting your view on Bolus/Basal before bed. In my experience bolus before bed to bring down higher than required BGL has nil affect, therefore I have experimented with my basal (Lantus) dose. I now correct before bed only with my basal dose by doubling my standard correction (1 unit insulin drops BGL by 2.5 units), ie if the correction is 2.5 units of insulin I take 5 units basal.

David T1 MDI 25 years.

 

[azure]

Have you done a basal test @Blackers183 ?

If your correction dose isn't working, it sounds like your basal might not be right possibly.

 

[catapillar]

Interesting your view on Bolus/Basal before bed. In my experience bolus before bed to bring down higher than required BGL has nil affect, therefore I have experimented with my basal (Lantus) dose. I now correct before bed only with my basal dose by doubling my standard correction (1 unit insulin drops BGL by 2.5 units), ie if the correction is 2.5 units of insulin I take 5 units basal.

David T1 MDI 25 years.

@Kristin251 's isn't really an unusual view on basal bolus before bed. The job of basal insulin is to keep you flat - it's not really supposed to drop you. It's supposed to keep you within 2mmol/l of the level you went to bed with when you wake up. Your basal correction is going to be active for the rest of the day, potentially making you more vulnerable to hypos. If a bolus correction dose has no effect you might want to look at your correction factor or even consider doing some activity once a correction is given to give it a chance to start working.

If the way you are correcting works for you and doesn't cause you any issues, great. It's an interesting view on basal bolus before bed.

 

[GrantGam]

Interesting your view on Bolus/Basal before bed. In my experience bolus before bed to bring down higher than required BGL has nil affect, therefore I have experimented with my basal (Lantus) dose. I now correct before bed only with my basal dose by doubling my standard correction (1 unit insulin drops BGL by 2.5 units), ie if the correction is 2.5 units of insulin I take 5 units basal.

David T1 MDI 25 years.

I agree with @azure. Bolus insulin correction doses should bring down your BG every time providing that you're basal insulin is set correctly.

In essence, your basal insulin is the same strength as your bolus and will have the exact same effect on your BG but over a longer period of time. So all you are doing unfortunately, is correcting your BG with basal insulin which takes longer to work and results in your BG remaining in a hazardous range for longer than necessary...