Honey moon period or insulin sensitive?

[LewisK123]

Hey everyone,

This year in January my sugars randomly started dropping without needing much or any rapid insulin at all. I remember for about 8 days I took 1 unit of levemir and not a single drop of rapid. This up and down rubbish continued all the way up to September/October time. And since then I've been able to take several units of levemir anywhere from 7-11 units, and take 1 unit of rapid to every 10 grams of carbs. I've been tested for various different things and I am deffo a type 1. My problem is, is that I can maintain my sugars being high so 13-19mmol but can't maintain them being lower. And what I've been finding is that the amount of insulin I take varies so I may have to take hardly any insulin then 4 weeks later raise how much I'm taking then 2 months later lower how much I'm taking.

What I've also been finding is that as im on 10 units of background I could eat 70 grams of carbs take 2 Units of rapid then I can still hypo?

My question is, is this the honey moon thing or does my sensitivity just fluctuate?

Sorry if I haven't explained some things well! Tried to cram the past 11 months of confusion and mishaps into one post

 

[Deleted Account]

I am not sure what to suggest.
My only thought is whether anything else is changing in your life at the same time.
For example, are you taking any other drugs which could impact your BG?
Or doing intensive exercise on and off such as training for a marathon and then taking a well deserved rest afterwards?

 

[LewisK123]

I am not sure what to suggest.
My only thought is whether anything else is changing in your life at the same time.
For example, are you taking any other drugs which could impact your BG?
Or doing intensive exercise on and off such as training for a marathon and then taking a well deserved rest afterwards?

I take the odd hay fever tablet when necessary but not every day, started taking omeprazol the past few days but put another post up the other day regarding that and have established that probably isn't a factor to consider. In terms of exercising I haven't done anything strenuous as my sugars can be rather volatile.

 

[himtoo]

hi there @LewisK123
you have managed to cram a lot of info and scenarios into that great post

I think I will start by saying that most of us have to make dose adjustments because things like stress, illness , exercise , the weather , for women - hormonal , -- all can cause our Bg's not to behave the same every day.

I think I understand that you are saying you find it easier to keep your bloods staying within a range when they are between 13 - 19 but that attempting to run lower and they start going all over the place. ??

it could be honeymoon , it could also be your sensitivity to insulin.

Have you discussed your concerns at all with your care team ?
do you have a specialist Diabetes nurse at hospital you can talk to ??

 

[LewisK123]

hi there @LewisK123
you have managed to cram a lot of info and scenarios into that great post

I think I will start by saying that most of us have to make dose adjustments because things like stress, illness , exercise , the weather , for women - hormonal , -- all can cause our Bg's not to behave the same every day.

I think I understand that you are saying you find it easier to keep your bloods staying within a range when they are between 13 - 19 but that attempting to run lower and they start going all over the place. ??

it could be honeymoon , it could also be your sensitivity to insulin.

Have you discussed your concerns at all with your care team ?
do you have a specialist Diabetes nurse at hospital you can talk to ??

Oh absolutely this has been a rather stressful year right from January (unrelated to my diabetes) but obviously those stresses can spill over and affect blood sugars.

Yes yes yes that's exactly what happens, even if I raise my background by 1 unit it could have drastic effects, which is exhausting as it could take ages to then build myself up to a nice dose of insulin.

Oh believe me pal I've been in constant contact with the nurses at the endocrine clinic or whatever it is, I am in contact with them pretty much every week. They've tested everything, blood tests all came back normal and didn't flag anything unusual, had a short synacthen test that came back normal.

Now I'm just left scratching my head wondering what on earth I can try.

 

[SueJB]

Hi
I can't suggest anything but really do sympathise. Virtual hugs

 

[himtoo]

ok @LewisK123
so looking at the basics -- have you got 1/2 unit pens for both your long acting and fast acting insulins -- these can help with fine tuning doses .....

how many times per day are you testing ?? what are your 7 , and 14 day averages ( out of curiousity ? )
do you have access to a libre ( either as a trial from your DSN ) or self funding full time.
has your DSN offered you a CGM to get a grip on things ?

I think your 24 hour patterns will be important it helping to "get to source" of the issues.

I am pretty sure you don't want to be on the forum ( if you could help it ) but I am glad you found us -- hopefully we can be there to support you through it all -- even if we can't pinpoint an exact cause.

sending a couple of virtual hugs [[[hugs]]]

keep posting
himtoo

 

[LewisK123]

ok @LewisK123
so looking at the basics -- have you got 1/2 unit pens for both your long acting and fast acting insulins -- these can help with fine tuning doses .....

how many times per day are you testing ?? what are your 7 , and 14 day averages ( out of curiousity ? )
do you have access to a libre ( either as a trial from your DSN ) or self funding full time.
has your DSN offered you a CGM to get a grip on things ?

I think your 24 hour patterns will be important it helping to "get to source" of the issues.

I am pretty sure you don't want to be on the forum ( if you could help it ) but I am glad you found us -- hopefully we can be there to support you through it all -- even if we can't pinpoint an exact cause.

sending a couple of virtual hugs [[[hugs]]]

keep posting
himtoo

I use pens that dial up in ones I haven't been given the chance to look into 1/2 unit pens perhaps I'll suggest it to my consultant nurse in a couple weeks.

My 7-14 day averages are about 12-15. And I test 4 times minimum but can be up to 13 times a day.

I think it will be a very long time before my endocrine clinic will be able to give me the libre for free or even as a trial, and there's no way I'm able to afford it.

What do you mean by a CGM?

Without meaning to be too sinicle ive found more advice on these forums than the past 2 years of dealing with DSNs.

 

[Kristin251]

I use pens that dial up in ones I haven't been given the chance to look into 1/2 unit pens perhaps I'll suggest it to my consultant nurse in a couple weeks.

My 7-14 day averages are about 12-15. And I test 4 times minimum but can be up to 13 times a day.

I think it will be a very long time before my endocrine clinic will be able to give me the libre for free or even as a trial, and there's no way I'm able to afford it.

What do you mean by a CGM?

Without meaning to be too sinicle ive found more advice on these forums than the past 2 years of dealing with DSNs.

I couldn’t live without my half unit humalog pen. Really need it for lantus but we can’t get it in the US.

 

[scotteric]

I use pens that dial up in ones I haven't been given the chance to look into 1/2 unit pens perhaps I'll suggest it to my consultant nurse in a couple weeks.

My 7-14 day averages are about 12-15. And I test 4 times minimum but can be up to 13 times a day.

I think it will be a very long time before my endocrine clinic will be able to give me the libre for free or even as a trial, and there's no way I'm able to afford it.

What do you mean by a CGM?

Without meaning to be too sinicle ive found more advice on these forums than the past 2 years of dealing with DSNs.

Your average is very high. What I will say is every day is different and it's impossible to get things perfect. I aim to keep my blood sugars between 4 and 8 as much of the time as possible, which I am pretty good at but which means sometimes I am 10 and sometimes I am 3 because I'm not perfect. I just accept hypos as part of being diabetic and treat them when they happen. Remember that 70 g of carbs can mean a lot of things. 70g of juice for example will spike you immediately, whereas 70g of a meal very high in fat could digest slowly and any insulin taken before or with the meal could send you low. You should start by basal testing to see if your basal dose is close to right. You may want to consider other treatment options as well, such as a pump or Tresiba insulin instead of Levemir.

 

[LewisK123]

Your average is very high. What I will say is every day is different and it's impossible to get things perfect. I aim to keep my blood sugars between 4 and 8 as much of the time as possible, which I am pretty good at but which means sometimes I am 10 and sometimes I am 3 because I'm not perfect. I just accept hypos as part of being diabetic and treat them when they happen. Remember that 70 g of carbs can mean a lot of things. 70g of juice for example will spike you immediately, whereas 70g of a meal very high in fat could digest slowly and any insulin taken before or with the meal could send you low. You should start by basal testing to see if your basal dose is close to right. You may want to consider other treatment options as well, such as a pump or Tresiba insulin instead of Levemir.

My last hba1c in September was 10, but that's because they believe I was honey mooning. What I'm finding is that I can raise the background and my sugars can drop a bit nicer and be at on average 8-11 mmol but I'm unable to snack on the levemir and if I raise The background too much I'll hypo very quickly. So I'm thinking an alternative background insulin would be a good start like you mentioned.

You made a god point about the types of food too, I've never bothered to plan and think about what I eat as it's never had an effect on me I've been able to eat whatever and control it, but as you also said everyday is different so perhaps it's time to focus on what I eat and plan my meals.

As I'm out and about quite often I worry about hypos so I do at times run myself high to avoid those possible situations.

 

[Jc3131]

Hey everyone,

This year in January my sugars randomly started dropping without needing much or any rapid insulin at all. I remember for about 8 days I took 1 unit of levemir and not a single drop of rapid. This up and down rubbish continued all the way up to September/October time. And since then I've been able to take several units of levemir anywhere from 7-11 units, and take 1 unit of rapid to every 10 grams of carbs. I've been tested for various different things and I am deffo a type 1. My problem is, is that I can maintain my sugars being high so 13-19mmol but can't maintain them being lower. And what I've been finding is that the amount of insulin I take varies so I may have to take hardly any insulin then 4 weeks later raise how much I'm taking then 2 months later lower how much I'm taking.

What I've also been finding is that as im on 10 units of background I could eat 70 grams of carbs take 2 Units of rapid then I can still hypo?

My question is, is this the honey moon thing or does my sensitivity just fluctuate?

Sorry if I haven't explained some things well! Tried to cram the past 11 months of confusion and mishaps into one post

I'm going through a similar thing at the moment. I've been diagnosed for around 6 months and I got my hb1ac down from 103 to 44 just from a change in diet and a little insulin.

I started off on 4units of Lantus, I found I couldn't keep my bloods up so the dsn said drop it to 3units. The 3 units have been fine until recently. I drop into the 3 mmols around 3 hrs after breakfast and have been having random lows. Today I have gone down to 2units of Lantus. This is coupled with 2 units of novorapid once a day before a meal, normally a meal that has over 60-70 g of carbs.

I am averaging 6.5mmol on my meter at the moment and I put my issues down to my pancreas, after initially struggling now decides to fire out random shots of insulin.

It's a hard thing to judge and get right, I'm just testing a lot, especially when hit with lows. The only good thing I can take out of it, is that I can feel a hypo coming on. And that I can sucessfully eat a Macdonalds breakfast without any insulin.

Good Luck.

 

[scotteric]

I'm unable to snack on the levemir and if I raise The background too much I'll hypo very quickly

I'm not sure what you mean. Do you mean if you have a snack, Levemir isn't keeping your blood sugar from rising? If that's the case then it's working just fine. Basal insulin is just meant to keep your blood sugar stable when you aren't eating. Eating anything at all requires an injection of rapid-acting insulin. Now because Levemir has a curve and slight peak it may be possible to eat a very small amount of carbs and Levemir will absorb it. Generally, I take insulin every time I eat though. Maybe I've misunderstood though, let me know if I have.

 

[LewisK123]

I'm going through a similar thing at the moment. I've been diagnosed for around 6 months and I got my hb1ac down from 103 to 44 just from a change in diet and a little insulin.

I started off on 4units of Lantus, I found I couldn't keep my bloods up so the dsn said drop it to 3units. The 3 units have been fine until recently. I drop into the 3 mmols around 3 hrs after breakfast and have been having random lows. Today I have gone down to 2units of Lantus. This is coupled with 2 units of novorapid once a day before a meal, normally a meal that has over 60-70 g of carbs.

I am averaging 6.5mmol on my meter at the moment and I put my issues down to my pancreas, after initially struggling now decides to fire out random shots of insulin.

It's a hard thing to judge and get right, I'm just testing a lot, especially when hit with lows. The only good thing I can take out of it, is that I can feel a hypo coming on. And that I can sucessfully eat a Macdonalds breakfast without any insulin.

Good Luck.

Sorry for the delay, but that sounds exactly like my experiences this year, contastantly having to change the background every week or so. And I feel you on the amount of rapid you're having to take it always seemed absurd that I would eat a large amount of food and take such little insulin, but whatever works works I suppose. Due to all the frequent random hypos I did find it easier to keep my sugars higher just for practicality purposes.

 

[LewisK123]

I'm not sure what you mean. Do you mean if you have a snack, Levemir isn't keeping your blood sugar from rising? If that's the case then it's working just fine. Basal insulin is just meant to keep your blood sugar stable when you aren't eating. Eating anything at all requires an injection of rapid-acting insulin. Now because Levemir has a curve and slight peak it may be possible to eat a very small amount of carbs and Levemir will absorb it. Generally, I take insulin every time I eat though. Maybe I've misunderstood though, let me know if I have.

Apologies that's my fault I didn't explain properly what I meant is what you said at the end there, I should be able to consume about 20/30 grams of slow acting carbs inbetween meals but at the minute I'm unable to do so.

 

[Binary]

Apologies that's my fault I didn't explain properly what I meant is what you said at the end there, I should be able to consume about 20/30 grams of slow acting carbs inbetween meals but at the minute I'm unable to do so.

In my opinion if you can eat 20/30 grams of slow acting carbs without raising your bloods then I would suggest that the background insulin is too strong as eating it would be preventing your bloods from going low and my concern is that you can't eat while your asleep. Having said that you may need a little bit more insulin at night then you do during the day or vice versa. If you split your background into two doses, morning and evening that get a little more during the day or night depending on your requirements.

The way we deal with type 1 shouldn't be textbook with one approach. We should look to fit diabetes around our lifestyle not the other way around although it doesn't stop us making positive changes to our lifestyle if we are happy to make them, life is for living after all.

If before being diagnosed type 1 you have always been someone who snacks regularly then running your background insulin a little higher allowing yourself to snack during the day without giving yourself extra injections may suit as long as your levels are at a safe level overnight.

If you have never been one for snacking then you may better at running you background at a level which doesn't require snacking, any snacking will then require an injection.

 

[becca59]

Apologies that's my fault I didn't explain properly what I meant is what you said at the end there, I should be able to consume about 20/30 grams of slow acting carbs inbetween meals but at the minute I'm unable to do so.

At the beginning of this journey I too could eat a snack without consequence. Now even a tiny amount will shoot me up. Luckily, apart from fruit, I’ve never been a snacker, so I now stick to meal times for all food.

 

[scotteric]

Apologies that's my fault I didn't explain properly what I meant is what you said at the end there, I should be able to consume about 20/30 grams of slow acting carbs inbetween meals but at the minute I'm unable to do so.

Hey Lewis, as others have said the purpose of Levemir shouldn't be to allow you to snack without consequence. It's just supposed to keep your blood sugar steady between meals. There is a curve and peak to it which you can use to cover very small snacks, protein spikes or delayed digesting foods if you're careful. However, generally you will need to take a shot every time you eat sometime, whether it's a meal or snack, if your Levemir is dosed properly. I was on a pump for years so would just enter the carbs I was eating into the pump every time I ate something. Now that I'm doing MDI I just pull my pen out a million times a day because I like to eat! If I ate 20-30g without taking a shot my blood sugar would shoot up to 20 in no time!