No insulin at breakfast or Lunch.

sheepareevil

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I'm waiting to hear back from my diabetic nurse but I was hoping for a bit of advice whilst waiting.
I have not be able to take insulin at breakfast since I was diagnosed because I will have a Hypo before lunch. Recently I have also had to stopped taking insulin with my Lunch (for the same reason).
My BG's are fine (No ketones) but I have had a couple of incidents of confusion, not knowing where I am nd not being able to form a sentence.

What would people suggest I do? Is it okay to go without insulin for so long?
 

mo1905

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Your BG levels will tell you if it's OK to go without insulin for so long. Do you take basal insulin too ? If so, this may need adjusting and could be why you hypo a lot. Not a lot of info to go on really to offer advice. Do you count carbs ? Are you newly diagnosed ?
 

sheepareevil

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Yeah I do count Carbs. I have been dignosed for just over a year.
I do take basal insulin, however I have reduced it. My blood sugar now goes up by about 2 points over night (before my dawn rise kicks in) so don't relly want to reduce it any more.
I know that it could still be my honeymoon period but I need to take less insulin now than 6 months ago (compared to carbs)
 

Juicyj

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Hiya,

You tend to find when first diagnosed that by taking insulin and getting your BG readings back down to 'normal ranges' puts less pressure on the pancreas so as you gain better control there is less stress being placed on the pancreas and it starts to squirt out more insulin - the longer you keep good control then the longer the pancreas will continue to squirt and the longer your honeymoon can last - however this can be a pain as it will cause you hypos, It helps when the pancreas does finally give up as it will make it easier for you to control your insulin and less hypos.

Keep a diary of your insulin doses in the meantime to monitor your adjustments and work out trends and patterns, this will help you and your dsn to control your diabetes.

Good luck ;)
 

mo1905

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If you were late onset the honeymoon phase could still be happening. Sometimes when you introduce insulin, it gives the pancreas a break and can even give it a bit of a kick start. There are a few here diagnosed LADA and managed to avoid insulin for approx a year.
 

Daibell

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Hi. I don't quite understand your point about Basal and blood sugar now going up 2 points and before the dawn rise kicks in? Can you elaborate because it doesn't sound quite right? Normally you would aim for a fasting blood sugar of between 5 - 7 mmol and adjust the Basal to suit this. If you carb-count but have hypos after breakfast and lunch then surely your carb ratio needs tweaking? I normally don't bother to have a Rapid at breakfast as it's only about 30 gm carbs and the 24 hour Basal is at it's peak (I don't split it). It doesn't matter how long you go without insulin as long as your blood sugar stays in the right range e.g. below 9'ish mmol most of the time and hopefully a bit lower
 

sheepareevil

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Hi. I don't quite understand your point about Basal and blood sugar now going up 2 points and before the dawn rise kicks in? Can you elaborate because it doesn't sound quite right? Normally you would aim for a fasting blood sugar of between 5 - 7 mmol and adjust the Basal to suit this. If you carb-count but have hypos after breakfast and lunch then surely your carb ratio needs tweaking? I normally don't bother to have a Rapid at breakfast as it's only about 30 gm carbs and the 24 hour Basal is at it's peak (I don't split it). It doesn't matter how long you go without insulin as long as your blood sugar stays in the right range e.g. below 9'ish mmol most of the time and hopefully a bit lower
On average my blood sugar before bed is about 6ish I have had to adjust my Basal insulin so that when I wake it is between 8 and 9 (This is before the dawn phenomenon happens in me as my results will continue to rise for about 2 hours, peaking at about 8ish). I have had to do this of other wise I have a couple of mid morning hypo's.

I was fine missing the breakfast injection but just wanted to check with others about the lunch injection. It just seemed strange to me that I can 20ish hours without needing Insulin.

My DSN and specialist keep telling me that my honeymoon period should have ended (I'm sure that I heard it could last up to 3 years?)

Without the insulin my blood sugar is pretty stable (5-8 most tests) I just wanted to check really that I'm not being stupid and missing something simple.

Thank you for all the help
:D
 

Kelsie

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144
Sounds like your still in your honeymoon period, my brothers lasted well over two years and mine is one year and still continuing! My DSN told me it could last up to three years too. I went about four months where I didn't have to inject after breakfast for same reason as yours but now I inject v small amount of only three units :)


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dtennant9

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Even though you say your not injecting insulin for 20 hours you still have your Basal insulin which your body will be using.
After the initial period after diagnosis I went around 6 months with no insulin for breakfast as I would always go hypo if I did.
Although I still took some at lunchtime it was usually around 1 unit.
Enjoy having less injections etc while it lasts.
 

mopsy21

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Hi, same here regarding breakfast and lunch. T1 diagnosed about 18 months ago - carb counting almost straightaway, using the Accu-Chek Expert Meter. Initially found bg levels dropping too much in the mornings, so on the advice of the DSN, I reduced the breakfast ratio down to the present level of 0.2 units for 10g carbs (yes, really!). This has meant no insulin at breakfast since June last year (40/50 g carbs). On the odd occasion that my waking level is higher than, say, 6.8, the meter will suggest 1 unit and I do take it then - or I might just eat less.

No insulin at lunch came about by accident. I'm on a ratio of 1 unit per 10g carbs for lunch and tea. I was struggling to eat 40g carbs at lunch, and one day I took in a much smaller lunch. To my surprise, the meter suggested no insulin (my bg level was 5.5 or thereabouts). I then realised that if I kept to 10g carbs at lunchtime, I didn't need to inject. I was pleased with this, as it was quite awkward injecting at work anyway. Teatime I generally have 20g carbs, and this requires either 1 or 2 units (Novorapid), depending on bg level. I am on basal insulin of course (14 - 16 units of Lantus), and I tweak this up or down if I spot any trends in bg levels. Generally, they are between 4.5 - 6.8 during the day, and I've had no hypos since diagnosis. My last Hba1c (October 2013) was 6.8% - medics are okay with this as I drive. My DSN's view was that I'm 'low carbing', but she accepted that I seem to be doing all right on it - she checked the 90 day info on the meter!

Just two injections a day is good. The downside is that I'm throwing away half to two-thirds of the insulin in the pre-filled pens each month, even though I take more insulin at weekends and on holidays when I eat more. I keep records of all my bg readings, so I can track changes in bg levels. I do wonder, though, whether this trend of no insulin at breakfast and lunch will continue - I hope so!
 

debbiiee

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I am new to this forum. Diagnosed type 1 five months ago. I am on novomix 30 twice a day. My insulin need is almost nil for the past 3 weeks. I am 20 years, BMI 19.5 & hba1c 7.4. My GP seeing my decreased insulin need asked to stop insulin & take metformin. Any type 1s on metformin alone? My doctor told me that i may be in honeymoon phase

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Indiana91

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706
Type of diabetes
Type 1
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I am new to this forum. Diagnosed type 1 five months ago. I am on novomix 30 twice a day. My insulin need is almost nil for the past 3 weeks. I am 20 years, BMI 19.5 & hba1c 7.4. My GP seeing my decreased insulin need asked to stop insulin & take metformin. Any type 1s on metformin alone? My doctor told me that i may be in honeymoon phase

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I haven't done this myself but I have heard of other type 1s being on it whilst in honeymoon period.

Indiana x


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smidge

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1,761
Type of diabetes
LADA
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Insulin
When I was first diagnosed with LADA, I needed intermediate acting basal only once every 2 or 3 days and then only a couple of units. Within 3 months I needed a unit or 2 of rapid acting with my evening meal, but it was a year before I added rapid acting for breakfast and probably more than 18 months before I needed it with lunch. Just use what you need.

As for the mid morning low, I remember it well! I took it as an excuse to have a finger of dark chocolate kit Kat (7g carb) with my cuppa to prevent the hypo that I would otherwise get. I miss that now LOL. Sometimes you adjust your insulin as best as you can but it isn't perfect - so you have to adjust something else. If you know you hypo mid morning, maybe the answer is a mid morning biscuit?

Take care

Smidge