Honeymoon period - no insulin needed today?

Hi all,

I was diagnosed type1 late in 2013. At first I was started on 26 units of Lantus per day and a 2 unit to 10g of Apidra. Over the past weeks i've gradually had to reduce this as I'v had several frequent hypos day and night.

I'm now on just 6 units of Lantus and a ratio of 1 unit of Apidra for every 15g of carbs. This week I've had several incidents where my sugar levels have rapidly decreased and I've had to take drastic measures to get them back up. Today was no exception. After breakfast when I took just 2 units with a 35g breakfast I was already low at lunchtime. I had a few crackers and decided not to take any insulin. 2 hours later I was falling fast and despite taking 6 glucose tablets I was still falling. Once I hit 2.2 I then took glucogel too. Eventually I started to rise again. At dinner this evening I had just 40g of carbs. my bs was 5.4. I decided not to take insulin. 2 hours after dinner I was 8.9. Since then I've had a 20g snack again without insulin. I should have taken my bolus over an hour ago but my BS is just 5.4

I'm guessing that my depleted beta cells have decided to do some work this week. It's making it **** difficult though. I'm tempted to not take Basal before bed and to see what I'm like in the morning. I don't want to take it and risk another hypo during the night. The dead in bed syndrome scares the life out of me. I'd much rather risk going high tonight than risk going low again.

Any advice or thoughts would be welcome.

Steve

miss_skellington said:

Hi Steve! I've been going through something similar,I was diagnosed type 1 in July. Started insulin 4 times a day and levels decreased to normal range. Then I kept having hypos no matter what I ate. My diabetic nurse had me reduce my insulin until eventually I stopped my basal completely and my bolus for breakfast and lunch. That was in September and I still only take bolus at dinnertime,usually only a couple units. Honeymoon period can be a frustrating time as the amount of insulin I need can vary day to day. I just try and test regularly so I don't accidentally go high without realising. Hope you get your levels under control

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Hi,

It's a relief to know that someone else has experienced the same thing. Your reply has helped me to decide. I'm going to stop my basal and then just take a reduced bolus tomorrow. I'll do plenty of testing to see what the effects are. I don't mind so much having to combat hypos during the day but the nightime ones are scary. I've just got used to having to reduce and increase on an almost weekly basis but this week has been trying! On Monday I was in an airport waiting to travel back from seeing a client and my sugars were dropping to really serious levels. Glucose just wasn't doing it for me, I resorted to getting a mars bar, a flapjack and some lucozade from one of the airport shop. It's been a week full of lows since. Thanks for replying Miss Skellington, you've given me the confidence to make an informed decision.

Steve

miss_skellington said:

No problem at all,I don't reply often on here as other members seem to know a lot more than me lol. But I sympathise with how trying it can be. At the moment I only take insulin for a meal with over 40g of carbs. With regards to my morning readings I go to bed with levels around 8 but they're in the mid 4's by the time I get up so I wouldn't risk taking basal because hypos would definitely happen. I suppose it's different for everybody but nice to know someone's going through something similar!

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You're right, it is a comfort to know that you're not alone, if feels that way sometimes. I haven't taken any insulin last night or today and yet earlier I was having to take glucose as I'd gone to 3.2 mmol/l. All very confusing! No doubt I'll get on top of it and it will change again!
Steve

I last took lantus on Friday Evening. I'm scared to take it if I'm honest. I'm waking up at normal levels, and during the day today with no basal or bolus I'm still going low. I've just eaten a meal an hour and half ago. I even had dessert to see what would happen. I was 5.1 before the meal. I've just tested again out of curiosity and I'm only 7.9. I've no choice but to not take insulin I guess.

I'm wondering what is in Lantus, what I mean is, is there any amylin or glycogen mixed in with it? If so, it may be beneficial for me to take the Basal and not the bolus until my pancreas gives in again.

Robert 2170 said:

Speak to your doctor what I was told was if you take your night time reading and your fasting reading next morning is with in I think 2 of you night time reading your lantus is ok you may have to adjust it but speak to the diabetic nurse they will help
I am on 12 units of lantus at night and my readings can be about 6.5 to 7.5 after fasting but all depends on what my night time reading was


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I'll contact my endocrinologist tomorrow, He's perhaps the best one at the clinic to speak with. Up until this week I was able to go to bed at 5.9 and get up almost the same. For some reason my pancreas must be having a final fling! Just tested my bloods again and they are 6.6. Remarkable really given that the meal I've just had I would have normally taken 6-7 units of Bolus.

Robert 2170 said:

It will sort its self out it is just a pain when it gives up then it starts to work again on its terms
As said to the doctor it controls me I don't control it and that was annoying me but as I said enjoy eating what you want and not having to inject cause it will change I am doing the DAFNE course in a couple of weeks time so that should help


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You'll enjoy the DAFNE course. I've just done the ICE course, I enjoyed it to be fair although I'd already thrown myself into carb counting quite early on. I'm not sure if I'm enjoying eating what I like. I'd got quite into measuring, calculating and bolusing. I'd been regularly between 4 and 7 and was steadily losing weight ( which was a good thing) I just hope my immune system finishes the job off soon and gets rid of the remaining beta cells

anna29 said:

What did the ICE course consist of ?
In case of emergency ICE ...

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Hi Anna,
It was essentially carb counting, it was one morning a week for four weeks. I had to attend it before being given a pump. Most of the people on the course seemed to be those who were used to taking fixed doses of Basal Bolus. It was basically to educate them about carbs, exercise etc. All quite basic to begin with but we did cover a little about Low GI foods and splitting bolus doses over a couple of hours to allow for different types of food. Quite good really

OH forgot to mention I.C.E. Insulin Carbohydrate Education

Robert 2170 said:

G2ADY have you got a pump just reading you did the ice course



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Hi Robert,

Not yet, I have my appointment at the pump clinic in May so hoping to get one then.

Steve

I'm torn about the pump. I really wanted one but up until this honeymoon period I was managing really well. I think the benefit would come from being able to finely tune. In addition my working days mean that my eating patterns are sometimes erratic. I'm often in meetings for hours or flying to see clients etc. I've had a couple of hypos that I've needed to treat lately whilst with clients. I had an absolutely awful one in Southampton airport the other day too. Luckily W H Smith was in the departure lounge and so a mars and lucozade came to the rescue. Being able to adjust basal on the fly really appeals. I'm just not convinced that I could get on with the tubing. I've asked about the omni pod but apparently funding isn't available yet.