Hypos, honeymooning and basal dose

[frenchkittie]

I wonder if anyone has any experience of hypos due to Lantus/basal while honeymooning?

For some time my BS levels have been getting lower and lower, and my carb ratio progressively better, and last week I stopped taking Novorapid altogether (for the time being) and my results after eating are now within normal (non diabetic) range.

I then started to notice that my levels on waking were becoming lower and lower, and I was often dropping below 4 during the day, due (I assume) to Lantus alone. So I started to reduce my Lantus. I was on 12 units, and have reduced this to 10, but even so was alarmed to find that my reading at 11.30 today was 3.3, and the only insulin I'd taken was my Lantus at 18:30 last night (and I know from experience that Lantus only usually works for around 18 hours for me).

I plan on reducing basal to 8, and doing a 3am test tonight, as it seems a good indicator when trying to balance Lantus. We're told not to reduce Lantus by more than 2 units at a time, and also to wait 2 days on each reduction to see the full results before making further changes, so it may take me some time to get to a dose that works for me.

I usually eat between 70 and 130 carbs per day, my calculated Hba1C is 5.6%, and my current insulin/bodyweight ratio is 0.2 (if that means anything to anyone).

So I suppose my question is, how low is it possible to go with the Lantus? Do some people stop taking it altogether whilst honeymooning?

 

[phoenix]

I've had lots of hypos due to basal and thats why I'm so grateful to my pump. Even today five years down the line there are days when I use less than 10 units basal. I've never cut out my bolus completely though.
I have read of people reducing their insulin to a tiny amount and this from Joslin confirms it
http://www.joslin.org/info/will_diabetes_go_away.html
The good news is that the later the onset, the longer the honeymoon may last. ( I read recenlty that this is possibly because there is a greater beta cell mass in the first place than with earlier onset type 1)

 

[frenchkittie]

Thanks for the link phoenix.

I'm waiting for my pharmacy to take delivery of some childrens' insulin pens capable of delivering half units of bolus, with a view to eating a bigger lunch and taking a half unit to cover the carbs.

If I go a bit low afterwards I'll use it a good excuse for a square of dark chocolate

 

[janabelle]

Hi Frenchkittie,
It is possible to be on no insulin at all during honeymooning. I was on nothing at all for about a month during mine 20 yrs ago-it was great! I was on Human Isophane and actrapid prior to honeymooning. Be very careful with Lantus, it's notorious for causing unpredictable BGs; when I was on it until fairly recently, I could hypo with NO rapid-acting on some days. It's not a true 24 hour basal so be careful and check your blood frequently.
Jus

 

[jameshallam]

I'm still honeymooning (since October) and currently on 8 units of Lantus.
I tend to have around 180-220g of carbs a day.

Going with a ratio of 1:10 at lunch/dinner and 1:20 at breakfast...

HbAc1 of 6% last time i was checked in early Jan

 

[frenchkittie]

Well wouldn't you know it, I've been and gone and caught a cold, and am having to experiment with higher doses of bolus to counteract elevated BG. Glad I found some "sick day" links.

Just when you think you've got it all worked out, life throws a spanner in the works :?

 

[Polgara]

My husband was diagnosed in January and is now honeymooning.

He's gone from 22 lantis, with Novorapid at 8, 8, and 10 - to 18 lantis (and I think he will drop that more over the next few days) and no novo at all since the weekend.

I know everyone says that you can't tell how long a honeymoon will go on for - but is it likely to be weeks or months?

 

[crisp]

Hi, i was diagnosed with type 1 dec 2009 and after two weeks on lantus and novarapid a dropped down to nothing within two weeks, honeymoon period lasted 10 months with no insulin before nurses got cold feet and put me back on lantus at 2 u which sent me all over the place for a month. Just started on small amounts of both insulin again. Age 38 when diagnosed