Insulin needs

[RD02]

Just a question I was diagnosed with type 1?? Strange diagnosis as had a severe virus that I’m told attacked my pancreas, no typical diabetic symptoms but actually in DKA when admitted to hospital. This was 2 years ago and I managed within about 2 months to get quite good control. For personal reasons I decided to self fund Omnipod 5 and have been on the system for a good 3 months now.

When on MDI I was giving 10 units of Lantus and had a ratio of 1/10 carbs with Fiasp. Over about the last 6 months and still on MDI I had to further reduce this and I actually ended up taking 4 units of Lantus and a 1/14 Fiasp for carbs.

Since being on Omnipod 5 this has all massively changed. To keep me stable through the nights/days I getting a maximum 1.2 units of background insulin. For meals I’m on a ratio of 1 / 25 Fiasp. Night times are like a flat line and I get no dawn phenomena, if anything the opposite it drops as soon as I move about.

I should also add, my sugars spike and come back down to virtually there pre-meal point with 2 hrs max, sometimes much quicker.

All I get from my diabetic nurse is extremely unusual. Has anyone else experienced any remotely like this.

 

[CheeseSeaker]

Hard to pin down whats going on but there are a few possible at play that might be worth considering.

There is a 'honeymoon' period (for you new types ) where the beta cells are still working, you might still have a bit of that going on - from research over the years most of us still have a few beta cells doing stuff, but they tend to get less and less over time.

What possibly caused your T1 is the virus was identified by your immune system, and this identification also flagged your beta-cells as the same virus, and so your immune system went for them too (might be wrong there as not read up on this in a while, but I think thats how it can work).

Worth bearing in mind FIASP has a DIA (Duration of Insulin Action) of around 9 hours in most people when you're pumping and using HCL - so more is active than you think (I am jealous of how little you need tho ).

For your return to normal BG after a meal - thats what you should expect on an ultrafast insulin - they kick in at about 15 minutes and peak at around 55 - as I say some is still active at 9hrs (though it tails off) have a look here:

Why DIA values are wrong | Diabettech - Diabetes and Technology

The values that we use for DIA in pumps and bolus wizards is wrong. Here's why and what you can do about it.

www.diabettech.com

Sounds like you still have an partially active pancreas - this might get worse over time, or you might be able to find ways to work with that.

 

[RD02]

Hard to pin down whats going on but there are a few possible at play that might be worth considering.

There is a 'honeymoon' period (for you new types ) where the beta cells are still working, you might still have a bit of that going on - from research over the years most of us still have a few beta cells doing stuff, but they tend to get less and less over time.

What possibly caused your T1 is the virus was identified by your immune system, and this identification also flagged your beta-cells as the same virus, and so your immune system went for them too (might be wrong there as not read up on this in a while, but I think thats how it can work).

Worth bearing in mind FIASP has a DIA (Duration of Insulin Action) of around 9 hours in most people when you're pumping and using HCL - so more is active than you think (I am jealous of how little you need tho ).

For your return to normal BG after a meal - thats what you should expect on an ultrafast insulin - they kick in at about 15 minutes and peak at around 55 - as I say some is still active at 9hrs (though it tails off) have a look here:

Why DIA values are wrong | Diabettech - Diabetes and Technology

The values that we use for DIA in pumps and bolus wizards is wrong. Here's why and what you can do about it.

www.diabettech.com

Sounds like you still have an partially active pancreas - this might get worse over time, or you might be able to find ways to work with that.

Makes very interesting reading the link above, thank you.

 

[CheeseSeaker]

Makes very interesting reading the link above, thank you.

The chap that runs diabettech has some really great information on his website - research into tech and medications for the type 1s (some apply to the type 2s too). He's one of the developers for AAPS (AndroidAPS HCL DIY system) and knows his stuff, so I'd recommend having a look at some of the articles and testing he does (though they are all N=1)

Its taught me a lot about the tech to manage this stuff, and I'm using his FCL loop at the moment - still tuning but amazing not to have to do anything when I eat (most of the time)

Another good source of info is BionicWookie (in Australia)

 

[RD02]

I’m quite into tech myself, I’ve read quite a bit on AAPS system and watched some podcasts on it. Did consider the dash system with loop, but for the moment stick with Omnipod 5. I get the Dex one via nhs then use an Anubis G6 transmitter to create the loop. Work fine, but as you say AAPS is far more advanced