Insulin sensitivity? (And a little update!)

[TheSparkyPony]

Hi everyone, not been on here for a while! Hope you're all ok

I'm still managing to impress everyone and am probably causing my consultants a lot of grief on the gambling stakes (I'd imagine they'd all have bets on me to crack and fail on my tight control :lol: )

My last HBA1C was an amazing 6.5% from a previous 14% in Oct 2010, which I am VERY happy with! Am still having the odd high reading at breakfast, but nothing has been over 15 mmol/l (which again is a huge improvement, at the beginning of my tight control they were still in the high teens in the morning) and are continuing to improve.

My only issue now, is constant hypos. I saw my DN last week who reduced all my insulin down but it still isn't helping. Thing is, as soon as I drop my insulin even lower, my levels then creep up, it's a bit of a lose:lose situ at the moment. The whole issue is slightly disconcerting now seeing as I was alone at the stables the other day and I dropped to 1.2 without noticing :shock: something I never want to experience again! I had to keep checking the BM monitor afterwards to make sure I had read it correctly, never been that low before.

I'm wondering, if I'm maybe becoming a little oversensitive to my insulin? I've always been on a load of insulin, huge amounts, daily. Even though these doses are now reduced and perhaps now with my good control I'm becoming more sensitive to it? Can anyone give me any research into this at all? Tried googling but it only comes up with resistance which doesn't seem to be an potential issue for me now :mrgreen:

Am going to the drop in clinic to see my DN tomorrow to hopefully gain some advice on this, and to try another way of combating my hypos!

 

[moonstone]

Hello there, yes what you're describing is completely normal and it's something to be watched for when lowering hba1c results and tightening control. It was drummed into us on my dafne course. Keep on keeping on, you'll find the right balance. I had a similar issue and it seems my background was too low and my quick-acting was too high so I did a bit of work to gradually rebalance them (after a bit of a talking-to by a diabetes nurse and the threat of a pump). It's meant to be about 50/50 apparently (counting up your total daily dose of each), and I was more 30/70. Good luck with it

 

[Snodger]

I've just had a bit of a root around on Google scholar and you're right, it's all about insulin resistance and especially about insulin resistance in "skinny mice" which made me giggle.
The only thing I did find was something pointing out that if you get very fit (exercise etc) you improve insulin sensitivity all round. Could that apply? Weren't you saying you had started to ride again after a while of not doing?

I'm sure you know but - it's very common to find your hypo warnings reduce or change when you get tight control. Mine have totally changed and I have to keep a much closer eye on the way my head feels, if that makes any sense. Shaking, sweating, all that stuff - just doesn't happen any more. Feeling slightly stoned/in a dark tunnel/just not quite getting things - that means hypo for me now.

PS that HbA1c change is bl**dy fantastic, well done.