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Living without taking insulin, an experiment

Hi Adam!

I'll follow your experiment with interest. However, I can assure you it will not work and you do need to inject at least your basal insulin.

How do I know for sure? I have LADA and I have been able to chart my increasing need for insulin as the condition progressed. I managed on diet and exercise for a little under a year while I was misdiagnosed as Type 2. I was eating far fewer carbs than you are aiming to eat - no more than 10g at any meal and this included the vegetables! I was still producing some of my own insulin but it was not enough. By the time I was properly diagnosed and went onto insulin, I was really quite ill. I first went onto just basal but within 3 months I needed to inject with meals too.

You've had diabetes most of your life I guess and are interested and excited to understand more about how your body works with the condition, but many of us have seen the progression at first hand and without insulin, it isn't pretty.

Take care of yourself and make sure you abandon the experiment as soon as you see it isn't working.

Smidge
 
I will also be following this with considerable interest. As an endurance runner/cyclist I want to be abel to utilise my fat buring metabolism effectively, which of course means ketosis and very little circulating insulin.

One of th ethings I'm routinely doing is slashing both basal and bolus doses the morning of a long run/ride, but I'm still finding the need to take in copious quantities of carbs.

What I am thinking about doing is having zero insulin either bolus or basal on the morning of a long run/ride and relying on the previous evening's dose to mop up the carb rich breakfast and then hopefully go off my fat reserves. Addenbrookes has a very good DSN who specialises with athletes, adn I was planning on discussing it with her.
 
The question you need to ask yourself is would a non diabetic person who adopted your regime require their fully working pancreas to produce more than zero insulin. The answer is undoubtedly yes.

On a 25% carbohydrate regime or roughly 125g of carbohydrates a day you will undoubtedly need some insulin. Even if you eat zero carbs you will find you will need insulin in far smaller quantities because you will need to start accounting for the protein in your diet.

Although I am T2 my son is T1 who on occasions does a sub 30g regime with considerable exercise for extended periods. While he cam dramatically reduce the amount of insulin he needs he still needs some. Likewise my nieces husband is T1 he cycle's an average of 20 miles a day and also follows a strict very low carb regime and again he can dramatically cut his insulin but not eliminate it entirely.

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I think we are missing a fundamental point here Adam, as we know insulin helps the glucose to move out of the blood and into the body’s cells so how is this going to be possible if you don't inject any insulin?

Undoubtedly we've all seen the benefits of exercise with regards to low insulin usage but we simply can't live without insulin, no experiment is worth putting yourself in danger so best that you don't go ahead IMHO.
 
As well as glucose transport, insulin is used to transport amino acids into cells during cell division. Errors during this process can cause genetic mutations, which themselves are the cause of cancer. I work in oncology research; don't mess with this process. Stop taking insulin at your peril.
 
But if you lower your carbs enough, can you go into ketosis and utilise your fat burning mechanism?

When I'm approaching a 40 miler, that's my aim.
 
As much as I really do genuinely admire your n=1 experiment and the reasoning behind it-please be careful! I ultra low carb but still need my injected basal insulin no matter how low my carb intake is as like others have said-protein does have an insulin requirement.
 
Dave, I expect so, but I don't know. The point I was making was that you are increasing your risk of cancer by not having any insulin in you. This is irrespective of the source of energy your cells are using.

As Paul has said, I low carb and exercise frequently, but I still need basal and bolus insulin.
 
SamJB said:
Dave, I expect so, but I don't know. The point I was making was that you are increasing your risk of cancer by not having any insulin in you. This is irrespective of the source of energy your cells are using.

As Paul has said, I low carb and exercise frequently, but I still need basal and bolus insulin.
Click to expand...

That would be enough warning for me Sam:(
 
Off Topic (would pm but haven't worked out how to do it in the new format)
Sam,
That's interesting and something I hadn't considered, something new to look up.. any references?. ( in the middle of a genetics course and writing an essay about genes, chance and cancer at the moment,)
 
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Like Smidge, I was a mis-diagnosed type 2 initially. I got to the point where eating just a couple of lettuce leaves and a small tomato would put me up into double figures on a regular basis so I agree you will at least need some basal even if you manage to do without the bolus.
Keep checking for keytones too as mine were high even though my figures weren't drastically high all the time.
Angie
 
phoenix said:
Off Topic (would pm but haven't worked out how to do it in the new format)
Sam,
That's interesting and something I hadn't considered, something new to look up.. any references?. ( in the middle of a genetics course and writing an essay about genes, chance and cancer at the moment,)
Click to expand...

None to hand sorry, Phoenix. It's just what I know from work. I can have a look in work tomorrow, I could do with brushing up on my molecular biology. The standard book for this is Molecular Biology of the Cell by Roberts et al. I expect there will be something in there.
 
And by contrast, as I've finally managed to get some consitency to my exercising over the last week, I've had four of the last 5 days with all readings lower than 8, adn on the other day, I know where I screwed up.

It is truly amazing how consistent exercise affects blood sugars and insulin sensitivity.

@sam, interesting with the cancer reference, however what is the specific increase in risk you're talking about, adn how would that compare, for example with a double scotch every night, or 5 cigarettes, or a bacon sandwich every day?
 
Specifically, I don't know. There are other amino acid transport mechanisms so you may be lucky and not get any mutations, but why risk it? This experiment is a bit paradoxical to me, but each to their own.
 
Sam: The 2002 of the book is online though TBH not sure if tells me much. At the moment my essay is mostly about people being unlucky enough to have '2 hits'.

Back to the original post,
No-one can keep up heavy exercise and strict dietary regimes day after day without a break. As soon as you stop then you will not be able to get your glucose into the cells. Muscle cells can indeed obtain glucose from the blood during and even after exercise without insulin but you can't keep going indefinitely. Insulin also acts as a brake on ketosis , no insulin and ketones will rise. (you can starve and have high ketones and low glucose levels if you don't have enough insulin)
If you are ill, or even have a small injury your insulin needs will rise Even if you are totally healthy,whilst exercising you will cause small amounts of damage that need proteins to 'mend' them. Insulin is needed for transport of proteins into the cells to repair that damage.
I know you are keeping watch but I do wonder why you're not just attempting to get the best possible control whilst taking the right amount of insulin for the diet/exercise you are comfortable with,
 
An interesting idea but I also don't think it could work.

As someone who low carbs (less than 30g per day) I also notice a drop in my insulin needs when exercising and for the following day. However I don't believe I could get away with no insulin as I've found that protein and fat both cause a rise in my sugar levels (obviously carbs do too) so I would not be able to eat anything without taking some sort of insulin.

I have heard of type 1s only taking basal with a low carb / high exercise regime but I haven't experienced this as I was on a pump when I started low carbing.


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Before insulin was invented starvation diets were the only way to try and save diabetics, but not very well. Reading this would definitely put me off stopping my insulin...

" In the early 20th century, diabetologists such as Dr. Frederick Allen prescribed low calorie diets-as little as 450 calories per day for his patients. His diet prolonged the life of people with diabetes but kept them weak and suffering from near starvation. In effect, the most a person afflicted with diabetes could do was blindly offer himself to the medical establishment and pray for a cure. In his book, The Discovery of Insulin, Michael Bliss describes the painful wasting death of many people with diabetes before insulin: "Food and drink no longer mattered, often could not be taken. A restless drowsiness shaded into semi-consciousness. As the lungs heaved desperately to expel carbonic acid (as carbon dioxide), the dying diabetic took huge gasps of air to try to increase his capacity. 'Air hunger' the doctors called it, and the whole process was sometimes described as 'internal suffocation.' The gasping and sighing and sweet smell lingered on as the unconsciousness became a deep diabetic coma. At that point the family could make its arrangements with the undertaker, for within a few hours death would end the suffering."

Taken from http://diabeteshealth.com/read/2008/12/17/715/the-history-of-diabetes/

Regards
Angie
 
Adam does say that his doctors are involved in this experiment with him, but I am very surprised that any doctor would have anything to do with this. Now, if Adam is actually LADA rather than Type 1, he might have enough residual insulin production to make a basal-only regime a possibility with hard exercise and a very low-carb diet. The insulin he is on is a good one for that type of approach as it has a very distinct peak at about the 6 hour mark and allows you to time it so the peak covers two of your meals if you split the dose morning and evening, but it isn't suitable for a full Type 1 and will only work for LADA while there is enough residual insulin production. Stopping the basal as well would be madness.

Smidge
 
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