1. Get the Diabetes Forum App for your phone - available on iOS and Android.
    Dismiss Notice
  2. Guest, we'd love to know what you think about the forum! Take the Diabetes Forum Survey 2020 »
    Dismiss Notice
  3. Diabetes Forum should not be used in an emergency and does not replace your healthcare professional relationship. Posts can be seen by the public.
    Dismiss Notice
Dismiss Notice
Find support, ask questions and share your experiences. Join the community »

Puzzled/confused/irritated - the normal diabetic

Discussion in 'Diabetes Discussions' started by Seacrow, Jan 23, 2020.

  1. Seacrow

    Seacrow LADA · Well-Known Member

    Messages:
    264
    Likes Received:
    114
    Trophy Points:
    63
    Sorry, this is long.

    Some background:
    Dx 06/01/2003
    Type 1 diabetic - positive GAD test
    Severely insulin resistant - usual daily dose about 400u
    Medication - insulin, no other diabetic drugs

    I have Recurrent Vomiting Syndrome, and had an attack this weekend. (Basically rvs makes you spend 6-8 hrs continuously crawling into the bathroom to throw up, then back to try and rest. Fluid intake of any kind triggers more puking, producing dehydration). Anyway, early on I puked on the pump, so removed it and handed it over to poor husband for cleaning.

    So Monday morning, I wake up with a hypo. I have had ZERO insulin for over 24 hrs, OK, also no food but... Have not yet put pump back on. After serious thought I assumed this is my liver restocking its sugar after a liver dump I was unaware of.

    Monday evening. Hypo. Still not put pump on, but am eating small amounts (2x toast, pot yoghurt). Beginning of confusion.

    Monday/Tuesday midnight. Ditto. That's right, hypo with no insulin. This time I checked with the Libre and two other devices. Beginning to think What's going on?

    Tuesday morning. Reinstalled pump, fortunately had the idea to reduce basal rates, and since I hate hypos, I went to 50% of previous. Had lunch, bolusing about half what I normally would. Another hypo. Decided against dinner. Another hypo in night.

    Wednesday. I'm just about keeping it under control, down to about 30-40% of previous doses (which have been steady for over a year). All Libre bg graphs just show a continuous steady downwards trend, only spiking when I eat at hypos.

    What the heck just happened to me?

    Any ideas, anyone please. Can 48 hrs of no food/energy intake 'reset' insulin resistance? I don't mind if my insulin dose goes back up, but if it crashes again I'm in danger. It's only because my husband was scanning my arm that two of these hypos were picked up.

    Edited by Mod
     
    • Hug Hug x 2
    #1 Seacrow, Jan 23, 2020 at 12:25 AM
    Last edited by a moderator: Jan 23, 2020
  2. Seacrow

    Seacrow LADA · Well-Known Member

    Messages:
    264
    Likes Received:
    114
    Trophy Points:
    63
    Sorry for the language mod. And I even thought I was keeping it down! Will do better, I promise.
     
    • Like Like x 1
  3. DCUKMod

    DCUKMod I reversed my Type 2 · Master
    Staff Member Administrator

    Messages:
    11,388
    Likes Received:
    6,665
    Trophy Points:
    298
    No worries. I read it as utter frustration. It happens.
     
    • Agree Agree x 1
  4. Brunneria

    Brunneria Other · Moderator
    Staff Member

    Messages:
    19,102
    Likes Received:
    33,121
    Trophy Points:
    298
    @Seacrow

    Firstly, your vomiting sounds horrendous. What an ordeal. Do you get it happening often? What a cruel situation.

    Regarding your insulin needs, how about this as a theory (but that is all it is...)

    The more insulin we use or produce, then the more insulin resistant we may get. IR varies from person to person, and there are many factors involved. As I am sure you know, T2 is a condition of IR, but T1s can and do experience it too if any of those many factors get involved. Sometimes T1s find that their insulin resistance grows in proportion to the amount they have to use.

    What if your illness, and not eating, and therefore reducing your insulin usage, caused your IR to drop? Therefore your body is suddenly making more and better use of insulin and not needing as much?

    If that theory is correct, your IR (and therefore your insulin needs) may rise again as you return to your normal way of eating.
     
  5. Seacrow

    Seacrow LADA · Well-Known Member

    Messages:
    264
    Likes Received:
    114
    Trophy Points:
    63
    So, no food AND no insulin drops the IR. Explains why previous vomiting attacks, where I kept basal insulin going, didn't have the same effect.

    Sounds plausible. It can't be quite that simple though, otherwise thousands of type two diabetics would be fasting for 48 hrs and reaping the rewards. Maybe you need to actually 'run out' of insulin, and a lot of type two's still produce some.

    I'm now down to 20% of my 'standard' doses and still going hypo. I just ate an entire bar of chocolate, and an hour later my bg has gone up by a whole 5 mmol/l. I've suspended my basal again. It sounds like a dream to suddenly not need insulin and wave bye to the diabetes, but it's actually just causing more stress.

    Yep, RVS is absolutely horrible. At diagnosis I was spending 18 hrs throwing up every fortnight, and another day and a half recovering enough to keep down food. I told my GP I was losing the will to live. It's a funny condition, only appears in people with a history of migraines. One of the current theories is that its an abdominal migraine, as opposed to a head-based migraine. With medication I'm down to 8 hrs a month.
     
  6. Brunneria

    Brunneria Other · Moderator
    Staff Member

    Messages:
    19,102
    Likes Received:
    33,121
    Trophy Points:
    298
    While agree with you - diabetes is never simple :) thousands of T2s do fast (known as intermittent fasting) and reap significant rewards. Also, reducing insulin resistance is one of the main drivers for T2s choosing to go keto or low carb.

    But yes, as I said above, it is a very complex thing. My own situation is that I have IR even without eating, due to PCOS and medication and a prolactinoma. Other people have other factors in play. Ceasing to eat is just one.

    I tend to view IR as a sliding scale. Some people live with none, other people live with a baseline well above that. But daily life, exercise, food choices, sleep quality, medication and other health conditions all play a part over and above that personal baseline.

    Having said all that, my post was just a theory about what may be happening in your situation. I'm not T1 and I don't inject insulin, so there may be suggestions that your fellow T1/LADAs may come up with that would never occur to me.
     
  • Meet the Community

    Find support, connect with others, ask questions and share your experiences with people with diabetes, their carers and family.

    Did you know: 7 out of 10 people improve their understanding of diabetes within 6 months of being a Diabetes Forum member. Get the Diabetes Forum App and stay connected on iOS and Android

    Grab the app!
  • Tweet with us

  • Like us on Facebook