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Type 1 who no longer needs to inject??

Discussion in 'Type 1 Diabetes' started by Zebediah, Jul 8, 2015.

  1. Zebediah

    Zebediah Type 1 · Member

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    I am struggling to understand whats going on, so i thought i would throw it open to you all to see if anyone could shed any light on this...
    A recent thread asked how much basal insulin people were taking and i thought mine was low at 2 or 3 units. It made me wonder if i even needed the insulin. Anyway, i completley forgot my basal injection yesterday morning and i had no real change to my blood sugar readings. (i deliberatley did not take basal this morning)

    Here are some pertinent facts:
    1. diagnosed type 1 2 years ago.
    2. have been injecting for 18 months
    3. Low carbing High fat for 6 months
    4. my carb intake at each meal is only 10 to 15 carbs, mainly leafy veg.
    5. I use the Freestyle Libre continous blood glucose monitor.
    6. The button i currently have, is being remarkably accurate - within 0.2 of my check glucose measures.
    7. my readings have been and still are (even after not taking basal) between 4 and 5.8
    8. Except last night when it went down to 3.8 until i woke up - then it rose to 4.7 within minutes.
    9. i am having to pop glucose to push my sugars above 5 so i can flippin drive!
    10. As an experiment i stopped taking my bolus yesterday and today, and BGs stayed below 5.5 (bolus is normally only 1 to 1.5 per meal)
    11. My blood ketones tested at 0.3 yesterday.
    12. When tested at diagnosis i had 2 antibodies (can't remember names... GAD?)

    Is it possible i am producing my own insulin? Has anyone else experienced this...? can beta cells regenerate?

    thanks for any help
     
  2. Jaylee

    Jaylee Type 1 · Moderator
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    Hi,

    Have you lost any weight since diagnosis? I'm probably wrongly thinking lowered insulin resistance..
    Or the old "honeymoon" period.?

    What ever your doing? Fair play!

    Edit. As far as I know. Beta cells cant "respawn".
    Your LC might be taking the edge off the D.! :cool:
     
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    #2 Jaylee, Jul 8, 2015 at 2:43 PM
    Last edited by a moderator: Jul 8, 2015
  3. Zebediah

    Zebediah Type 1 · Member

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    Yes. i forgot to mention that. i have lost 2 stones whilst low carbing (last 6 months).... taking me to about 24 BMI.
    with regard to insulin resistance i generally inject one unit per 10 grams carbs... and that has been right for 2 years.... except the mornings when i struggled to be able to keep BG's down.
     
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  4. Jaylee

    Jaylee Type 1 · Moderator
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    Cool. I like to explore all the variables without touching on "false hope." ;)
    See my edit up stairs. Our posts kind of crossed..

    There are more knowledgeable than me that may have a different view..?

    But I'm thinking the honeymoon with the lowered insulin resistance.. The LCHF diet is doing immense favours too! :)
     
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  5. tim2000s

    tim2000s Type 1 · Expert
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    Given your age @Zebediah , this sounds suspiciously as though you are in fact a type 1.5 or LADA rather than a full type 1, and the use of insulin has protected your beta cells to the extent that they can cope without needing additional insulin for the time being. @Ian DP may be able to comment!
     
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  6. azure

    azure Type 1 · Expert

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    I'm tending to agree with tim2000s. I also noticed you were diagnosed two years ago, but have only been injecting for 18 months. Did you manage without insulin for those first 6 months then?

    I'm fascinated to know more. Your sugars are certainly very good.
     
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  7. Ian DP

    Ian DP LADA · Well-Known Member

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    Hi zebedeia
    Sounds very much like you are a T1 in the honeymoon period, often referred to as LADA, seems to me that you are very much producing some insulin yourself, this is normal for us in the honeymoon period. I often have BG readings similar to yours, my carb intake is about the same as yours. I am a T1 in the honeymoon period and not on insulin yet. Diagnosed nearly two years ago, I have been following Dr Bernstein solution for a year now, it is working for me, and my diabetic consultant told me last week to carry on with it, as it is clearly working.

    Dr Bernstein has said that he has seen beta cell regeneration in some of his patients. But most say it is not possible. Mine seem to have been stable over the last year, can't really tell if they are any worse or better.
     
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  8. nmr1991

    nmr1991 Type 1 · Well-Known Member

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    I've stopped taking my basal for a few days at a time, it hasn't really made much difference but after a week of no basal I can sort of feel the effects, adding on to my existing depression and anxiety, heartburns and stabbing pain in the chest, those are the sorts of withdrawal symptoms i'd expect from not injecting lantus for 3 or more days. But I cap it at 3 days for now, and I still see no reason to inject it, i see no visible change in blood glucose. And I do think 2 years is a bit further along to have a honeymood period still - hell maybe my pancreas is still producing beta cells but my body is still attacking them and some still get through?
     
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  9. tim2000s

    tim2000s Type 1 · Expert
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    @nmr1991 - what are your ketones up to when you stop injecting insulin? Its worth bearing in mind that insulin's effect is multiple - it allows you to metabolise glucose but also controls fatty acids. Your symptoms sound a lot like DKA, which in theory shouldn't be happening, but it's worth checking.
     
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  10. Zebediah

    Zebediah Type 1 · Member

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    Many thanks for your replies.

    in answer to the questions and also below a bit of an update after talking to my diabetic nurse :

    Azure: Yes i managed for about 6 months without insulin, just tablets. I actually asked to go on insulin because i read that its worth trying this to protect beta cells.... i presumed this didn't work - but i was eating based on the prescribed high carb "eatwell" plate until January this year.

    Ian: i have read Dr Bernstein, and i vaguely remember him talking about possible regeneration of cells.

    Tim: My blood ketones were 0.3 on Tuesday night - but i have run out of sticks. see below - my nurse agrees with you.

    by the way my last HBA1c was in April this year and was 5.4%

    I just spoke to my diabetic nurse. She says its unlikely that cells have regenerated, but it may be residual cells coping better now i have lost weight and am eating fewer carbs.. pretty much what you guys are saying i think. Interestingly she wanted to know about my ketones. i now have an prescription to pick up later to get some more blood sticks. I wanted it in my notes that i am currently not injecting because i was having to pop glucose to get above 5 so i could drive! I have to say my DN is very supportive of my low carbing and has been a real help to me since i have been seeing her. I just wish there were more in the NHS that understand how carbs affect us.


    thanks
     
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  11. Jaylee

    Jaylee Type 1 · Moderator
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    Sounds to me like you have a sensible well rounded handle on what's going on with great support from your nurse too! :cool:
    Keep us posted on how you are doing.. :)
     
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  12. Ian DP

    Ian DP LADA · Well-Known Member

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    He says he has seen it in patients when there BG levels are constantly in the 4.6 fasting and 5.6 2hrs after meal range.

    I think gradually, slowly more NHS staff are coming around to the low carb way.

    I asked my diabetic consultant last week why he didn't tell me about very low carbing when I was diagnosed, knowing how well it can be for patients. He said very few patients can manage very low carb, but that if anyone wishes to do low carb the hospital will help and support them. He had never heard of Dr Bernstein. He made a note of his name, after I told him I thought he was probably the most eminent diabetic Dr in the world and has thousands of patients, and I had been following his guidelins for a year.
     
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  13. nmr1991

    nmr1991 Type 1 · Well-Known Member

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    I always check my ketones when I don't feel too good even when my blood glucose levels are within range. And I did test my ketones during that time I was feeling symptoms of possible DKA but there weren't any ketones present when I tested for them. Never had ketones in my life, well as far as I have tested for them that is, for the times I haven't i'll never know.
     
  14. Zebediah

    Zebediah Type 1 · Member

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    Update:
    I still have no sticks to test my blood ketones. But i found some urine testers and my ketones registered 4 mml. which i think is moderate to high ?
    My blood sugars are still ok though. going no higher than 5.6 after a food (albeit low carb). interestingly my BG's was below 4 during the night (3.5 - 3.7) even though i am not injecting still.

    I have maybe lost about half a pound of wieght in the last 3 weeks.

    So, i have a new question for you veterans : Should i be worried about these ketones when i have normalish blood sugars? My DN was aking about my blood ketones, so i guess she rates it as important. At what point does ketoacidosis kick in?
     
  15. Ian DP

    Ian DP LADA · Well-Known Member

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    My understanding is you don't have to worry about keytones when you have low BG readings (which yours are). I have seen 4mmol keytones readings before with low BG readings. This means you are ketogenic, and thus running off fat rather than glucose. You probably have more long term energy levels now than before, maybe not needing to snack between meals like you maybe used to, these (amoungst lots of others) are the benefits of a ketogenic diet.

    Are you wanting to loose weight, if so good, well done. If not you may want to consider upping your fat intake.
     
  16. Zebediah

    Zebediah Type 1 · Member

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    Thanks Ian
    Yes i am trying to lose another stone. I do have more energy and don't have Dad naps after dinner anymore. Generally i have found hunger is not part of my life since cutting out carbs... its brill :) just very shocked to find my body is coping without insulin.
     
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  17. tomfalc

    tomfalc Type 1 · Member

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    Long term insulin can take several days to stop having any effect after you stop taking it, so keep an eye on your levels. Good luck with it though.
     
  18. Zebediah

    Zebediah Type 1 · Member

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    Thanks Tom. I may be just starting to edge up with my readings. I was averaging 4.7, this is now approaching 5. Blood ketones steady at 0.3 ish.
    It could be that there was a residual basal dose in me...
     
  19. cz_dave

    cz_dave Type 1 · Well-Known Member

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    Hi Zebediah,

    I think I am in somewhat similar situation except for the ketogenic diet. I was diagnosed diabetic in November 2014 and as T1 in honeymoon phase in March 2015. Some people here have suggested I am LADA.

    I found I am able to process up to 20g carbs without injecting any NovoRapid and still not go over 5.6. I tried to go very low carb a few months ago but felt strange after a couple of weeks - and I am still not sure why.

    By the way, I stopped taking my basal insulin during my brief ketogenic phase and I found that my fasting BS went from 4.7 to 5.2 after a few days, so I resumed taking it.

    Currently I eat about 100g carbs per day and inject 1 or 2 units of NovoRapid before eating. I also inject 6 units of Levemir per day. I am not sure if I should start another experiment with going very low carb.

    I would be interested to learn if you had to overcome any difficulties when going ketogenic. Also, what do you typically eat?
     
  20. Zebediah

    Zebediah Type 1 · Member

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    Hi Dave
    Thanks for your reply.
    Regarding my diet.
    I typically skip breakfast. i am not hungry and any carbs at all before 11am push my bg's up. Lunch is green leafy salad with olive oil and some protein such as tinned fish or sliced meat. usually with a lump of cheese and some mayo.
    evening meal is whatever my wife cooks (and i'm grateful for it!) with the carbs subbed out for leafy green veg. eg pasta with meat bolognese sauce becomes sauce& meat & salad & cheese. Burgers and chips becomes burger (without bun) & salad or butter fried cabbage.
    often i am too full for pudding. but my favourite is full fat greek yogurt with double cream and a few blueberries....
     
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