Why So Perfect?

[mrburden]

Hi All,
Over 35 years of having diabetes I have been through most situations relating to living with it but I am now experiencing something quite odd.
My diabetes has always been easily upset and described by some of the specialists as "brittle" or "fragile". I have been taking quite high doses of Levemir (80 at night and 38 in the morning). About 2 weeks ago I suddenly started to get really bad random hypos (4am/7am/2pm/7pm etc) without warning, with my BG going down to below 2 and staying low for the rest of the day. The doc reduced my Levemir to 60 at night & 30 in the morning which reduced some of the hypos and now I'm on 54 at night & 30 in the morning, a reduction of about 25% over the day!
My BG is now running at around 5-7 all day. I'm very happy with this but I want to know why I'm so stable so that I can continue doing whatever is keeping me like this. I am not very active at the moment due to foot problems so unusual activity is not the cause and I have not changed my eating habits recently. The heat may be partially responsible but we've been in hotter places for periods of time in the past without such drastic effects.
Any ideas?
Thanks

 

[ebony321]

Hi,

There are a few things that can alter your insulin requirements as drastic as you have experienced a few are;

Activity
Illness
Heat
Hormones

I would say they are a common four amongst many. Seeing as you have ruled out most of the above, it leads me to think hormones. I see you have had diabetes 35 years, which makes you obviously 35+. Don't be fooled in thinking hormones stop at teenage years!

I have a slightly higher dose of insulin for my size and that's because i'm 23 and still experiencing these **** hormones, i've been advised my insulin requirements will drop when i hit around 25.

It could be the same for you. Your body is contantly changing all the time, i'm sure over your 35 years of diabetes your requirements have fluctuated over time.

Just an idea, you may not find out the cause for the drastic drop in insulin, but i'm guessing it's nice not to have to inject so much insulin, and to have excellent BG results and of course to shift those terrible hypos!

My advice would to keep going as you are, you clearly have a good sense how to react to your BG results and adjust your insulin accordingly. Your body will demand whatever insulin amount it needs to process your food and to keep your BG at a good level, this you can't really change much without drastically changing your food intake or activity levels, so enjoy it while it's here and hope it intends to stay

 

[mrburden]

Hi ebony 321,
Thanks for the reply. Yes, I'm over 35 (45 now) and never really thought too much about hormones (always thought they were for women!!). Things are still pretty good now. Still on the lower doses and yes, that is a bonus too.I wonder if I have just left the "honeymoon period" that people talk about? I might hold the record for the longest honeymoon period, eh?
The hypos have sort of helped, in a strange way. I'm being assessed for a pancreas transplant and one of the criteria is having hypos with no warning. For all the years I've been diabetic I have had clear signs, but suddenly I'm not getting any so that is a tick in a box for me.
Many thanks.
PS Could these hormones be the same things that made me buy a tandem for my 40th bithday??

 

[eddiemac]

Hi Mr Burden

I'm 35 with 25 years experience and on the same insulin and split Levimir as yourself. Thats one long honeymoon period you have had there!! A mystery to me why you suddenly start having hypos!!! Are you conrolling the amount of novorapid by DAFNE?

Eddie

 

[eddiemac]

Hi Mr Burden

I'm 35 with 25 years experience and on the same insulin and split Levimir as yourself. Thats one long honeymoon period you have had there!! A mystery to me why you suddenly start having hypos!!! Are you conrolling the amount of novorapid by DAFNE?

Eddie

 

[mrburden]

Hi Mr Burden

I'm 35 with 25 years experience and on the same insulin and split Levimir as yourself. Thats one long honeymoon period you have had there!! A mystery to me why you suddenly start having hypos!!! Are you conrolling the amount of novorapid by DAFNE?

Eddie

Not really sure of the DAFNE system but I did a course where I learned to work out a carb-to-Novorapid ratio, which may be a similar thing. I currently need 2 units of Novorapid to each 10g of carbs. Until this all kicked off I was using 2 units to 10g + 2 units on top. So during the day my Novorapid has only reduced by about 6 units all together, but it is still a reduction. The Levemir is still down by a good 25% too!

 

[eddiemac]

Yep thats the DAFNE course mate. I'm on 2 units to 1 carb portion in the morning, 1.5 to 1 at lunch and 1 to 1 at tea time. Are you doing 4 bloods a day? I find if I dont I loose all control!!

 

[mrburden]

Yes I have to test before each meal and before bed. If I mis-calculate a meal I often have to give a correction dose, or the whole thing goes out of balance for a day or two at the least. Last night was a good example - had an "african" meal out, mis-calculated the carbs and I'm 17 this morning, so had to up the Novorapid. Hope to be back to about 6-7 by lunchtime. The course was a great help, without that my BS would have been above 10 all day today and up and down by tomorrow!