Heres the deal. I am a 44 year old T1 diagnosed (and test confirmed) a year ago. I have an analytical mind, so my doctor and I think that I am the type that gets the drill. My A1C has hovered around 5.7. The issue is that lately, my insulin requirements have been dropping dramatically.
I went from eating whatever I felt like before my DKA coming out (a whole dominos pizza or more), to watching carbs and limiting them to about 40-50 per meal most of the time since going on shots. This worked well with about 4 units Humalog per meal or big snack, and 22 units of Lantus. So now I am in Mexico. It’s hot, humid, and the kids have me keeping active, but not that active. When home I run every 2-3 days averaging 3-8 miles at a time, coach soccer and baseball, work in the yard, etc, so I am not a couch potato.
Normally when I exercise I cut back on my humalog, but for the last couple of days I haven’t been taking any and am still avoiding highs and fighting lows. I was going scuba diving (yah yah, I know) and wanted my numbers up so I cut my Lantus from 22 to 15 over a few days, and was still so low on the boat that I ended up eating 250 to 300 carbs over a few hours to keep above 100 and was still just below that for a late lunch. I know strenuous, and I was taking it real easy and was not stressed, so that’s not it. I can chalk some of this up to activity, but it seems to be more than that.
Maybe I am cured (JK). Tomorrow I am dropping my lantus to almost half the amount that I have taken for the last 9 months up until a few days ago. What gives?
My doctor has pointed out to me several times that we are, after all, injecting a hormone into our body fat for absorption. There’s going to be some variability in how much of that insulin gets into our blood-stream, and how fast it gets there.
Another idea is how’s your sleep? If you are sleeping more and better down in Mexico (I assume you’re on vacation and not working?), then your insulin resistance might go down, down, down as sleep deprivation causes an increase in insulin resistance and getting good-quality sleep has the opposite effect.
Ditto stress reduction (lowering of your stress hormone output lowers insulin resistance over time).
Honeymooning, activity, heat and humidity, all of the above.
Also, your basal and bolus needs will change over time. I don’t think anybody on MDI or pumps has used the same basal/bolus rates for their entire diabetic lives. I’ve recently found that the more I exercise, the more likely I am to not need any insulin at certain times of the day. But I still need a megadose basal in the morning for my dawn phenomenon.
Enjoy it. The less insulin you use, the less money you spend. Keep adjusting your basal until you can go hours without going high or low. The other option would be to look at a pump. That lets you adjust all your values at a moments notice.
Sounds like the heat . I had an experience where I went to a beach in Guatemala (I lived in the cool mountain area). I walked 1/2 mile down the beach to a good restaurant that made their own pasta. I ordered raviolli a rare treat for this diabetic and sat and looked at the Pacific. Then I went to bolus and the needle broke. I hadn’t carried an extra with me. My food was on the way and I didn’t want to walk in the heat back and forth to my hotel room. So I figured I’d eat, then I’d go back and would be very high and correct. One hour, two hours, three hours, no rise and for the rest of that trip I was borderline low taking much less insulin that normal! Enjoy it while you have it. That was two years ago and I haven’t had ravioli that good since!
K . so I’m 42 and just trying to figure this out myself …
I’ve just gone through this very same thing and it was all to do with stress ,.Well …thats what I believe.
I WAS on 16 lantus in the morning and 10 Humalog at each meal or large snack…(five meals a day) 50 units of Humalog.
I CUT way back over the course of four months to this point I was now taking 4 units Lantus in the AM and 3 units of Humalog for each meal and STILL going LOW three or four times a week.
NOW on the pump ,as this was the best thing for me I had NO symptoms of lows { 1.4 (canada) and on the phone with the paramedics}.
I still do not have any idea or concrete solution to my situation.
Thanks all. I guess I will know more soon as the trip is coming to anend. It is just so strange to cut my basal dose in half after remaining constant since I initially dialed it in 9 months ago. Isn’t it a bit late to have a honey moon, it’s been almost a year, and everyting has been pretty consistent (as much as it can be).
Carribean. Between Cancun and Playa Del Carmen. Great weather, not too crowded. Went diving off Cozumel Thursday, my first diabetic submersion. All went well. Maybe I will have to move down here permanently.
I have peeked at pumps, but really don’t want to carry another thing around. Also don’t like the idea of always having a needle festering in my skin. My thinking is that as long as I am 6.0 or below, I will stick with my laxed approach. I had been getting a bit of the morning pehnom before this, and know it would be great for that. Thanks for your help
Nice, I loved Playa Del Carmen, but it was getting a bit touristy (and expensive) for me even when I was last there 15 years ago! Still, very beautiful. I decided to extend my visit by a week and called my work from a pay phone on the street where I had a view of the Carribean. I was babbling something about a virus, and being told to rest and the next flight in my price class being a few days beyond that, blah, blah, and finding it hard to keep the bliss of that turquoise blue water out of my voice! Enjoy the rest of your trip!
I’ve had a similar experience, and only been on insulin for about 3 weeks now (dx as type 1, adult onset). My endo basically told me that type 1 in adults progresses much slower, and it is likely that I am still producing a fair amount of my own insulin, although the production of it probably varies from day to day. For example, today, I have only required 2 units of insulin thus far (through 2 meals) to keep my blood sugar stable. Usually, I’m averaging about 12 units a day. I noticed that when I’m warm (i.e., in a hot room or it’s warm outside), my blood sugar drops low and can drop fast. Exercise/activity speeds up absorption.
Basically, I’m just going with the flow at this point and reacting as best I can to the changes in my body. I am also in the process of investigating the pump. Seems like the pump offers more flexibility and will better allow me to adjust my insulin dosage around all the myriad factors that can impact blood sugar levels. My endo agreed and is sending me for a pump consult.
This exact problem happened to me a little while after I was diagnosed with T1. I went down to taking 4 units a day of any insulin and still managing to have lows. My doctor even considered taking me off insulin altogether at one point. However you just have to listen to your body, and take as much or as little insulin as you need, because your needs will change all the time. After a while for me, my sugars just crept up and so I increased my insulin little by little in response. Everything will level out over time, just hang in there!
