Two weeks ago I was taking 10 units of lantus every night and usually waking up at 90-110. This was pretty much normal for me. Seemingly spontaneously my levels started tapering lower and lower… Waking up consistently in the 70s so I would reduce the lantus dose a bit. Well I’m waking up consistently at 70-72 now according to my meter, and I’m only taking 4 units— all that’s left at this point is pretty much to stop taking it altogether… Which I’ve done in the past, but I’ve never seen my insulin requirements taper off this fast. A little perplexed, any thoughts?
You were diagnosed about 2 years ago? Sounds like honeymoon (known to be delayed in adult onset).
Yeah I was diagnosed about 2 years ago but believed I had been honeymooning ever since with only using small amounts of basal or none at all
There's a couple different things that can go on.
LADA onset with low doses is very common. Some folks call this honeymoon but this is not the classical definition of honeymoon (as explained to me about a third of a century ago!)
Classical honeymoon is where in months or year or two after diagnosis, insulin needs get smaller or may disappear entirely, for a period from weeks to months.
A lot of the published literature about later onset, indicates that honeymoon is often delayed and slower than classical "diagnosed as a kid" honeymoon.I always understood the honeymoon to be the period after diagnoses when the pancreas is still producing some insulin. In kids it may last weeks or months, in teens maybe a year, and for adults can last many years. It may not be present right away, especially if you are diagnosed in DKA, but I've never herad of a honeymoon appearing months or years after diagnosis. I was diagnosed at age 9 and my honeymoon started about a month after my diagnosis and lasted for two or three months after that (the last month was really sporadic). And I never had a full-fledged honeymoon—I still had to take insulin and had some minor highs throughout, but it was definitely a honeymoon. I think it's likely that LADA, especially, who doesn't experience DKA at diagnosis and can maintain much better control today compared to 20+ years ago, could be in a honeymoon phase for years.
Sam, are you still having to cut back your lantus? I'm down to just 6 units PM dose of levemir (equal to about 4u lanuts, i guess) and think that too will end up being too much. For me, I just think I was always taking too much.
I had reduced all the way down to 4 units and still seemed to be more than I needed so I’ve stopped taking it completely the last few days… Have been waking up in the 80s to 90s without it— don’t expect that to last for very long but right now its working… Ironic thing is that I’m really not all that insulin sensitive either-- with novolog I dose 1:5, 1:6 and 1:8 for breakfast lunch and dinner-- which is a pretty hearty dosing I think…
wow, that's crazy. yeah, just keep a watch on it, as I'm sure you know.