Pancreas working off and on?

My pancreas seems to work pretty good after a respite period created by using insulin for a few months. This is weird. Twice in the last year I have stopped insulin to check on my pancreas. Is this fairly common?

You are referring to “the honeymoon.” Since you are no longer asking it to do ALL the work, it gets a chance to catch its breath. And work…for a while.

Eventually, it will produce perhaps a LITTLE insulin. But not enough to do the job.

My honeymoon was about eighteen months. Oral meds were working well enough that mealtime insulin was not needed.

Just keep an eye on your numbers. Eventually, you will wake up and the honeymoon will be over.

Tim…I was diagnosed a year ago, but I have just seen an endocrinologist. He concurred that I have LADA and I now test once a day, 2 hours after a meal. My bs has been 88-100. I’m fine. He’s running auto antibody tests and I see him in a few weeks. I also have Hashimoto’s. have never taken oral meds. No type 2. My question to you is…did you have symptoms (excessive thirst and urination) before your honeymoon period was over. I want to honeymoon forever, dammit!!!

There’s new evidence that both insulin treatment and fasting promote beta cell regeneration for type 1s. For me this will not happen because I was at the end stage/dka when I finally got diagnosed. 2 hours of no basal and I’m in trouble. Early type 1s should stay on insulin treatment to hopefully have an easier time overall.

Further in the case of type 2, many people (Bernstein among them) have voiced a suspicion that using insulin to give the beta cells time to rest and recover may permit partial recovery. That’s one reason some (including Joslin) will sometimes put a newly diagnosed T2 on insulin temporarily.

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i had quite a long honeymoon but always had to use some insulin. for the first year it was just a couple of units of longacting, as long as i ate pretty low carb and exercised after meals. the honeymoon can be a beautiful thing. mine was stable and i learned a lot while i was in that stage. it got me ready for the real thing. enjoy it while it lasts!

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Let me be clear on this. The reason for my diagnosis was NOT just a blood test. For five weeks, I was thirsty, constantly peeing and lost 20-25 pounds. So I went to the doctor, thinking it was something else. They took a blood draw and two days later called me to tell me I was a diabetic.

I did not get a second round of pee/thirst/weight loss. I was on basal insulin from diagnosis (and oral meds for meals). So, the way I discovered I had Type 1 was a rise in A1C. It would have been much better for me to be testing more (especially around meals).

Then I would have quite rightly sounded the alarm on the end of my honeymoon. Despite what many think, insulin is NOT failure: it is reality. You can control your numbers much better with insulin (when you need it).

Now, insulin is a pain in the ■■■ (stomach, really).It is sometimes the equivalent of running a VW Bug on rocket fuel. But it’s better than nothing. And when you need it, you need it. So, I’m just giving you a heads up. Keep an eye on your numbers. They will eventually tell you the respite is over. The sooner you are aware that it’s happened, the sooner you can start to deal with it.

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I love this analogy!

My endo only has me testing once a day two hours after a meal and I’m always 80-100. He doesn’t have me doing any insulin but did say at some point I will have some mealtime insulin to begin with. I just saw him for the first time 3 weeks ago and I’ll see him again in 3 weeks. My PCP diagnosed me a year ago, I lost 65 pounds on a low carb diet, and I fast for 16 hours most days. I’m 20 pounds from goal weight. Will insulin make me gain weight? Please say no!

@LHromika – Here’s a clip from Dr. Bernstein’s Diabetes University – Note 3. Extending The Honeymoon Phase in Type 1 Diabetes - Dr. Bernstein’s Diabetes University

Most PWDs postmeal peaks are at ~75 mins. Given that most of us are most insulin resistant in the morning, you might wish to capture some peak post-breakfast numbers.

Since it appears that minimizing the risk (no guarantees, darn genetics!) of complications involves minimizing blood glucose variability, Dr. Bernstein’s goal is to keep meal spikes to 10 mg/dl. So, you might consider testing your fasting BG, too… And, whatever level of control you seek, insulin is your friend!

As always, consult your D-team!

@LHromika - Great to hear you are already on a low carb diet! That may be a great way to extend your honeymoon. But also, most T1Ds and T2s discover that low carb is the best way to smooth out their blood sugars for life. That’s what I do (30 yrs T1D w/o complications), but it took me 10-15 years to figure it out! One other thing to consider doing is to eliminate one of the big troublemakers in the human body - Gluten. It’s been implicated in T1D and other autoimmune disease. So if you were to take it off the table, you might find that your body calms down and is less inflamed. Eating whole, nonprocessed foods and eliminating grains is something I wish I’d known about before my diagnosis. Give whole foods a try…it’s a diet being tested by many with autoimmune disorders.

The question of whether insulin will make you gain weight is a complex one. The simple answer is no.

What will make you gain weight is having excess carbohydrates that your body doesn’t need for its daily functioning.

Being a Type 1 on insulin doesn’t mean you can eat anything you want. It means you can eat anything a non-diabetic can. But if you need 2,000 daily calories and you’re eating 2,500, you’ll gain weight. This is an important point that some people are missing. I need to take the right amount of insulin with my food to consume its energy. But I also need to eat the right amount of FOOD (carbs) for my energy needs.

The measure of having the right diet is the same for anyone else. If I’m eating the right amount of food for my needs, my weight shouldn’t vary that much.

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I agree, but before going Gluten Free, rule out celiac disease with a simple blood test. Celiac disease is linked to Hashi’s and TD1. A close to 1% of the population has it, but are undiagnosed. That is probably due to the fact that doctors have the preconceived notion that you must be wasting away from malnutrition. Here is more about testing and possible symptoms:

University of Chicago:

http://www.cureceliacdisease.org/screening/

Montana State University:

http://www.montana.edu/mountainsandminds/2012/fall/celiac.php

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I’m thrilled to hear this, as I have been gluten free for this whole time, as well. I’m so thankful my PCP led me to this way of eating! Hope I honeymoon a long, long time!

I agree that insulin is not why some people gain weight. I have learned the hard way. I always knew I was taking more insulin than I needed but I hated the highs and of course the lows would happen and I would need to eat. So all my extra weight was caused from me “feeding the insulin”. Once I finally felt OK with much less insulin, the lows disappeared and I didn’t need to eat all the time. And like magic the weight came off. And while this is not the answer for everyone, I really do feel much of my weight issues was just to much insulin. So please don’t put off insulin because you think you will gain weight. If the doses are correct you will probably feel much better and regret that you waited.

Yes @Cyclinglady, I agree with you on getting tested for Celiac Disease before you give up gluten, if at all possible. Unfortunately in my case, I had reduced my gluten intake substantially before my testing and tested negative. Regardless of that negative test, I discovered that I was gluten sensitive anyway and that alone is shaping up to be an independent risk factor for all sorts of inflammation and even future heart disease. So my thinking is this: test for Celiac, but then avoid gluten for your own health. Wheat is a known problem for human digestion, and modern wheat is much worse than that which was produced pre-1970. You may miss your daily bread, but your body will thank you 1,000 times over.

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Good luck! I hope your honeymoon is for life! Also @LHromika, may I ask what your A1C was upon diagnosis?

It was 5.4

Wow, 5.4 is a great A1C, @LHromika! I asked because I have a friend who I think should be tested for T1. She’s middle aged (50ish), thin, and received an A1C of 5.8. They automatically assigned her a “pre-diabetes” designation (pre-Type 2), but she could certainly be under autoimmune attack (LADA).

To diagnose LADA, she will need an auto antibody screening. Her anti-GAD numbers will be high. That signals an auto-immune disease where the body attacks the beta cells in the pancreas. Eventually no insulin (or not enough) will be produced and we will be insulin dependent. When? Nobody knows. I’m testing daily now and I’m fine. My pancreas is producing insulin, but I’m on the low end of normal.