T1 Who wants to come off insulin

I was wondering if it would be possible to come off insulin if I ate very low carb and excercised enough to keep my bg down? Has anyone ever tried this? What are the risks if I decide to try this?

Simply put? No, that is not possible. Your body no longer makes insulin everyone needs insulin to live. The only time this is possible (and perhaps you heard of this?) is when someone is in their honeymoon period. I see you are ten years into diagnosis. If you have been using insulin for ten years and maintaining decent blood sugars, you need to continue doing so. You can, if you want, reduce your insulin needs by eating very low carb and exercising, but you will always need insulin. Unfortunately that is what Type 1 is about. If anyone told you different, they are ignorant. Sorry to be so blunt and I know that this is not what you want to hear. Perhaps you can talk a bit about why you are asking this?

Your most immediate risk is going into DKA

http://en.wikipedia.org/wiki/DKA

When you're not getting insulin, this can happen even if your BG isn't that high. I wouldn't recommend it.

Hi Unknown Diabetic. Your profile says that you were diagnosed in 2002, so you are clearly past the honeymoon stage. It would be extremely risky to go off insulin. Testing often, you can lower your basal and your boluses gradually as you lower your carbs and increase your exercise. Please don't go off cold turkey, and test, test, test. The risk if you try? DKA.

My mom used to try and get me off the insulin in many "cures" at the time. I just want to tell u that that's not the best desion at all. U really rick DKA during that. If ur a Type 1 u will always be insulin dependant. Sorry to give u the bad news but PLEASE don't try that!!!

That is not physically possible. T1s produce little to no insulin. You don't just need insulin to break down foods, but also for your body to perform basic metabolic processes associated with life. Dr. Allen was able to keep a handful of newly-diagnosed T1 diabetics alive on his starvation diet, but in hindsight, his diet was likely just taking advantage of the honeymoon period generally experienced after the onset of T1. His starvation diet just made it possible for some folks to stay alive a little longer. But even if you ate NO carbs and exercised like a fiend, your BG would still go up and you would still go into DKA and eventually die without insulin.

Why would you want to do this?

Here is a news article and Wikipedia link for a case of a T1 going off insulin. I will play the role of spoiler: The parents refused to provide their T1 daughter insulin believing that thier faith would save her. T1 daughter dies and parents have been convicted of criminal charges.

http://www.nytimes.com/2009/10/08/us/08sentence.html

http://en.wikipedia.org/wiki/Kara_Neumann_case

Years ago I found a self-published book online about a guy who was diagnosed with T1 and refused to take insulin. He went on the old school, pre-insulin diet of boiled veggies. I regret not buying the book because I haven't been able to find it since. I think it would take extreme discipline, and even then any highs would take a long time to come down without insulin.

I doubt this VERY highly. I got sick with a kidney infection last week and my blood sugars ran in the 400s for DAYS. It’s not only about the food you eat. Your blood glucose can rise under a variety of circumstances.
Eric

I pretty much agree with most comments proffered, a few additional things: what about when you get sick? Or incapacitated in some way that prevents exercise? If you do go off insulin (though I'm recommending that you don't), I would make sure to always have spare insulin around... and just a point about exercise (though I might be wrong), the blood glucose lowering effect is caused by faster insulin circulation/ distribution to cells, too!

Even exercise is iffy. For the last two weeks, every time I walk my BG goes up. I used to be able to walk down a high BG; now it just gets higher. I'm frustrated!

Yeah, same for me. Some forms of exercise will make me go low, but some have the opposite effect and make me go high. From what my endo recently told me, this is a specific issues with T1s. T2s generally still produce some insulin, so exercise will make them more sensitive to the insulin produce and therefore bring down BGs. However, because T1s produce no insulin, if we don't have enough injected/infused insulin circulating in our system, exercise can actually cause our BGs to RISE because of the other hormones that are frequently released during intensive exercise. I know when I go out for a fast-paced run or do any kind of sprinting or any physical activity that causes some sort of adrenaline rush, my BG goes UP.

Before the discovery of insulin, doctors found that a near-starvation diet of a few hundred calories per day helped to extend some patients' lives by a year or two. Most diabetic patients were severely malnourished and very few weighed much more than 70 pounds towards the end of their illness. So it's not impossible ... but only if you want a life expectancy under 5 years.

Before the discovery of insulin, T1's could live for a month to (in a few very exceptional cases) a year or two without insulin, on a super-duper extreme starvation diet.

Typical "compliant and long lived on super extreme diet" T1 patient before insulin, and after insulin, illustrated below. Few were this succesful. Read Bliss's "The Discovery of Insulin" for details.

That's why I don't exercise - just another crazy variable to add to the already crowded mix of things that can affect my blood sugar.

Just kidding....sort of.

Is something bothering you so much that you want to risk death rather than take insulin? What is up ?

Please, Please DO NOT TRY THIS.

God bless, Brunetta

Interestingly, I have been advised by doctors in the past to simply avoid strenuous exercise because it would make managing BGs too hard. For me, personally, that is not an option because I love to be physically active. I have just found a way to work around my BGs (or work out in spite of them). For me, at least, this has been a huge incentive to logging and reviewing data, something I probably would otherwise not be as diligent about.

As to the "why" some people want to do this... societal, family, or work pressure to get "off insulin".

Societal or family pressure... it's not as bad today as it was 30/40/50 years ago but there is still a lot of shame in being "dependent" on injected drugs.

Work pressure... There are still many jobs that insulin-using diabetics are simply not allowed to do. Of course if I don't use insulin, I'm dead, and it's hard to do the job then too :-)

Understood, Tim. I'm just with Brunetta in that I hope the OP will tell us what is behind his desire to go off insulin so maybe we can help him with that issue.