I agree Kari, it doesn’t take me very long for my BS to shoot up without insulin.
Exactly. Even when I disconnect my pump to shower, for example, I have to give a mini bolus to cover the missed basal. Otherwise I might be go up to near 200.
If I had to ‘fast’ from insulin for even 4-6 hours, I could easily hit blood sugars of 500+. That’s without eating a thing.
I would be the same as you. When my pump was dying and started getting air in the tubing, I woke up about 4 AM over 300. I don’t know what time the air started but I usually go to bed at 11. It doesn’t take long to skyrocket.
You are right Ken!
The only reason to skip an insulin dose is to test what level of natural fasting insulin remains. For most T1s, this is a “useless” test. Exogenous insulin will “suppress” your natural insulin production to a certain degree, and that is why it is necessary to stop insulin. But this is by no means a standard test.
My experience is that I am asked to fast with no food or other nutritive liquids in preparation for a cholesterol test. And even in that case, the only level really affected is your triglycerides which surge following a meal. I actually have a dr appointment monday at 4:3pm. I “refuse” to fast. They can test my cholesterol and obsess over it without making me not eat all day, and it won’t matter anyway, cause I won’t do anything about my cholesterol levels.
So don’t skip your insulin unless you are specifically instructed and given a specific test which it will confound.
I’ve NEVER been asked to omit my insulin for labs. Granted that I am on a pump, and my basal takes care of my fasting needs, but I can’t imagine anyone telling you to omit insulin. Do they want you to start working on going into DKA? Or are they simply sure that EVERY adult is a Type 2 producing lots of insulin, who can conceivably go without if they are not eating? (I’ve been there and done that, and it wasn’t pretty).
I would simply ignore their instructions and take your basal. You COULD argue with them about it, or you could simply keep your mouth shut – what they don’t know won’t hurt THEM, it will only hurt you.
Good luck!
Isn’t it usually enough to not have breakfast the morning they are going to take the tests?
Stuart, are you sure that you are even a Type 1? Have you ever been officially tested or were you just told that? There are plenty of Type 2 kids. Even today, doctors still have a tendency to “assume” what type you are without running tests. Back when you were diagnosed, I doubt they even had those tests to run.
I know that I would be dead if I went “days” as you claim you can do without insulin. I know what happens to my body with just a few hours without insulin. When I had a c-peptide last year to get a pump, mine came back as <0.1 on a scale of 0.9 – 4.3. I know for a fact that I am not producing any insulin. Can you say the same? You must be producing some if you can go days without insulin. When I was researching information to get a pump last year, I also read a lot of stories about people who thought they were Type 1 for years and when Medicare required a c-peptide before they could get a pump, they found out otherwise. My gut tells me that you are in that category.
I personally don’t care how much insulin anyone produces but I think you owe Kari an apology.
Hello Montanasugar:
Great to hear from you! Thanks for jumping in…
What’s the deal with the “no short acting” insulin onboard for these kinds of panels/tests? . I suspected the lipids aspect but lacked the language to explain it.
So for many of the tests we typically get, there is a human manipulation factor for them? Any way they get “manipulated” that you are talking about which would potentially alter the results for these other tests potentially?
Stuart
I would definitely bring that lab instruction to the attention of your doctor and make sure the medical director of the lab you are using knows that there is likely a problem with the instruction. I have never been told not to take my insulin and that instruction simply makes no sense. Even if they wanted to check your insulin production - that is a c-peptide test and synthetic insulin would not interfere with it because it does not have c-peptides. And the others are right – some people will go into DKA very quickly. This instruction could be truly dangerous for some people.
If you have an adequate basal (or long-acting insulin), and you are fasting, you should not require any short-acting insulin. I’m having surgery on Tuesday, and it’s scheduled for 2:30 PM – they want me fasting, so I will not take any boluses, except for correction, as needed. But I’m not expecting to need any corrections, because I use a pump, and my basals are set correctly. If I had no basal, I know my BGs would go up.
Maybe your lab meant “no short-acting insulin” based on the fact that many Type 2’s don’t take a basal, and only take short-acting insulin when they eat, and are really being told not to eat, because many of them don’t understand the relation between their morning insulin and their breakfast. (Type 2’s can be woefully undereducated).
If you can go a WHOLE bunch of days without having your BG go dangerously high and/or going into DKA, you DEFINITELY have endogenous insulin production. (Not sure how many a whole bunch is, but it sounds like more than three or four). But I wonder, have you actually tried doing that, or are you just making it up?
I was on Levemir when I had my cataract surgery done. I did basal testing so knew that was set correctly. I do 24 hour basal testing with Levemir (and when I was on the pump) but I never could have done that with Lantus. Between stress & DP that morning, I needed to take some Apidra in addition to my regular Levemir amount. The nurses flipped out when they heard I had taken any insulin. When they tested me, I was in the 140s and they agreed that I needed that insulin and knew my body. I was afraid of taking too much because I did not want to have to treat a low but I knew I needed something.
OK, so if I DO need a correction, I will take it and just not tell anyone! Can’t have anyone flipping out, you know! Thanks for the tip! 
Unless you have a nurse that gets it but unless you are psychic and not telling us, better safe than sorry! Did you need one the day of your heart procedure? I can’t remember but I know you did good that day.
No, I didn’t need one the day of the angiogram, because I had set my basal 0.1 lower and was running 140-160 on it. That’s what I expect will happen on Tuesday, as well, but better to be prepared for all possibilities!
I think the 140-160 goal is a good one, because I don’t want to be 100, for example, and have some over-cautious nurse decide to hang a bag of dextrose on me while I’m unconscious. Doctors are currently confused as to what BGs should be for hospitalized patients, and it’s scary to have them make decisions while you are unconscious!
And by the way, the antibiotics are finally working, and the pain is much reduced – still feel it a little, but not enough to make me want to take a pain killer!
Plus, the medical people are not used to dealing with people in good control - we are in the minority. They probably see someone at 100 and crash!
I am glad the antibiotics finally kicked in! That has to be a horrible place to have pain in.
I’m confused too. You have to be using a basal. I did without a pump the first 16 years…but I had a basal. How can a Type 1 NOT have a basal/long-acting insulin? If you are only bolusing, you are not a Type 1 diabetic.
This has got to be a misunderstanding. Never a reason for a type 1 not to take their insulin, period. Fasting has nothing to do with your insulin. There is no way in hell that I would withhold my kids insulin for any blood test. Lots of years between them both and never been asked to do so, nor have I seen a post like this on any diabetes message board. Now, a person that can go for days without insulin is a completely different story, although I still don’t believe a lab or doctor would tell a patient not to take insulin.