When to start back on pump?

So it’s been about two weeks since I tried getting completely off insulin because even the smallest amount made me go low in this honeymoon period. The first week my waking blood sugars were in the 90s and only when I ate a certain breakfast did I spike above 160. It usually came down to below 120ish. I was very happy with these results.

Start of the second week I went on a 3 day water fast for religious purposes, my fasting blood sugars constantly were in between 95-115. After the fast, I resumed normal eating patterns, but the last 4 days of this experiment, I have noticed that my before meals bg doesn’t get below 120. My spikes still aren’t horrible, but once my pp readings peak, they just hover around 180 for hours. I concluded that I needed a little bolus to get by. I’m good with all that…

My question is the last couple of nights my sugars have been holding around 110-120 until 430, where it rises to around 150. Are these elevated enough, if they stay consistent, to get back on a small basal? I find it weird that after just two weeks, my fasting blood sugar has risen 20 to 30 points. Just wondering what the threshold is before a small basal is needed.

maybe you could look at doing a small bolus for meals - if you don't get so high after meals, your pancreas may be able to cope better with the rest of the day? I'm not sure about any of this as I was through my honeymoon before I even got diagnosed!

Yeah, we are on vacation the past few days, so my eating habits are a bit different. I am not going to start anything until I see what my numbers are once I get back on a normal routine. I woke up at 190 this morning though, so it has gotten worse. We will see…

More background (sorry if I missed posts.) When were you diagnosed? And were you diagnosed and tested as a T1? It seems really recent, which makes me wonder why you are on a pump. Your numbers are definately higher than I would strive for, but I am not having a great BG night..

I hesitate here, but fasting is not advisible for a T1. I understand the religous aspect, but really use care. Please.

I’m 25, 6’3 now 165lbs. I played college football for 5 years. I consider myself very active, diet has always been good, not excellent, but I was always in tune with what I put in my body. In December of last year on vacation I started urinating every couple of hours. Had constant dry mouth, appetite tripled, and I started shedding weight. I originally was 195. No diabetes in family. After a little over a month I had a very noticeable amount of strength loss. I could barely get my bball shot to the rim. Went to general physician on February 6. 10 hour fasting bg of 330. A1c of 11%. C peptide of 0.9. Gave me insulin pen, long and short.

Referred me to local endo. After looking at my bg numbers and how much insulin I needEd to get back to normal with all my tests, he said type 1. We didn’t like the fact that that bomb was dropped on us in less than 5 minutes and we were sent out the door with a booklets of insulin pumps. We decided to take our tests to Houston for second opinion. This endo explained everything much better, but he also confirmed the T1 diagnosis.

we decided to go ahead and try to get approved for the devices that we knew we would want. After a month on insulin, my needs decreased to nearly nothing. Took the minimum basal, and it was sending me low. Got off pump, seeing how I would react to no insulin. Worked well for a week. Then I needed to take just a bolus for meals. Now after I bolus for meals, I drop down to close to 100, but after 4 hours, it starts to rise again with no food, and settles around 180. I assumed this was me coming out of honeymoon. Thinking of getting back on small basal if this stays consistent.

I don’t think the lacksidasical (sp) approach to make yourself think insulin is not necessary and that you arr trying to guage based on your readings whether or not you need the insulin is smart. Your pancreas and kidneys will definitely pay for it later which makes me think it’s not worth the risk get a third opinion if needed but definitely take seriously the realization that your body needs the insulin even if your blood sugar reads 95.

Re the AM BG "bump" you are observing, I put an insulin "bump" in from 4-7 AM, running at 1.1U/ hour, instead of my "usual" .85U/ hour.

Hi Benjamin: You probably aren't coming out of your honeymoon, which is the time period when your remnant beta cells still produce some insulin (if you were not honeymooning, you'd hit 500+ mg/dl and go into DKA). If you maintain tight control and use exogenous insulin, even very small amounts, you can prolong the honeymoon period for a very long time, perhaps indefinitely, which is a total advantage to your health and well-being. Also, have you gotten the books "Think Like a Pancreas" and "Pumping Insulin?" They are both excellent. Good luck!

Well where do you balance needing insulin and constantly having to eat to climb out of lows? I understand the concern, but why do I need to take insulin when I was so low? Again, I am not in denial or think I am an exceptional to what everyone else has to do for diabetes. Just like every diabetic needs their own specific amounts of insulin, I think taking insulin just because I am type 1, doesn’t make sense. Right now I need insulin to cover meals. From what I have been hearing it’s trial and error correct? And the goal is to do whatever it takes to have normal readings. That’s all I am doing.

Hi Benjamin -
I agree with what others have said....it may be odd to you that right now you don't need insulin, and you may be rethinking why you need it at all, but trust us its just your honeymoon phase....a confusing and all-too-short period of time where you don't need as much insulin.

I was diagnosed at 21 (I'm 28 now) with your exact story (same 10 hr fasting and A1C to the letter, actually), and for about 6 months after my diagnosis I needed much less insulin than I do now, sometimes even none. Also worth noting that I went undiagnosed for about 3 months, thinking it was stress...so the honeymoon seems to kick in as soon as you do get on insulin and get your hormones back under control. As soon as your body feels 'safe' again it will reactivate the beta cells that it has shut down while you were at deaths door in DKA, but unfortunately your auto-antibodies will kill off those reactivated beta cells within about a year.

There doesn't seem to be a way to tell or predict how long your honeymoon phase will last, for me I just noticed a steady increase in the amount of insulin I've needed, up until a few years ago actually. The best thing you can do for yourself right now would be to invest $$ in a CGM, not an insulin pump. I had neither for the first 4-5 years, and have had a CGM for the last 4 and it makes life SO much easier. Right now I have a pump that I use on occasion, but I can do without it....the CGM, not so. Without my Dexcom I'd be a mess, and have sore fingers on top of that.
For your situation, being able to constantly know your trends while you go through the honeymoon and then level off into total diabetic-dom (sorry dude, but it's coming :-/) would really be invaluable.....

Hope you're doing alright otherwise! And don't worry you'll put the weight back on eventually, once your body settles out.

Jen

PS where around Houston are you? I was in Conroe when I got diagnosed.

I actually live in Central Louisiana. We have a limited number of specialists in our area, so when we were diagnosed, we wanted to get a second opinion. Ended up loving the doctor there so we are going to make the 3 hour journey every 6-12 months or so. Thanks for the advice! I do have a Dex, have had it for a couple of weeks now and I love it!