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My insulin requirement has dropped Why?

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John Epton

New Member
Relationship to Diabetes
Type 2
After successfully controlling my sugar levels for many years with 8 units of insulin in the morning and 12 units at tea time, I have recently had to drop my levels to 4 in the morning and 6 at night to prevent hypos. This is still too much and I need to reduce it further - perhaps to zero.
Could anyone explain why, over a period of 6 weeks, my insulin requirement has dropped?
Thanks
 
Hi John, welcome to the forum 🙂 What insulin are you on? It's not unheard of for people to experience increases in insulin sensitivity, even after a number of years. Has anything changed at all recently? Have you been more active, lost weight or made any changes to your diet? Hotter weather can also cause an increase in sensitivity. I experienced a significant drop in my insulin requirements a few years ago, dropping from 20 units of lantus to zero units. How long have you been diagnosed?
 
Hi thanks for replying.
I am taking Humalog mix50.
I was diagnosed in June 2009 after pancreatic surgery for cancer in 2000 and several liver resections and ablations between 2000 and 2008.
There have been no recent changes in diet or exercise levels and the insulin changes started before the weather warmed up.
 
I'm presuming you still have a pancreas given your diagnosis was 9 years after the surgery. It is strange, but possibly you have recovered some beta cell function in your pancreas and are now producing more of your own insulin? Do you experience the lows at particular times of the day? What does your nurse/doctor have to say? A puzzle, definitely! I hope things settle down for you soon. 🙂
 
I had a Whipple's procedure so still have part of my pancreas.
I get my lows first thing in the morning now my readings are between 3.0 and 4.0 compared to between 5.0 and 8.0 before.
I also get them mid to late morning.
My GP and diabetic nurse can offer no suggestions.
 
I know this sounds like a cop out, but insulin requirements do just change for no meaningful reason. If they're decreasing, generally that is a Good Thing, assuming you modify your dose accordingly, which you have done.
 
Absolutely they change over time - sometimes up and sometimes down - hot or cold weather can exacerbate it. However whether it's heat or cold, the body does acclimatise - I always use the red hot fortnights we used to spend on the beach in Southern Crete.

The first few days my needs would reduce a lot and stay very low for a week or so - then the last few days, it would go back up again to normal pre-holiday levels.

So I don't really think it is wholly that, but the weather may have exacerbated it.

However, you can only do what you have been doing BUT!! - it does need mentioning to the Head Honcho you see about this - so if you don't have an appointment soon - get on the phone to his secretary and get one made.

If you have recovered some of your own output it would be great - but the mixed insulin it sounds like you are on at the moment, may not be the ideal bedfellow with your changed body - so it may mean a change of regime. Anyway - it needs discussing with a bloke that knows the ins and outs of it, doesn't it? The devil is usually in the detail of these bodily glitches, whatever they may be.

I take it incidentally you are only classed as Type 2 because of the circumstances of your pancreatic lack of function - that because it wasn't auto-immune it isn't classed as Type 1 - whereas you don't have any of the 'normal' T2 markers eg metabolic syndrome or insulin resistance - because you are on very low doses for a grown man anyway - T2s normally require one heck of a lot more than a T1. I may only take 8-ish units of basal a day - but I still take another c.10 units for the c.100g carbs I eat daily - whereas you are going to be bigger than my 9 stone 5ft 3 package anyway I should imagine? and most likely eat quite a lot more carbs daily? - so if you were T1 I'd expect you to need more - and T2 could easily be 2x or 3x as much.

Just keep testing - frequently! - and adjusting doses accordingly until you can get specific advice.
 
I've only been T1 since last October but my insulin requirements have dropped like a stone. Basal from 16 to 2 units of levemir and Novorapid from 1 to 5 to 1 to 12. I'm not complaining.
 
I seriously wonder how long all the internal bits of anyone's body REALLY take to heal after a serious operation? Yes an lot of them are done through so called 'keyholes' these days - but it doesn't lessen the trauma of actually cutting out bits of it, and then joining the raw edges inside back up again.

So maybe John - it's just a sign that your innards are now as good as they can get post-op?
 
Hi all
Thanks to you all for taking the time to respond. Your comments have all been very helpful.
John
 
Just a quick update.
I am now taking no insulin but still getting the occasional low mid morning!
Am I still a diabetic?
John
 
Just a quick update.
I am now taking no insulin but still getting the occasional low mid morning!
Am I still a diabetic?
John

It's hard to say for sure! Your history is certainly unusual, and it sounds like the beta cells in your pancreas have recovered, as you are clearly making sufficient insulin now to cover your needs! 🙂 There is a test that they can do to determine how much insulin your body is producing - it might be worth requesting this. My pancreas recovered to some extent after 4 years, it sounds like you've gone one better! If your lows are around 3.3 then that is a lower limit for a non-diabetic and shouldn't be a concern

What does your GP have to say about it?
 
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