Insulin sensitivity

[Northerner]

Not entirely sure what's going on at the moment. I'm finding that I'm having to reduce my insulin by up to 40% and still getting quite low readings. I'm not being particularly more active at the moment, although I am generally pretty active - as my running has only increased marginally in recent weeks I would have only expected a marginal reduction in my insulin requirements, but seemingly not! For example, for my evening meal last night I had 11 units novorapid. The same meal a couple of weeks ago required 18 units!

Has anyone else experienced such a dramatic decline in insulin requirements? I don't think it can be 'honeymooning' as I'm 9 months into my new diabetic experience.🙄

I'm conscious of the fact that my levels are pretty low and worried about losing my awareness. Today I measured 2.4 without any symptoms at all. Might have been a meter glitch - I didn't retest as I was just about to eat my lunch.

 

[Copepod]

Honeymoon phase

Just done a bit of googling on the topic - Diabetes UK just says that teenagers should expect to have "honeymoon phase" explained to them by their medical team (and no mention that adult type 1s are affected http://www.diabetes.org.uk/en/Guide...d-my-diabetes/Healthcare/What-care-to-expect/
; JDRF explains what it is, but doesn't say how long it lasts http://www.jdrf.org.uk/page.asp?section=163#FAQ2

Definition here suggests honeymoon can last up to 1 year: http://medical-dictionary.thefreedictionary.com/Honeymoon+phase

In any case, if you're adjusting your insulin requirements to accommodate your activity, food, infections, weather etc, you're doing just the right thing. As you say, it is worth checking meter accuracy and finger pricking technique as well, as readings can vary.

 

[bev]

Northerner,
Could it be the warmer weather? Alex 's requirements have gone down this week too - but we have changed his levemir so not sure if its weather related for him. Bev

 

[sofaraway]

It could be the change in weather as Bev suggests. You might find this interesting

(taken from a post by DeusXM over at diabetesforums)

"It could even just be a change in the season - March is the time of year (along with October) when this forum seems to have a sudden flurry of people having trouble with their BGs all of a sudden. Basically (and I've no real science to prove this, so take it for what it's worth), lots of people seem to have difficult with their readings in March and October, which just also happen to when Spring and Autumn happen. My personal theory is that your body's metabolic rate varies according to the season, and as a result your body will process glucose either quicker or slower as a result of that. Therefore your insulin requirements will change accordingly."

 

[Northerner]

It could be the change in weather as Bev suggests. You might find this interesting

(taken from a post by DeusXM over at diabetesforums)

"It could even just be a change in the season - March is the time of year (along with October) when this forum seems to have a sudden flurry of people having trouble with their BGs all of a sudden. Basically (and I've no real science to prove this, so take it for what it's worth), lots of people seem to have difficult with their readings in March and October, which just also happen to when Spring and Autumn happen. My personal theory is that your body's metabolic rate varies according to the season, and as a result your body will process glucose either quicker or slower as a result of that. Therefore your insulin requirements will change accordingly."

How interesting! I was still very much new to things last October, plus having other difficulties with meds etc. so don't have any experiences there. But Spring has definitely sprung here in sunny Hampshire!🙂 Still quite chilly though - seems to be colder inside my house than outside, so it's not a 'warmth' factor.

I've just taken a reading two hours after lunch and I'm 3.8, despite the fact that I deliberately underestimated the insulin. Perhaps there is a 'sunshine factor'? My mood is always lifted in Spring, I'm a bit of a SAD person (Seasonal Affective Disorder) and hate winter with a passion. Of course, I don't currently have any prior experience of the seasonal influence, but will watch out for it in years to come!

 

[Copepod]

seasons, weather and health

Having worked on meteorological projects and living with an Antarctic meteorological engineer, I can't get away with ever just vaguely blaming the weather for how I'm feeling... http://www.metoffice.gov.uk/health/ However, most research on weather and health concerns lung and cardiovascular health. I'm also not allowed to vaguely claim the season, but have to define either astronomical or meteorological - and confirm which hemisphere! see http://www.metoffice.gov.uk/climatechange/guide/effects/seasons.html for a simple explanation.

 

[diagonall]

As you have increased your activity Northerner have you lowered your basal?
Normally with an increase in exercise the basal is the 1st thing to reduce this then leased to a reduction in insulin: carb ratio.
As others have stated weather does effect blood sugars too.

 

[randomange]

I've noticed the same thing recently - I was having trouble with my numbers being on the high side, and suddenly they're the opposite, and I haven't done anything different. I'm reducing my insulin and adjusting my levels, but I'm still dropping low far more often than I'd like.

How weird and interesting though!

 

[Northerner]

As you have increased your activity Northerner have you lowered your basal?
Normally with an increase in exercise the basal is the 1st thing to reduce this then leased to a reduction in insulin: carb ratio.
As others have stated weather does effect blood sugars too.

Hi Sue, yes, I have reduced basal by 20% and am currently on the lowest lantus dose since diagnosis. My waking levels have been around 4.2ish, which is normal for me. In the past when I have reduced basal by even one unit this has caused an increase of 2 mmol/l - currently I am 4 units below (16 instead of 20) what I used to be, but with no change in waking levels.

 

[Vanessa]

Of course, there may be another explanation - too much laughing at the jokes on the forum. From the article referred to in "In the news" re us needing Einstein's jokes

"Although this may be the first study looking at the link between laughter and blood sugar, there has been plenty of research showing that having a sense of humor can help people with diabetes live healthier lives. Dr. William Fry of Stanford University, for example, has reported from his research that laughing improves oxygen flow, helps blood vessels expand and contract more easily, and stimulates heart and blood circulation, just like any standard aerobic exercise. "

No idea how on earth you account for exercising that chuckle muscle tho!

 

[janine19]

Oh Northerner u must be so frustrated. Im still 'honeymoonin' and levels required keepin dropping alot. They have changed me onto a new pen. Novopen Demi which does half doses as they think it will help my control. We'll see how it goes. Cant say im pleased to hear the honeymoon period can last for a year. I go on my honeymoon in June and was hoping this honeymoon would be over so I could enjoy my real one!!

 

[litto-miss-loz]

im kinda the same, since the nice weather we have been having, i have had a couple more hypos....

think i will reduce my insulin tommorow and see what happens.

 

[Northerner]

Well, I was 4.0 before my evening meal. I took a lower dose than usual for the meal I was eating, but when I measured 2 hours after eating I was... 4.0! I had a couple of hobnobs and some chocolate and just measured again before bed - 4.4! Soooo, I have had another hobnob and a slice of bread and peanut butter, also lowered my basal, so we'll see what happens tonight!

I appear to be keeping things just on the edge of OK, but it is continually surprising me because I keep expecting higher levels!

 

[Sugarbum]

Sounds strange. Sounds like you are feeding your insulin. Its good to be the rebel of the group hey?!

 

[Northerner]

Sounds strange. Sounds like you are feeding your insulin. Its good to be the rebel of the group hey?!

I am, but not on purpose (feeding the insulin, that is!🙂)

 

[MarcLister]

I think I'm getting a similar thing. I had Weetabix for breakfast this morning and decided I would only have 2 units of Novorapid, which I reduced from 3-4 because of this weather and the fact I'm getting a lot of hypos right now, despite lowering my insulin units.

I dropped to 2.8 at lunch! I was shocked. I even went to the pharmacy to get my needles and since I hadn't "budgeted" for that I had a biscuit to compensate and yet I still hit 2.8!

 

[katie]

i REALLY wish i had this problem

 

[lemit]

Hi Northener

Im having alot of Hypos too, seem to always be during the day. Spoke to my DN this morning and they've put me on a ratio of 0.5 for breakfast and lunch. They've given me a NovoPen Junior so I can increase my doses in 0.5 increments (they didn't have any other Pens in stock).

I only inject 8 units of BASAL at the moment which seems to work for me as all my waking B/S are between 5 and 6.

I'm at the point now where I just can't wait for the honeymoon period to pass as im fed up of Hypoing**** all the time!

* is that even a word?

 

[Copepod]

Diabetes type 1 does have a mean streak - injections are most uncomfortable when you're skinny, soon after diagnois; and blood glucose is most difficult to control during honeymoon phase. But it does get easier, gradually - the condition itself settles down, once honeymoon phase ends, you tend to put on a bit of weight, and your management techniques improve - well that's how it was for me when I was diagnosed aged 30 years.

 

[Northerner]

I think that, with me, it is a sensitivity issue rather than honeymooning. My results aren't sporadic, but more of a factoring down of insulin requirements. In any case, I have been diagnosed nearly 10 months and have been pretty stable throughout that time. My BG levels have dropped overall over the period, but that is due to my increasing knowledge of how best to achieve tight control.

In a way, it would be nice to think my pancreas (or at least, my beta cells) hasn't totally expired, but if it's just spluttering it would be far more manageable if it just stopped trying!