Everything’s topsy turvy!

[everydayupsanddowns]

Sorry to hear how difficult your partner is finding it managing his diabetes.

Has he ever had his (stimulated) cPeptide measured? It seems like there is some capacity for insulin production with the low BGs he has experienced, but I wonder whether his insulin signalling may be impaired, and/or first phase insulin response compromised so that levels are rising soon after eating and the second phase is struggling to bring things down.

In T1, the early years for some people can be characterised by some pretty erratic and confusing BG behaviour as the flagging beta cells (which as you probably know in T1 are being gradually destroyed by autoimmune attack) have a last gasp of stuttering and splurging, or not really working at all.

I was reading something a year or two ago about impaired insulin signalling in long term T2, especially where there is visceral fat around liver and pancreas, which may be contributing to the erratic glucose excursions he is seeing?

I have no medical background, but wonder whether adding a little exogenous insulin might help smooth things out if his home grown insulin release is a bit ‘patchy’?

 

[helli]

Sorry to read about the challenges your husband is having
As i have Type 1, I can't offer much advice.
However, I was interested in your comments about low BG at night and that he is using a CGM.
Were these low readings checked with a finger prick? I ask because these may be false lows caused by pressure applied to the sensor when he lies on it. These are so common they have a name : compression lows. I believe the pressure blocks the flow of interstitial fluid so the sensor gives a low reading. Often these can be spotted where there is a sharp dip when the pressure is applied and a sharp rise when we move and the pressure released.

 

[Buttonmoon78]

Look up the times it opens and put it in at the start then?

Honestly, tried that. The surgery is so oversubscribed that you can have it ready typed to paste in and it still is closed before you can press go. I didn’t believe it myself until I saw it with my own eyes. My surgery is full. His is in free fall meltdown. He lives in a commuter town which keeps getting expanded by new build estates but no amenities. I really don’t know how planning gets through.

 

[Buttonmoon78]

Sorry to hear how difficult your partner is finding it managing his diabetes.

Has he ever had his (stimulated) cPeptide measured? It seems like there is some capacity for insulin production with the low BGs he has experienced, but I wonder whether his insulin signalling may be impaired, and/or first phase insulin response compromised so that levels are rising soon after eating and the second phase is struggling to bring things down.

In T1, the early years for some people can be characterised by some pretty erratic and confusing BG behaviour as the flagging beta cells (which as you probably know in T1 are being gradually destroyed by autoimmune attack) have a last gasp of stuttering and splurging, or not really working at all.

I was reading something a year or two ago about impaired insulin signalling in long term T2, especially where there is visceral fat around liver and pancreas, which may be contributing to the erratic glucose excursions he is seeing?

I have no medical background, but wonder whether adding a little exogenous insulin might help smooth things out if his home grown insulin release is a bit ‘patchy’?

That’s very interesting, thank you. I’m feeding this all back to him. I think the only way we’re going to get that sort of care is if we see a private specialist again but I’m going to try to find one later today and get cracking!

 

[Buttonmoon78]

Sorry to read about the challenges your husband is having
As 8 have Type 1, I can't offer much advice.
However, I was interested in your comments about low BG at night and that he is using a CGM.
We're these low readings checked with a finger prick? I ask because these may be false lows caused by pressure applied to the sensor when he lies on it. These are so common they have a name : compression lows. I believe the pressure blocks the flow of interstitial fluid so the sensor gives a low reading. Often these can be spotted where there is a sharp dip when the pressure is applied and a sharp rise when we move and the pressure released.

That’s really interesting! And sometimes yes definitely they are false - which would be explained by that. Sometimes though they’re confirmed on finger prick, with that reading being 0.1 or 0.2 higher than the cgm.