Increased insulin sensitivity

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Sarahfl91

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Type 1
Hi there
I’m just looking for some advice and to see if anyone else has been through something similar.

In the past year my insulin sensitivity has increased dramatically. I used to take novorapid 12-14 units with meals, rarely suffering from hypos. My insulin requirements have now gone down to 1-2 units with meals and I’m having frequent hypos I also take tresiba 16 units in the evening now, where as I used to take 21.

My weight is the same and I haven’t been more active.

I’ve been type 1 diabetic for 20years, and have never experienced this before. I had such a severe hypo this week I was admitted to hospital.

Has anyone been through something similar and can offer any advice? I would be extremely grateful!

Thanks.
 
Hi @Sarahfl91
I am really sad to read about the problems you are having with your diabetes management. It sounds horrendous.

I know this is question is going to sound a bit strange but I'll ask it anyway (and then explain why):
Did the insulin sensitivity start when you had covid or a covid vaccination?

I was concerned about the covid jab and was ready to need to increase my insulin dose when I had mine. However, the opposite happened and I hypoed for a couple of days after my jab until I reduced my basal by about 25%. That was 2 years ago and my insulin sensitivity has remained the same since.

To be honest, apart from reducing your insulin dose and monitoring your levels closely, I have no other advice. If you do not have a reliable CGM, I recommend demanding one - it is totally justified.

Big hugs!
 
Welcome @Sarahfl91 Sorry to hear about your bad hypo - they can be so frightening. I hope you’re recovering mentally from it.

Two thoughts - have you had a recent coeliac screen, and have you been tested to rule out Addisons?
 
helli said:
Hi @Sarahfl91
I am really sad to read about the problems you are having with your diabetes management. It sounds horrendous.

I know this is question is going to sound a bit strange but I'll ask it anyway (and then explain why):
Did the insulin sensitivity start when you had covid or a covid vaccination?

I was concerned about the covid jab and was ready to need to increase my insulin dose when I had mine. However, the opposite happened and I hypoed for a couple of days after my jab until I reduced my basal by about 25%. That was 2 years ago and my insulin sensitivity has remained the same since.

To be honest, apart from reducing your insulin dose and monitoring your levels closely, I have no other advice. If you do not have a reliable CGM, I recommend demanding one - it is totally justified.

Big hugs!
Click to expand...
helli said:
Hi @Sarahfl91
I am really sad to read about the problems you are having with your diabetes management. It sounds horrendous.

I know this is question is going to sound a bit strange but I'll ask it anyway (and then explain why):
Did the insulin sensitivity start when you had covid or a covid vaccination?

I was concerned about the covid jab and was ready to need to increase my insulin dose when I had mine. However, the opposite happened and I hypoed for a couple of days after my jab until I reduced my basal by about 25%. That was 2 years ago and my insulin sensitivity has remained the same since.

To be honest, apart from reducing your insulin dose and monitoring your levels closely, I have no other advice. If you do not have a reliable CGM, I recommend demanding one - it is totally justified.

Big hugs!
Click to expand...
Hi, thanks so much for responding.

I’m lucky not to have had COVID yet but I have had all my vaccines. My sensitivity seemed to increase after I had my son almost three years ago. But more dramatically in the last year.
I’ve had recent bloods done to check everything, and nothing seems amiss.

I’m just hoping someone has been through something similar and can find a possible cause. I’m terrified of going low all the time and it constantly feels like my body is fighting the insulin to keep my level up.

It’s like I’m not diabetic anymore and I’ve never heard of this happening to anyone else.

Thank you again x
 
Inka said:
Welcome @Sarahfl91 Sorry to hear about your bad hypo - they can be so frightening. I hope you’re recovering mentally from it.

Two thoughts - have you had a recent coeliac screen, and have you been tested to rule out Addisons?
Click to expand...
Hi inka, thank you for replying!

I’m still terrified of it happening again, I have never needed glucagon before or hospital treatment.

I had some bloods down recently - full hormone profile included. But they haven’t flagged anything I’m just at a loss of what to do x
 
Are you absolutely sure they did the Cortisol test for Addisons? And a coeliac screen? I’ve had to push my surgery before for a complete list of tests because I’ve been told that they’ve “tested everything” when they haven’t. This particularly happens with the coeliac screen.

Leaving possible medical causes for the moment, have you done a basal test recently?
 
Best to do basal tests to rule out your basal doesn't need adjusting.

Not same as you but did use to take 10 sometimes 12 units with meals years ago, as I've got older that's decreased for whatever reason that is, now on average 5u for same meals as before, so insulin needs do change with time, either up or down.

Hypos are horrible so have my sympathy.
 
Inka said:
Are you absolutely sure they did the Cortisol test for Addisons? And a coeliac screen? I’ve had to push my surgery before for a complete list of tests because I’ve been told that they’ve “tested everything” when they haven’t. This particularly happens with the coeliac screen.

Leaving possible medical causes for the moment, have you done a basal test recently?
Click to expand...
I don’t know for certain. I have called my endocrinologist today to see what they tested for, but it could take weeks for them to get back to me!
Yes I’ve done several basal tests recently, and brought my long acting down accordingly. I’m just so puzzled why my requirements have dropped so much when nothing has changed. Thanks
 
nonethewiser said:
Best to do basal tests to rule out your basal doesn't need adjusting.

Not same as you but did use to take 10 sometimes 12 units with meals years ago, as I've got older that's decreased for whatever reason that is, now on average 5u for same meals as before, so insulin needs do change with time, either up or down.

Hypos are horrible so have my sympathy.
Click to expand...
Thanks for responding

I’ve done several basal tests and reduced my background. I just can’t believe how fast my requirements have changed. Completely puzzled as nothing has changed.

Hypos are always horrid, I’ve just never had them so severely.
 
Have your cortisol levels been checked? (Addisons disease)

My levels of sensitivity have changed a lot recently and the amount of insulin reduction is an eye opener, I resorted to switching my pump off last night for 4 hours.
 
Pumper_Sue said:
Have your cortisol levels been checked? (Addisons disease)

My levels of sensitivity have changed a lot recently and the amount of insulin reduction is an eye opener, I resorted to switching my pump off last night for 4 hours.
Click to expand...
I’m not 100% sure. My endocrinologist took a load of bloods at the end of December and said he would check all hormones as well. I haven’t had the results yet.

Thank you so much, it’s a question I’ll be asking him when he eventually calls me back
 
Another thought @Sarahfl91 - have you changed your injection area or lost weight? Could your body composition have changed after giving birth? I have three children and over the years I’ve found my stomach has changed and absorption has been quite strongly affected. At some points it’s hardly worked at all, but at others I’ve had swift hypos even with small amounts of insulin. Other body areas have changed a bit too. So, if you’ve been using one area for boluses, maybe try a new area, or see if the area used affects the hypos (ie compare two or more areas).
 
Inka said:
Another thought @Sarahfl91 - have you changed your injection area or lost weight? Could your body composition have changed after giving birth? I have three children and over the years I’ve found my stomach has changed and absorption has been quite strongly affected. At some points it’s hardly worked at all, but at others I’ve had swift hypos even with small amounts of insulin. Other body areas have changed a bit too. So, if you’ve been using one area for boluses, maybe try a new area, or see if the area used affects the hypos (ie compare two or more areas).
Click to expand...
Hi,
This is what’s puzzling me, I haven’t changed anything. I still inject in the same areas, and my weight is the same as before I was pregnant.
I know in the past when I’ve lost weight it’s affected my sensitivity but I don’t think it’s the cause this time. It’s been gradually getting worse. Just hoping the doctor comes back to me soon with the results. Thanks again x
 
Sarahfl91 said:
Hi,
This is what’s puzzling me, I haven’t changed anything. I still inject in the same areas, and my weight is the same as before I was pregnant.
I know in the past when I’ve lost weight it’s affected my sensitivity but I don’t think it’s the cause this time. It’s been gradually getting worse. Just hoping the doctor comes back to me soon with the results. Thanks again x
Click to expand...
I will try changing sites though thank you
 
Sorry to hear what a tricky time you’ve been having @Sarahfl91

Sounds like you are doing everything you can and I can completely understand how frustrating and frightening this could be.

Have you had your cPeptide measured? Or been screened for monogenic markers (MODY)?

I have the dimmest recollection about people having been on insulin for some time ending up on oral meds instead with MODY, but I can’t remember where I saw it to check my half-memory of it unfortunately.
 
Sarahfl91 said:
Hi,
This is what’s puzzling me, I haven’t changed anything. I still inject in the same areas, and my weight is the same as before I was pregnant.
I know in the past when I’ve lost weight it’s affected my sensitivity but I don’t think it’s the cause this time. It’s been gradually getting worse. Just hoping the doctor comes back to me soon with the results. Thanks again x
Click to expand...

My weight didn’t change either but my fat distribution did - and quite significantly. I now avoid my tummy as it’s far too fast. Thighs and bum are slower and worth a try. I totally get how worrying it all is x
 
Sarahfl91 said:
Thanks for responding

I’ve done several basal tests and reduced my background. I just can’t believe how fast my requirements have changed. Completely puzzled as nothing has changed.

Hypos are always horrid, I’ve just never had them so severely.
Click to expand...

It is odd, maybe ask for further tests as mentioned above, really hope you get things sorted.
 
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