Medication helps protect insulin production in type 1 diabetes

[Amity Island]

A drug approved to treat high blood pressure, called verapamil, protected insulin-producing cells in the pancreas in people with type 1 diabetes. These protective effects lasted as long as people took the drug over the two years of the study, reducing the amount of insulin treatment required.

Medication helps protect insulin production in type 1 diabetes

A drug approved to treat high blood pressure, called verapamil, protected insulin-producing cells in the pancreas in people with type 1 diabetes.

www.nih.gov

 

[rebrascora]

Much as I liked using less insulin, I am not sure I would have wanted to extend my honeymoon period, as it was unpredictable and difficult to manage. I know some people find that it smooths off the edges and can make their introduction to insulin easier but I am happier to be manually running the show rather than driving an unreliable semi automatic pancreas.

 

[Robin]

But presumably it lowered their blood pressure as well. What if it was on the low side to start with?

 

[trophywench]

Well I wouldn't have thought they'd have prescribed it to anyone who already had low BP ? Although having said that, my Consultant recommended a low dose Ace inhibitor and a statin even though I didn't have high BP or cholesterol both 'for their protective properties'. Won't bother commenting on how unprotective the statin was, but the Lisinopril caused me to cough ...... but by then anyway, my BP needed medical treatment so I then had Losartan instead.

This was a good 30 years after diagnosis anyway, so neither had any effect whatever on my BG !

 

[nonethewiser]

Like rebrassco was pleased to get out of honeymoon phase, never been one to worry about insulin usage as you need what you need.

 

[Ian68]

I am still in the honeymoon period and my pancreas seem to get out of bed about 3 hours after me. then kicks in so I am high in the morning if I eat more than 10g of carbs, then spend the rest of the day fighting to keep my count up above 5 so I can drive.
it does my head in.

 

[mikeyB]

Verapamil is used as second line treatment for hypertension. It has a list of side effects, particularly postural hypotension, constipation and a few others. Whether the risks of using the drug outweigh the need to use less insulin (which is, after all, a marginal benefit) is doubtful.

 

[rebrascora]

I am still in the honeymoon period and my pancreas seem to get out of bed about 3 hours after me. then kicks in so I am high in the morning if I eat more than 10g of carbs, then spend the rest of the day fighting to keep my count up above 5 so I can drive.
it does my head in.

I think it is likely a combination of honeymoon and Dawn Phenomenon (DP). Your liver is hard at work on a morning pumping out glucose (DP) making you go higher than your basal insulin can deal with and then, when your liver stops pumping out glucose and your body is using it up through your daily activity, the basal insulin is too much and drops you. We are also usually more insulin resistant in the morning so giving our breakfast bolus extra time to work and perhaps adding a little extra to it can help.
I inject my breakfast bolus before I get out of bed every morning and it usually needs 45 mins to work before I eat breakfast to prevent a big spike and if I am not going to have breakfast, I still inject myself with 1.5-2units of bolus insulin to deal with DP. This keeps my breakfast spike consistently under 10....usually under 8
Not saying this is what you should do, but it can help to cautiously experiment with these strategies to see what works for you as an individual. If you currently prebolus 20 mins for breakfast, try 25 for a day or two and then 30 to see how that works. Do you have Libre? That makes it easier to see when the bolus insulin is starting to kick in and when to eat your breakfast. If you don't eat breakfast, the liver will continue to pump out glucose until you do eat, so skipping breakfast means you are likely to still need some bolus insulin to cover that liver output. Kind of like a correction in advance, if that makes sense.
Unfortunately basal insulin injected once or twice a day is a very crude tool to manage the liver's output, so it sometimes needs tweaking here or there with a bit of bolus insulin or carbs (like at bedtime or afternoon in your case) to improve the "fit".

 

[Ian68]

I think it is likely a combination of honeymoon and Dawn Phenomenon (DP). Your liver is hard at work on a morning pumping out glucose (DP) making you go higher than your basal insulin can deal with and then, when your liver stops pumping out glucose and your body is using it up through your daily activity, the basal insulin is too much and drops you. We are also usually more insulin resistant in the morning so giving our breakfast bolus extra time to work and perhaps adding a little extra to it can help.
I inject my breakfast bolus before I get out of bed every morning and it usually needs 45 mins to work before I eat breakfast to prevent a big spike and if I am not going to have breakfast, I still inject myself with 1.5-2units of bolus insulin to deal with DP. This keeps my breakfast spike consistently under 10....usually under 8
Not saying this is what you should do, but it can help to cautiously experiment with these strategies to see what works for you as an individual. If you currently prebolus 20 mins for breakfast, try 25 for a day or two and then 30 to see how that works. Do you have Libre? That makes it easier to see when the bolus insulin is starting to kick in and when to eat your breakfast. If you don't eat breakfast, the liver will continue to pump out glucose until you do eat, so skipping breakfast means you are likely to still need some bolus insulin to cover that liver output. Kind of like a correction in advance, if that makes sense.
Unfortunately basal insulin injected once or twice a day is a very crude tool to manage the liver's output, so it sometimes needs tweaking here or there with a bit of bolus insulin or carbs (like at bedtime or afternoon in your case) to improve the "fit".

Thank you so much for the advice it helps to make sense of it all. I only Basal at the moment and only 8 units. I do have a libre 2 which is helping me to understand what I can and can’t eat which has broadened my diet.

 

[SB2015]

I am with @rebrascora i found the honeymoon period so frustrating as the remaining beta cells gave no warning when they decided to join in. However others have kept going for ages on very little insulin and managed this effectively, so could be useful.

For high BP my understanding is the the ……pril tablets are cheaper and offered first where appropriate. If you go back complaining about the consequent coughing they will try others. I have quite often been chatting with a friend who just keeps coughing. We tracked it down to Ramipril and when they switched they stopped coughing. (Shows that I am of a certain age in that so many of us are up BP tablets!)

 

[rebrascora]

Thank you so much for the advice it helps to make sense of it all. I only Basal at the moment and only 8 units. I do have a libre 2 which is helping me to understand what I can and can’t eat which has broadened my diet.

If I were you, I would start pushing for a quick acting insulin. It is ridiculous to expect to balance your BG levels with just a basal insulin and you are likely using more basal than you need to try to cover food and liver output. You should be able to eat a normal healthy amount of carbs rather than have to restrict your intake to try to keep your levels reasonable. If necessary, start eating more carbs in order to make your point to your DSN to get bolus insulin added to your prescription so that you can start learning how to manage your diabetes effectively. Even if you just need tiny doses or none at all for some meals. It is also helpful to have fast acting(bolus) insulin incase you get ill as it is an important factor in keeping BG levels from going too high and developing ketones and perhaps needing hospital treatment if you got ill with say Covid or Norovirus.... both of which are obviously doing the rounds and highly infectious so entirely possible that you might catch either.

 

[rayray119]

Much as I liked using less insulin, I am not sure I would have wanted to extend my honeymoon period, as it was unpredictable and difficult to manage. I know some people find that it smooths off the edges and can make their introduction to insulin easier but I am happier to be manually running the show rather than driving an unreliable semi automatic pancreas.

Oh yes predictatible is so much better(not that you can always predict things honeymoon or not)