New and still learning

SThomas

Member
Relationship to Diabetes
Type 1
Hello,

New to the forum and am looking for advice.

2018 was diagnosed Type 2 - metformin, linagliptin and gliclazide. None worked.
2019 diagnosed Type 1 - Lantus x10 and Novo Rapid x4 @ breakfast, lunch, dinner.

I must admit I had been blasé about my T1 and truth be told not taking it seriously (me not coming to terms with it) with bloods up and down.
February this year saw the nutritionist who said I could lower my dosage as I wasnt eating in my meals enough to warrant the dosage of insulin.

I have recently overhauled my diet and exercise regime. What I am noticing is that my bloods are consistently within normal range.

For example today - Breakfast with 1 shot of NovoRapid, lunch (no insulin) remained normal, dinner (no imsulin) with bloods lowering to the point where before bed I was 4.2. I've been testing frequently before meals and 1-2 hours after.

Usually I would take insulin with every meal but I'm finding I dont need to and my bloods are remaining or even lowering.

I'm quite nervous about this and was wondering whether anyone has had this and whether I should take my insulin anyway and eating more to go with it. Or whether it is ok to not take it so long as my bloods are normal.

Any guidance would be greatly received.
 

Drummer

Well-Known Member
Relationship to Diabetes
Type 2
I am absolutely not a HCP nor even a type one - but the insulin is required by a type one to do the best that can be done to keep the blood glucose normal. An overdose would mean a hypo - not a good thing.
I think this is the bolus insulin you are cutting down (see - got the lingo) you don't mention the basal, but really you ought to check with your HCPs, as soon as possible to get their best guess but if you don't need to lower your blood glucose - it might be a little bit silly to inject....
 

trophywench

Well-Known Member
Relationship to Diabetes
Type 1
Hiya @SThomas - I'd say Blimey that's 2 of you on this forum, cos the chap who was Admin of this very forum - Alan, aka @Northerner - doesn't currently need ANY 'mealtime' fast acting insulin whatever these days, and has therefore labelled himself 'Type Weird' which he's been the sole and exclusive member of for quite a few years by now!

What you could do, is do what's known as a 'basal Insulin test' to see what if anything, the Lantus is actually doing for you - have a read of this page to see how to go about it, Can't be done quickly, to get the full 24 hours of BGs, so just take your time and plod through it as you can and frankly, should, if you want it to be honest. Resist the temptation to change anything whilst it's in progress though!

Will be very interested to see the results of that - and also be very informative and useful for your medical team! Here's how - https://www.diabetes-support.org.uk/info/?page_id=120
 

trophywench

Well-Known Member
Relationship to Diabetes
Type 1
If I've got it base over apex, I apologise - Type weird is correct though! LOL
 

SB2015

Forum Host
Relationship to Diabetes
Type 1
Welcome to the forum @SThomas

As my consultant tells me ‘you need as much insulin as you need’ . It just takes a lot of head scratching to get that sorted. As @trophywench says a basal rate test would help. That will show you how much insulin you need to sort out the glucose your liver is producing. This always takes me a few days to do, as things don’t always go as planned, so just take your time.

Let us know how you get on.
 

SThomas

Member
Relationship to Diabetes
Type 1
@tropmany @drummermany thanks for the replies.
Apologies for the ignorance but am I tight in saying

Basal is long lasting, Bolus fast acting?

Thank you for the link, I will give that a go as I've already had breakfast this morning.
Went to bed with a BG of 4.2 took my Lantus dose of 10 and woke to a level of 4.9 and only one shot of insulin the whole day yesterday and didnt rise above 6.9.

I'll give the Basal rate test a go @SB2015
What am I looking for in regards to results to the test? Again excuse my ignorance.
 

Inka

Well-Known Member
Relationship to Diabetes
Type 1
Hi @SThomas You’re quite recently diagnosed, so could be in the ‘honeymoon period’ where you’re still making a little of your own insulin. Possibly your basal insulin (Lantus) is doing some of the work covering your meals, which is why you don’t need much bolus insulin. (Fast-acting).

My honeymoon period went on a while and I found I still had some insulin production. At one point I thought maybe I’d been misdiagnosed but I hadn’t. I was and still am Type 1.

I second (third?) the idea of the basal test as it might work better for you to have less basal and small amount of bolus insulin as needed.
 

SB2015

Forum Host
Relationship to Diabetes
Type 1
I'll give the Basal rate test a go @SB2015
What am I looking for in regards to results to the test? Again excuse my ignorance
Absolutely no apologies needed for not knowing things. We have all been there and that is why it is great that you are firing questions at the forum. Keep asking

If the basal rate insulin (Background/ Long lasting) should keep you roughly level. If your glucose level does not rise or fall by more that 1.5 mmol/L then that is fine. The advice @trophywench referred you to suggests splitting the day up into sections, and missing one meal at a time. I find it most useful to do the overnight first, as that then gives me a check on quite a few hours to 'tick off'. I eat early the evening before and make sure that that meal does not include slow release carbs or high fat (avoiding beans and pizza or curry). I am then able to check from 4 hours after that meal. It is a bit of a hassle having to wake to test through the night, but good to get that done and dusted.

Keep coming back with any questions that you have. Happy to help
 

everydayupsanddowns

Administrator
Staff member
Relationship to Diabetes
Type 1
Welcome to the forum @SThomas

Your situation certainly sounds unusual!

If your form of T1 is LADA, it generally destroys beta cells more slowly and gradually than ‘classic’ T1. In fact some people with LADA have a year or two on T2 meds before they lose enough beta cells to realise that something is wrong with their diagnosis.

Perhaps your fairly rapid switch to insulin gave your pancreas a bit of a breather and allowed it to bounce back a bit. Enjoy it while it lasts!
 

brisr949

Well-Known Member
Relationship to Diabetes
Type 1
My honeymoon period went on a while and I found I still had some insulin production. At one point I thought maybe I’d been misdiagnosed but I hadn’t. I was and still am Type 1.
It was the first thought that went through my mind as i was reading the thread, but i think its the honeymoon period..(BTW, who on earth came up with such a silly name for it)
 

SThomas

Member
Relationship to Diabetes
Type 1
I'm currently doing the Basal test so I'll see what happens with that, although I'm not 100% sure on the method!!

In regards to the honeymoon period, how long does it last as I was diagnosed Feb 2019 with insulin. With it not being uncommon for my bloods to be over 7 and me adjusting doses.

I've recently basically cut out most carbs, refined foods and drinking more water and have seen my blood levels drop and remain stable (not going above 6.9) with me not requiring not to take any NovoRapid at all.
Like I said before I wasnt taking it seriously when first diagnosed but since Covid and being at home more my mind is more occupied.
 

Inka

Well-Known Member
Relationship to Diabetes
Type 1
The honeymoon can last a very short time or a few years. It depends on the individual. The best way to lengthen it (as much as it’s in our control) is to avoid high sugars and take insulin. My honeymoon lasted a few years and gradually faded. I put that down to partly luck and partly taking enough insulin to eat a nourishing diet. If you don’t eat a balanced diet, your blood sugar will stay lower but that’s not something I’d recommend.

You don’t need to drop carbs unless you’re trying to lose weight and/or have insulin resistance. Carbs aren’t the enemy for Type 1s. Just eating a normal healthy diet without excessive carbs is fine. I like the Med diet - healthy carbs, beans and pulses and plenty of veg. There’s a lot of fad diets around and no food group should be demonised. Type 1 isn’t a punishment for ‘eating badly’ - which is what I sometimes felt when first diagnosed. It’s just bad luck that our daft immune systems decided to attack crucial cells in our pancreas.

Don’t worry about doing the basal test exactly right. Any info you can get will help. I’m sure you’re doing absolutely fine :) All you’re trying to do is check that your basal insulin keeps your blood sugar steady - ie you’re taking the right amount. It can take a while to get things sorted. Never a truer word than “Diabetes is a marathon not a sprint”.
 
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trophywench

Well-Known Member
Relationship to Diabetes
Type 1
I've always said that as far as I'm concerned - honeymoons should be enjoyed! No idea whose bright idea it was, maybe they thought because it's when you really get to know each other it was appropriate. Not so in this day and age though since such a lot of couples have been cohabiting for years previously before they do the legal stuff!
 

SB2015

Forum Host
Relationship to Diabetes
Type 1
It was the first thought that went through my mind as i was reading the thread, but i think its the honeymoon period..(BTW, who on earth came up with such a silly name for it)
It is a rediculous name.
I enjoyed my honeymoon, but the T1 Honeymoon period was not fun.
 

trophywench

Well-Known Member
Relationship to Diabetes
Type 1
I remember both my real honeymoons with pleasure but if I had a diabetic one, nobody told me! Dunno whether you'd be able to tell really, only testing your wee once a day!
 

everydayupsanddowns

Administrator
Staff member
Relationship to Diabetes
Type 1
My diabetes honeymoon period was characterised by more in range numbers, with less effort and more ‘latitude’.

As my doses increased over the first few years I assumed the honeymoon was wearing off, and I had to fly more entirely manually - whuch was harder. I suspect I still have a small amount of pancreatic function as I was Dx in adulthood and I’ve always had a pretty decent HbA1c, but it takes much more effort and tweaking these days to aim for ‘in range’ numbers.
 

brisr949

Well-Known Member
Relationship to Diabetes
Type 1
Im a little confused, which as only being 5 years in i still have a lot to learn..the OP now takes no bolus and only 10 units of lantus which has no real peak so its a pretty constant background so how can they be a type1? Or can type 1 be corrected by diet alone?
I understand the honeymoon phase as mine lasted i think 2 years as after that my doses rose steadily for a couple of months to treble what they were but to take that little insulin your honeymoon must be having a first class holiday :)

Adam.
 

Inka

Well-Known Member
Relationship to Diabetes
Type 1
@brisr949 No! That’s a shout of horror not reprimand :) Type 1 cannot be cured by diet - which is one of the many reasons I dislike fad diets and the many websites peddling utterly false hope to Type 1s.

I take less basal insulin than the OP but I take bolus insulin because I eat a normal diet. If I started restricting my food, I could just take basal insulin too probably (I unofficially tried this out during a hectic house move when I didn’t eat all day - blood sugars stayed in range) but that wouldn’t be a good idea.

A healthy diet doesn’t cut out whole food groups. A healthy diet is balanced. But - however healthy it is, it will never cure Type 1 because Type 1 is an auto-immune disease and not a result of poor diet or eating carbs!

The OP is in the honeymoon period. Some people in the honeymoon period can eat normally and stop or greatly reduce their insulin because they still have some residual insulin production of their own helping to control their blood sugar. It’s a temporary state not a cure.

And it’s not made any better by a restrictive diet. In fact, I believe such a restrictive diet messes up your insulin sensitivity and comes back to bite you in the bottom.
 

everydayupsanddowns

Administrator
Staff member
Relationship to Diabetes
Type 1
I think the other thing to bear in mind is that T1, like T2 is, I believe new research confirms, more than just one thing.

There are T1s who produce absolutely no insulin, and exhibit no antibodies several years after diagnosis (having no beta cells left to kill off), and there are T1’s for 50 or 60 years (Joslin medalists) who still produce some insulin and are still antibody-positive Suggesting that they are still producing beta cells, but that their immune system is continuing to splat them.

There is fascinating work going on in this areas, and like most things connected to diabetes, it seems it’s far less straightforward than it first appears!
 
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