Setting point and insulin secretion

[Lucyr]

Because in type 1, not enough islets remain. In T1 there is nothing (or not enough) to stimulate in most cases. There may be micro secretions, and a few valiant beta cells resisting attack, or being regenerated and then destroyed by antibodies on an ongoing basis.

I agree with this, in fact this is exactly how I managed to get the cpeptide and antibody tests. As I’ve posted elsewhere my stimulated blood cpeptide is 265 which is low, but higher than something like 95%+ of type 1s.

I’ve tried every type 2 medication going and many of them work by stimulating your existing cells to produce more insulin. But none of them worked for me, even though my body is capable of producing insulin, it’s just not capable of producing enough extra to manage my blood sugars any better.

If that’s my experience as someone who doesn’t produce much insulin but has higher insulin production than the vast majority of type 1s, then it’s just not going to work for those producing less or none.

I do agree with the article further up that having some insulin production remaining can slightly improve time in range. I can 100% tell when my body is producing more or less insulin. It’s erratic but it goes through phases of producing more, and things are so much smoother and easier when it’s in that phase.

From experience though, if I stop insulin in that phase I still quickly get very high bgs and ketones. My body simply can’t produce enough insulin to stop injecting it for more than 1-2 days.

 

[Satan’s little helper]

I didn't stop my basal lightly, i was only on 2 abasaglar a day and getting repeated nightime hypos...i dropped to 1, then zero.
I was a bit reluctant, actually, but your body needs what your body needs. I expect to need basal again soon.
I totally need bolus

Basal needs are individual. (I certainly agree.) Mine can be fine for a number of days then suddenly need a tweak up or down by a U. After years of observational basal testing with different (conditions flu or colds.) & environments. Hot climates (& or activity level.) can increase sensitivity for me. (But by no means negates my requirements for it’s use.)
My comment upstream by no means intentioned to undermine your personal experience. 🙂

 

[Lucyr]

It’s erratic but it goes through phases of producing more, and things are so much smoother and easier when it’s in that phase.

Feel like I should clarify this a bit, it isn’t always plain sailing when my pancreas is in an insulin producing mood. It can cause sudden hypos if my body randomly decides to produce insulin and I’ve already injected a correction. But there are other times where it’s producing a bit more but predictably and those are easier

 

[everydayupsanddowns]

Again, early introduction of insulin helps preserve the remaining beta cells longer. So it’s a good thing not a bad thing.

I think this may be behind some of the ‘remission in T1’ stuff that @Bubbleblower is referring to? I found this today which I thought was helpful:

Complete remission in children and adolescents with type 1 diabetes mellitus—prevalence and factors

Little is known about complete remission in Type 1 diabetes mellitus (T1D) with the discontinuance of insulin treatment for a period of time. In this retrospective study we analysed the frequency and factors of onset and duration of 1. remission and 2. ...

www.ncbi.nlm.nih.gov

A study where of 500ish participants, 40% went into full or partial remission with T1 - but the definition of remission is really crucial, because the term is being used for what we often call ‘honeymoon period’ here.

Remission in T1D, also known as the “honeymoon” period, is characterised by a decline of insulin doses and stable glycaemia shortly after initialisation of insulin treatment1. ​

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However, both partial and complete remission in T1D do not have a very long duration and usually disappear within several weeks to years. Remission lasting longer than 3 years may signal a misdiagnosis for another type of diabetes mellitus (i.e. monogenic diabetes or type 2 diabetes)1,6.​