update on hypos with no insulin

[brett]

Hi people havnt been on for a while, not been to good. A little while ago i was having loads of hypos with being active despite having no insulin at all. Seen diabetic nurse to have some tests. Thyroid test came back all clear and should have results for celiac early next week. While this was happening i felt awful. Not sleeping for long, headaches sickness the lot. Went for 7 days with no insulin and better levels than a non diabetic always between 3-6 never higher, frequently needing snacks to avoid hypos. So, while i was on no insulin decided to stop my citalpram 30mg a day (anti-depressant). After a few days no headaches, stomach pain or sickness. 7 days on back on 1 unit of lantus which i think will have to be increased as starting to wake in the high sevens and 20-25 units nova rapid a day. Dont know if it was the citalpram as i did reseaerch too much seratonin can cause low sugars which i was having frequently or if it was my body squeezing out all the insulin it had left. Just a bit of coincidence it was after i stopped these tabs. Have got an appointment end of the month with my consultant to discuss the problems i have been having. After 7 days off tabs never felt better full of energy and back to my old self. Also my levels are a lot more stable than they have ever been since dx 9 months ago.

 

[Northerner]

Thanks for the update Brett, I'm really pleased to hear that you've finally got some stability and that you are feeling much better! 🙂 It does seem to be quite a coincidence that the turnaround has come when you stopped the anti-d's, doesn't it? It will be interesting to hear what your consultant has to say - let us know how it goes!

Your current insulin requirements are interesting to me - I'm on about 20-25 novorapid and have just reduced my lantus from 1 unit to zero!

 

[brett]

will upate, think my appointment is on the 24th. This time will be seeing my own consultant on request from my surgery as i have only ever seen a junior since distcharge from hospital. I have had a few of these periods going to no insulin and back. It does seem different this time as my levels are higher than usual with my insulin and am still increasing bolus on a daily basis. I will only be increasing my basal by 1 unit a week as it takes some time to find the right level with that.

I did see your post and also found intersting - will be monitoring

 

[Robster65]

Hi Brett.

Some thing Pumper Sue on Alan's (Northerner's) thread was about a lack of cortisone, which causes the liver to secrete glucose into the bloodstream. If it isn't there, presumably the liver stops that function.

I wonder if the seratonin is a kind of 'anti-cortisone', in that it de-stresses and therefore removes any need for the cortisone to be produced. Or something equally weird!

Any special case can help the rest of us to understand our 'normal' diabetes better so thanks for posting.🙂

Rob

 

[brett]

I totally agree. What i read was that the extra seratonin levels doesnt directly cause low sugars, but as you said effects other parts of the endocrine (scuse spelling) system resulting in low levels. Also after reading the side effects headaches, poor concentration, muscle cramps/spasms realised i had nearly all of these symptoms. About nine days off now and feeling better every day as im sure its agradual decline in serationin rather than an immediate stop. Must stress though although i never with my doc, but will be discussing with my consultant not to stop prescibed meds without advice from doc. I did this as it was the only thing i was left on and still having major probs

 

[trophywench]

I'm sure it's the cortisol Brett, I had Citalopram for anxiety and major panic attacks that would elevate my BG off the scale on my meter (about 33 from memory) and then of course I'd have to correct that because you just can't live with it, and subsequently have a crashing hypo, then a rebound and off we'd go again, see-sawing all the way. The Citalopram were utterly brilliant at stopping most of the panics (or was that because by now I was off work sick LOL) and I had a period of pretty good BG control all things considered. That went base over apex when I tried to return to work so I had to take an early and permanent bath.

But when I packed em up some time after that - my BG levels did suffer and I was soon back into the 8's (A1c I mean) instead of several 7's I'd had no prob whist onthe tablets! (low 8's had been the story of my diabetic life since 1972)

 

[brett]

consultant reveiw today

After some back and for with docs and erratic levels with big highs and lows had an excellent consultation toady. Because my levels are quite eratic and big drops spontaniously my doc had blood tests done immediately to rule out various other immune disorders. From what i can remember these include thyroid function (more detailed than the standard ones i had at the surgery), celiac disease, addisons disease and also something to do with muscles. On top of this i will have an appoitment to the day hospital for them to do a biopsy of my stomach which he said i will have very shortly and run various blood tests throughout the day as my levels fluctuate so much.
Also i was told i am definately type one as i had plenty of the gad antibodies when i was diagnosed, and very high ketone levels. )didnt even know i had this test as when i asked the junior consultant some months ago for this test he said no, but didnt tell me i already had it). He did seem to think something will be picked up as he suspects some sort of malabsorbtion disorder.
Of course he did end with al these may be negative and i might just be having a very long honeymoon period- coming up 9 months, but wants to rule out all other possibilities instead of possibly continuing with another problem, which is all i wanted.
Overall he went throgh all of my short history and i left with no unanswered questions as once i gave him my readings he explained his thoughts in terms i could understand. re visit to discuss all tests and reults in 6 weeks.

 

[Northerner]

It sounds like a really good consultation Brett 🙂 I hope that it helps you to find better treatments so that you can control things better in the future without all this uncertainty 🙂

 

[brett]

It sounds like a really good consultation Brett 🙂 I hope that it helps you to find better treatments so that you can control things better in the future without all this uncertainty 🙂

Thanks , that is the concern of consultant, having no steady control. although i have done a carb counting course and mostly understand it i cannot get accurate carb/insulin ratios, as they change on a daily basis.

 

[trophywench]

Well - I should insist on seeing him again and again Brett - because that sounds very positive indeed.

I wonder if you really had the 'whatever it was you got prescribed Citalopram for' - or whether you were having abnormal high/low BGs leading up to diagnosis of D - and that was affecting your mood to the degree it appeared like more of a MH prob?

 

[brett]

Did at ask at the appoitment to see him next time, did say he was not always available. Think i only got to see him at the request of nurse at gps. Think he covers a few different hospitals in our area. Had to phone his secretary 1 week before appoitmentment and ask at desk on day of arrival to see him. Popular man prob because he is more interested in what you have to say and not just look at hbac level. Although mine is a 6.7 (ok) mixture of highs and lows. Also i agree with what you said about the citalpram. Was prescribed for depression - but i never really felt depressed although after being told by diabetic nurse and three different doctors i was due to my symptoms started to yhink i must be so gave it a go. Wont make that mistake again. My mood does still change with lows and highs but that is the reason.

 

[Pumper_Sue]

Having read all this I am still a bit confused about insulin.
Are you on insulin now or not?

Does sound as if you have found a great consultant.

 

[brett]

Did have 7 days needing no insulin with great bs readings but felt awful. They did start to slowly rise a liitle while after i stopped the citalpram.

Currently on 2 units lantus and 15-20 units of nova rapid a day. Thing is to avoid hypos and have good sugars i have the following
b/fast 1/8 insulin carb ratio
lunch 1/30
Tea 1/15

My sugars can be anything between 6-15 2 hours after food despite eating same amonts and usually same meals each day, no varying activities. Although sometimes high 2 hours later i do no corrections and still have to snack to avoid hypos before next meal.

 

[Pumper_Sue]

Did have 7 days needing no insulin with great bs readings but felt awful. They did start to slowly rise a liitle while after i stopped the citalpram.

Currently on 2 units lantus and 15-20 units of nova rapid a day. Thing is to avoid hypos and have good sugars i have the following
b/fast 1/8 insulin carb ratio
lunch 1/30
Tea 1/15

My sugars can be anything between 6-15 2 hours after food despite eating same amonts and usually same meals each day, no varying activities. Although sometimes high 2 hours later i do no corrections and still have to snack to avoid hypos before next meal.

Your problems could be just a simple thing (haha) of analogue insulin's not being compatable with you. Perhaps try a different sort ie as in either human or animal insulin.
Another option to think about is what time do you inject your bolus, as in how long before a meal?