View Full Version : I'm confused by something.
Injecto
01-22-2008, 07:22 AM
Confusing issue: If I go to bed between 8 and 10 mmol (144 - 180), and do NOT bolus a correction, I will wake up below 6.0 (108). However, using the SAME ratios I can go to bed at between 4.6 and 6.0 (83 - 108) and guess what? I'll also wake up at below 6.0 (108). ???
It's like I will drop from a slight higher bed number back to perfect in the morning which would make you think my basal rate is a tad bit too high, and yet if I go to bed at a lower BG, I will not go low at night but rather stay level. I'm confused. I've tested this with a CGMS (the Medtronic Minilink) several times too. I just don't get it.
Scratch
01-22-2008, 07:35 AM
Confusing issue: If I go to bed between 8 and 10 mmol (144 - 180), and do NOT bolus a correction, I will wake up below 6.0 (108). However, using the SAME ratios I can go to bed at between 4.6 and 6.0 (83 - 108) and guess what? I'll also wake up at below 6.0 (108). ???
It's like I will drop from a slight higher bed number back to perfect in the morning which would make you think my basal rate is a tad bit too high, and yet if I go to bed at a lower BG, I will not go low at night but rather stay level. I'm confused. I've tested this with a CGMS (the Medtronic Minilink) several times too. I just don't get it.
You're still honeymooning though, aren't you?
If that's the case, when you go to bed a bit high, the honeymooning beta cells correct you down during the night.
Injecto
01-22-2008, 08:13 AM
You're still honeymooning though, aren't you?
If that's the case, when you go to bed a bit high, the honeymooning beta cells correct you down during the night.
No no no, I've said that so many times. I've had two c-peps and I've been empty for over 9 months now.
morrisma
01-22-2008, 08:25 AM
Strenuous, regular exercise did that for me. I was on a 4 day backpacking trip and while I had to have extra carbs during the day as needed, I always evened out overnight & my morning numbers were generally good regardless of my before bed numbers.
Mike
Scratch
01-22-2008, 08:28 AM
No no no, I've said that so many times. I've had two c-peps and I've been empty for over 9 months now.
I missed the post where you stated that. I was curious and a search for c-pep turned up the following thread:
http://www.diabetesforums.com/forum/diabetes/16580-c-peptide.html
Of course, that's nearly a year ago, but you certainly had some beta cell function then.
But if you're out of native insulin production, then there must be some other factor involved causing your blood sugar to decline in the one case and not in the other. Still, overall, if that's a consistent pattern, it's rather indicative of some residual beta cells spitting out some insulin to get you back towards normal blood sugar levels.
Scratch
01-22-2008, 08:37 AM
Ah, here we go. See, it's possible that if your control is really good with your pump, you can depress your c-peptide results value, so the body might not show that it's producing insulin, but that's simply because there's been no demand to produce insulin by the surviving beta cells.
Diabetes Case Study: Interpreting the Results of the C-Peptide Test (http://www.diabetescasestudy.com/Inter.htm)
Of course insulin users (type 1) with good blood glucose control are C-Peptide negative or of low value, let me explain:
A child has a cold-like infection and his blood glucose levels increase to astronomical heights (lets say 500 mg/dl). This is considered an emergency situation (because of ketoacidosis). So after a quick finger test in the emergency room the patient is put on insulin (intravenously) according to standard procedures.
The high blood glucose levels, caused by infection, are lowered to normal levels again with exogenous insulin. The child is told not to eat. 6-10 hours pass and finally an endocrinologist comes around to examine the patient, then he orders a C-Peptide test. And of course it comes back negative or have low value: confirming type 1 diabetes.
This is a false conclusion because the exogenous insulin is controlling the blood glucose and the child has not eaten in 6-10 hours so there is no new glucose entering the blood stream through the intestines. The pancreas has no reason to release insulin (measured by the C-Peptide test). Hence, the result is C-Peptide negative or of low value.
Insulin pump users with good blood glucose control will also have these same misinterpreted results.
Funnygrl
01-22-2008, 01:58 PM
No no no, I've said that so many times. I've had two c-peps and I've been empty for over 9 months now.
C-peptides only measure down to a certain amount. You could still make some insulin, in amounts that can be measured but still may help, especially in response to food, even if your c-peptides show you're very clearly type 1.
JediSurfer
01-22-2008, 03:44 PM
More than likely you are getting the tail end of a previous bolus or from your basal rate. The insulin does not stick to the models given by the manufacturers not matter which method you use to put the stuck into yourself. If you go to bed with a lower rate you body proberbly compensates with a liver dump of glucose.
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