advice needed

[REDLAN]

Don't often ask for advice, but I think I'm going to have to...

for those of you who live in the US, over here in the UK we've been having an azores high - it's been really warm and sunny this last week or so. I've known for a while that good weather means that I need less insulin than usual, only this time it's meant a lot less insulin than usual.

2 and half weeks ago I was running 16 + 16 unit split on my basal and it was pretty much spot on - I dropped to a 15 + 15 split a week ago, and then down again to a 14 + 14 split, and now friday I'm down to a 13 + 13 split.

I've had to cut my carb ratios as well by around 30% - but I'm sat here - and I mean sat here having to eat otherwise I will drop into a hypo. Fast-acting is nearly all but finished at 10.30pm, but I'm still dropping...

looks like my 13 + 13 split is still too high.

tonight is gonna be a bedtime snack + plus early morning alarm to make sure I'm OK.

what I really want to know is has anyone else experienced a sudden drop in insulin requirement and how did they handle it? Surely there has to be a faster method than just stepping my dose back 2 units at a time?

[BlueSky]

I have also had periodic sudden reductions in the insulin requirement. It doesn't happen much any more though, 30 years after becoming T1, and the frequency of these episodes has been declining steadily over time.

The only possible explanation, IMO, is that the pancreas spits out some insulin before the newly regenerated beta cells are destroyed by antibodies. I remember being told by endo's when reporting this that I must be mistaken. That was back in the days when it was thought that beta cells were not regenerated. It is now accepted that this is not the case. The regeneration of beta cells is ongoing, and sometimes the destruction of them by ant-bodies lags behind. The supply of some endogenous insulin is what makes the injected insulin requirement drop.

It sounds to me like you may be producing some insulin, at the same time as the weather has warmed up. The combined effect is a substantial reduction in your injected insulin requirement. But it won't last, so you need to watch your numbers carefully. ;)

[Mich]

Well, once again I'm chiming in behind Blue Sky. I had the same thing happen in the first ten or so years after diagnosis. I never could see a pattern in when it happened--maybe once every two or three years. It was beyond the scope of the normal seasonal adjustment.

Now that I know that even us old timers still manage to produce a few beta cells now and then (which are immediately killed by our T cells) it is easier to understand. I'm watching and hoping for a development in the effort to suppress or control those T cells soon without suppressing us in the process. Go Denise Faustman!

Soo, Redlan... Enjoy it while it lasts.

Mich

[REDLAN]

regeneration of beta cells - yeah about 80% of type 1's will have some remaining beta cells - and the more you have the better your A1C on average (according to one cadaver study)

Soo, Redlan... Enjoy it while it lasts.

:D I liked that :D

Although I dunno if I quite qualify for oldtimer status at the 26 year mark, I'm pretty sure I'm out of the honeymooner bracket too.

I was thinking it might have more to do with insulin resistance - recovery of beta cells shouldn't force me into a hypo, although they will prevent me from going quite as high.

If you buy into the insulin resistance as a cold/winter adaption...

winter comes, my body thinks quick lay down fat...

and it does this by increasing insulin resistance - I need more insulin to force glucose into muscle... the surplus glucose gets turned into fat, and the extra levels of insulin makes sure it stays there.

we have an azores high, my body thinks....

yeah it's spring, don't bother laying down fat, quick get going again, insulin resistance plummets, fat gets mobilised... and I'm taking waaaaay too much insulin.

not that this helps much :o

But it won't last, so you need to watch your numbers carefully.

yeah, I've been praying for rain :D

[BlueSky]

I have also noticed the seasonal effect. I was very aware of it in South Africa, where the temperature extremes are far apart (in Johanesburg). I used to increase the basal by up to 50% in winter. Interestingly, I haven't noticed this effect since moving to New Zealand. It could be because the temperature in Auckland is not as variable. Switching from NPH to Lantus could also have something to do with it.

Anyway, the sudden reductions in insulin requirement that I suspect is was caused by periodic insulin production, was clarly a different phenomenon. It happens at any time of the year.