Stupid question, does anyone experience the same?

[Pitzi]

Something that has always been puzzling me over the 10-odd years since I was diagnosed is the fact that my diabetes is ever changing. There are some periods of my life that I have to reduce the insulin dosage by a lot, to avoid going too low, it almost seems as either my body produces a bity of insulin, or for some reasons itb doesnt need that much insulin. Over these periods I eat like a pig, and it doesnt affect my BG levels much. I always put up a bit of weight and generally look good, but I have to be careful of my insulin dosage, 1 single unit too much and i go hypo very easily when I am in this phase.

Then I get phases where my body needs so much more insulin, and I have to increase the dosage frighteningly to maintain constant levels, and I have to reduce my food intake. Eating the same portion of food as the week before will send my BG rocketing, whilst just a week back it barely blipped on the radar screen. I normally tend to lose a bit of weight during these periods and don't feel too great physically.

We are not talking of different environments or health states either, I live a pretty stable life, with a similar daily diet and a pretty stable stress levels as well.

I would like to know why is this? Sometimes I feel as though my body is healing itself, only for something to trigger the need for increased treatment levels for periods of up to a month, until I go back to my "mini-honeymoon" as I like to call it.

If I keep doing my daily exercise routine without slacking off too much, I can prolong the "mini-honeymoon" sometimes.

Funny how this condition displays in different ways in different people.

[akornak]

On "can't get my low blood sugar up" that I JUST posted. Very similar stories and I have no idea what's going on. I'm hoping my Dr. may have some answers.

[Pitzi]

I personally don't think that any doctor can give an accurate reply on his subject. I have heard he "because you body's needs may change with sickness or health" crock too many times, my needs change irrespective of whether I am sick or healthy. Of course when I am down with flu or an infection my BG goes up, but sometimes it goes up or down all by itself.

It's almost as if sometimes my pancreas makes a bit of insulin, other times none at all.

[DeusXM]

Generally it's now thought that your pancreas is constantly regenerating new islet cells but they get killed off again by the same autoimmune reaction that made us diabetic in the first place. So that's one explanation.

The other is that the body's needs simply aren't constant. A change in the seasons means that your metabolism will change - after all, you don't need to burn quite as much energy maintaining your body temp in summer as you would in winter. Then there's just all sorts of other reasons why your metabolism is slightly different - maybe your stress levels have changed, perhaps you're eating slightly differently, a different batch of insulin. Your insulin requirements will never remain consistant, and it's one of the reasons why I'm against ratios. Granted, they can help you out, but basically every day is like starting a blank slate. Some days you can actually go without insulin; other days you just can't get enough. Everyone with diabetes has the same problem, and there's not really a lot you can do except celebrate on the days you get it right.

[Pitzi]

Generally it's now thought that your pancreas is constantly regenerating new islet cells but they get killed off again by the same autoimmune reaction that made us diabetic in the first place. So that's one explanation.

The other is that the body's needs simply aren't constant. A change in the seasons means that your metabolism will change - after all, you don't need to burn quite as much energy maintaining your body temp in summer as you would in winter. Then there's just all sorts of other reasons why your metabolism is slightly different - maybe your stress levels have changed, perhaps you're eating slightly differently, a different batch of insulin. Your insulin requirements will never remain consistant, and it's one of the reasons why I'm against ratios. Granted, they can help you out, but basically every day is like starting a blank slate. Some days you can actually go without insulin; other days you just can't get enough. Everyone with diabetes has the same problem, and there's not really a lot you can do except celebrate on the days you get it right.I have tried to document the differences in my condition as much as possible, but what I am talking about is different from the odd day where I need more medication because I have overdone the food portions, have opened a new bottle of insulin, or don't feel too good because I skipped my exercise regime or have picked up a virus or infection of some sort. That I know will affect my insulin needs, but what I am talking about is near exact food intake, on the very same batch of insulin, with stable stress levels and lack of disease during this period. The latter also lasts longer than the former.

*edited to add*

The autoimmune explanation might be a very interesting new discovery, because I am sure that there could be a way of suppressing this autoimmune response, rather than having to transplant cells or the islets.

[DeusXM]

That I know will affect my insulin needs, but what I am talking about is near exact food intake, on the very same batch of insulin, with stable stress levels and lack of disease during this period. The latter also lasts longer than the former.

Yeah, I know. That's what I meant. Some days you can do the exact same thing as you did the day before and get a totally different set of results. That's because there are literally millions of factors influencing your metabolism, and it's impossible for anyone to control more than about 4 at any one time. Like Jedi's sig says, managing diabetes is an art rather than a science. A constant routine is good for helping you to very roughly predict what will happen, but it's not a guarantee. There's simply too many factors beyond your control which change for no apparent reason whatsoever. For instance, for reasons I don't understand yet, I've had to increase my evening bolus from 12u to 18u. It just happened one day and it's been like that since. In a couple of months it'll probably change again. It's just 'being diabetic' - the only thing you can ever really figure out for sure with the condition is that whatever you thought you had figured out will be 'unfigured' in a few month's time.

That's what I'm getting at when these odd, inexplicable changes last longer. It's a combination of a total change in your body's metabolic needs and there's probably some pancreas wake-up going on. I'd imagine we're going to see a lot of people on here suddenly noting that their requirements have changed for reasons they don't know. It happened this time last year too - and coincidentally, this time of year just happens to be the change from spring to winter, when there's more daylight around. Your body reacts to this stuff and totally changes how it's been working for the last 6 months - and that means a change in your metabolism and insulin requirements.

[seacomp]

The autoimmune explanation might be a very interesting new discovery, because I am sure that there could be a way of suppressing this autoimmune response, rather than having to transplant cells or the islets.
Yes, there's been some interesting work in this area that has been posted in the forum. So far the work has been with mice, but human trials are scheduled.

[Mick]

Yeah, isn't is just ****ed strange??? lol...!! It took me a lot longer than 10 years to figure that out--good for you! In fact, I had intuited that my pancreas MUST be getting regenerated and then destroyed in some unpredictable cycle, over and over. During my 40 years of diabetes, I have experienced my insulin requirements change dramatically from time to time, always to return eventually, in a few weeks or a few months, back to my baseline. One time, maybe five or six years ago, I was taking virtually NO insulin, yet maintaining perfect glucose levels--well, not perfect, because I was having lows all the time and thus continuously reducing my insulin. It lasted over 2 months, and I had an a1c and endo visit toward the end of that phase. My a1c was as low I I have ever had--6.1, and when my doc saw the amount of insulin I had redused to, he joked, "Well, maybe your pancreas has regenerated itself!" Ha-ha, we both laughed--I asked him, "No, really, why does this happen?" He could offer no rerasonable explaination. So, I'm not surprised at the theory that it IS, in fact, what I had almost in jest proposed a while back. And so it goes--up and down, high and low--just when you are sure your control is excellent, wait a few weeks--it's tale off somehwere with a mind all its own!

Michael
T1 40+ yrs.

[Pitzi]

I think the next 10 years will see some very interesting stuff coming out on Diabetes research.

There are a lot of unanswered thaings that might be answered if this "immune system continously attacking our pancreas" theory is proven to be true.

There could be more spinoffs to this than just Diabetes treatment.
Approximately 3 years after I was diagnosed, and my Diabetes was well controlled, something else happened to my pancreas, and it might well have been caused by more immune system reactions. My pancreas first stopped producing the stuff that neutralizes stomach acid, and I experienced stomach acid problems, and am on medication that limit the acid production ever since (5 years now) and after a further 6 months, my digestive enzyme production also stopped. This might well have been caused by my immune system attacking the different functions of my pancreas.

Another condition that in my ignorant opinion could be linked to immune system problems could be gluten intolerance

The other interesting thing would be, for how long do the cells try and heal/regenerate themselves? I cannot believe that it can be something that can go on forever?

[stella117]

Something that has always been puzzling me over the 10-odd years since I was diagnosed is the fact that my diabetes is ever changing. There are some periods of my life that I have to reduce the insulin dosage by a lot, to avoid going too low, it almost seems as either my body produces a bity of insulin, or for some reasons itb doesnt need that much insulin. Over these periods I eat like a pig, and it doesnt affect my BG levels much. I always put up a bit of weight and generally look good, but I have to be careful of my insulin dosage, 1 single unit too much and i go hypo very easily when I am in this phase.

Then I get phases where my body needs so much more insulin, and I have to increase the dosage frighteningly to maintain constant levels, and I have to reduce my food intake. Eating the same portion of food as the week before will send my BG rocketing, whilst just a week back it barely blipped on the radar screen. I normally tend to lose a bit of weight during these periods and don't feel too great physically.

We are not talking of different environments or health states either, I live a pretty stable life, with a similar daily diet and a pretty stable stress levels as well.

I would like to know why is this? Sometimes I feel as though my body is healing itself, only for something to trigger the need for increased treatment levels for periods of up to a month, until I go back to my "mini-honeymoon" as I like to call it.

If I keep doing my daily exercise routine without slacking off too much, I can prolong the "mini-honeymoon" sometimes.

Funny how this condition displays in different ways in different people.
I haven't had it long enough to see that pattern. I know when I was on Lantus there was a period when 6.5 units seemed to be working fine (although that may just be because I wasn't doing good pre-prandial readings), but then 9 units wouldn't work at all.

Then I switched to Levemir and settled at a split dose of 14 units and that was working well. Then I needed to go up to 16 units, and now I'm back down to 14. All within a couple months.

During this time, my bolus doses haven't varied much however.

A couple of things to keep in mind:

Weight loss or gain will affect insulin requirements.
Increased/decreased activity will affect insulin requirements.
Stress affects BG and therefore insulin requirements.

Which essentially is what Deus said.

[Goldrun]

I've decided there is no rhyme or reason with diabetes. (of course I know scientifically that's not true, but it sure feels like it sometimes!). I was diagnosed last June...and it's been such a roller coaster ride.

For example, yesterday I had a fasting bs of 102. Not bad. Had a day trip for work, so I ate an egg mcmuffin and coffee for breakfast. Low calories, relatively low carbs (usually I don't have to bolus for this meal), for lunch.... a low carb wrap from Subway...didn't check my sugar before hand, because I'm used to having 70-80 by lunch with that breakfast.

Stopped on my way back into town and ran 2+miles at a track. checked my bs....137. I bolused 3 units for dinner (chicken sandwich...no fries). Got home...bs of 227 before my evening Lantus.

Grrr. I've found that my sugars actually go up sometimes after a run...but they go down after a bike ride. go figure!

[seacomp]

Grrr. I've found that my sugars actually go up sometimes after a run...but they go down after a bike ride. go figure!
The thread "Exactly how does exercise reduce BG levels?" in Exercise deals directly with that issue. It gives pattern to the confusion.:D

[Goldrun]

thanks Seacomp! reduced confusion is definitely desired!