[rak1978]

It is a hope/dream/wish of mine that someday I will magically become super healthy and become non-insulin dependent. In my warped mind, I think that if I loose weight, eat zero carbs, exercise daily, etc...that I will not need to take insulin.
Have any of you gone off of insulin and still managed blood sugars? Am I in denial by thinking this is possible? I currently take about 35 units a day (pumper) on a lowish carb diet.

I welcome any advice you may have (I can take it...I think). Thanks!

[foxl]

Originally Posted by rak1978

It is a hope/dream/wish of mine that someday I will magically become super healthy and become non-insulin dependent. In my warped mind, I think that if I loose weight, eat zero carbs, exercise daily, etc...that I will not need to take insulin.
Have any of you gone off of insulin and still managed blood sugars? Am I in denial by thinking this is possible? I currently take about 35 units a day (pumper) on a lowish carb diet.

I welcome any advice you may have (I can take it...I think). Thanks!

That is a low dose. I think you could ... especially if you do have a component of insulin resistance. Probably not permanently off, but a few weeks' to months' holiday?

[sarahspins]

Hmm.. well I DON'T think that 35u a day is all that low.. I am 100% insulin dependant and that's about what I use.

Have you recently had a c-peptide test done? That will really be the indicator of how much residual insulin production you have.. if your c-peptide is very low it's unlikely that you can go off insulin entirely.

[fgummett]

Good question Rachel...

As a Type 2, early last year (2008) I was using around 120u Total Daily Dose (TDD) via an insulin pump --- mixture of basal + bolus -- to manage fairly decent BGs

May 2008 I started CPAP for sleep apnea which cut be back to around 100u TDD -- basal + bolus

August 2008 I switched to a very low-carb diet which cut me back to around 50u TDD basal + bolus

October 2008 (having lost 25lbs with the diet) I underwent a Vertical Sleeve Gastrectomy which together with my diet has resulted in an overall weight-loss of 80+ lbs and rapidly decreased need for exogenous insulin.

Currently I use 8.25u TDD -- all basal and nearly all around DP.

I have not had to bolus for a meal since November 2008... with postaprandial spikes less than 8mmol/l and back below 7mmol/ within 2 hours of eating.

I could probably gain even tighter BG control if I did use more insulin but I want to balance that against continued fat burning and excess fat mass loss. That said, my last A1C was 5.5%

On occasions when I try leaving the pump off for a couple of days my Fasting BG is over 7mmol/l -- diabetic range still.

I was very hopeful that one day I will be off insulin altogether but the Fasting BGs have me thinking that I have long term damage that may not resolve... only time will tell.

[rak1978]

Originally Posted by sarahspins

Hmm.. well I DON'T think that 35u a day is all that low.. I am 100% insulin dependant and that's about what I use.

Have you recently had a c-peptide test done? That will really be the indicator of how much residual insulin production you have.. if your c-peptide is very low it's unlikely that you can go off insulin entirely.

Funny you should ask...I just had my blood work done this morning (including a c-peptide, islet antibodies, and gad65). Will know results in a couple of weeks. I already tested positive on the gad65 last year, this is just a follow up.
We'll see .

[rak1978]

Originally Posted by foxl

That is a low dose. I think you could ... especially if you do have a component of insulin resistance. Probably not permanently off, but a few weeks' to months' holiday?

Ahhhhh...an insulin holiday/break would be nice.
I need to get off of it to loose the weight so that I can get off of it. Vicious cycle. I do believe I am insulin resistant, but I also have diminished insulin production, so I may be dreaming.

[rak1978]

Originally Posted by fgummett

Good question Rachel...

As a Type 2, early last year (2008) I was using around 120u Total Daily Dose (TDD) via an insulin pump --- mixture of basal + bolus -- to manage fairly decent BGs

May 2008 I started CPAP for sleep apnea which cut be back to around 100u TDD -- basal + bolus

August 2008 I switched to a very low-carb diet which cut me back to around 50u TDD basal + bolus

October 2008 (having lost 25lbs with the diet) I underwent a Vertical Sleeve Gastrectomy which together with my diet has resulted in an overall weight-loss of 80+ lbs and rapidly decreased need for exogenous insulin.

Currently I use 8.25u TDD -- all basal and nearly all around DP.

I have not had to bolus for a meal since November 2008... with postaprandial spikes less than 8mmol/l and back below 7mmol/ within 2 hours of eating.

I could probably gain even tighter BG control if I did use more insulin but I want to balance that against continued fat burning and excess fat mass loss. That said, my last A1C was 5.5%

On occasions when I try leaving the pump off for a couple of days my Fasting BG is over 7mmol/l -- diabetic range still.

I was very hopeful that one day I will be off insulin altogether but the Fasting BGs have me thinking that I have long term damage that may not resolve... only time will tell.

WOW! Congratulations on your success! That is really amazing.

[fgummett]

Originally Posted by rak1978

WOW! Congratulations on your success! That is really amazing.

Thanks Rachel... I did realise it may not all apply in your case with your probable auto-immune involvement but at the very least I have found I can minimise my need for insulin by altering what I eat.

I should add that my activity levels have also increased -- nothing formal like the gym -- but I walk a lot more and take the stairs etc... I'm sure that also has a positive effect on my BG management and general well-being.

[foxl]

Rachel, Do you know which antibodies you have? The number of types has prognostic values.

In addition to GAD, the most common, there are:

ICA, IA2 and Zn8 (which is a recent discovery).

The more types you have, the more quickly you are apt to progress.

[rak1978]

Originally Posted by foxl

Rachel, Do you know which antibodies you have? The number of types has prognostic values.

In addition to GAD, the most common, there are:

ICA, IA2 and Zn8 (which is a recent discovery).

The more types you have, the more quickly you are apt to progress.

I know that I have the GAD. Not sure on the other ones. I had some blood work done today to test for "islet antibodies". Are those the ICA and IA2?...sorry, I should know by now.

[foxl]

Originally Posted by rak1978

I know that I have the GAD. Not sure on the other ones. I had some blood work done today to test for "islet antibodies". Are those the ICA and IA2?...sorry, I should know by now.

ICA are islet cells, IA2 are insulinoma antibodies (actually to insulin, not a tumor, I bet you were teted for them though) and a zinc-containing enzyme?

Good you are getting them -- they are supposed to help you know what will happen and your doc sounds on top of em!

[Subby]

Originally Posted by rak1978

It is a hope/dream/wish of mine that someday I will magically become super healthy and become non-insulin dependent. In my warped mind, I think that if I loose weight, eat zero carbs, exercise daily, etc...that I will not need to take insulin.

If you are truly type 1 / 1.5 / with a deficit of insulin, non of those things will compensate for the lack of insulin in your body. The connection you seem to make between taking insulin and not being super healthy/being sick, is an unfortunate one - and does seem a little like denial to me, yes. Any ideas why you feel this way, was there particular things said by someone or particular thoughts you have had?

[rak1978]

Originally Posted by Subby

If you are truly type 1 / 1.5 / with a deficit of insulin, non of those things will compensate for the lack of insulin in your body. The connection you seem to make between taking insulin and not being super healthy/being sick, is an unfortunate one - and does seem a little like denial to me, yes. Any ideas why you feel this way, was there particular things said by someone or particular thoughts you have had?

Subby, I totally appreciate your honesty. I think my feelings stem from the fact that when I was eating much better, I didn't need much if any injected insulin. (worth noting that this was at the beginning of my diagnosis...probably in the honeymoon phase). Maybe it's guilt. Over the past year or two, I have developed poor eating habits, and need much more insulin. Hence, the accociation of MY insulin use with guilt. I don't in any way look down on others for their insulin use or think associate their need for insulin with being sick. Actually, it's just the opposite. It's a necessary step to prevent them from being sick. It's a personal thing. I was on almost no insulin before I got the pump (2 yrs ago), and was 40 lbs lighter. Once I got the pump, eating habits declined, gained 40 lbs., and am on 35+ units a day. Do you see where I am coming from?
I know that the only way to get out of this way of thinking is to get myself back to where I was regarding eating habits and weight to assess how much of this is insulin resistance and how much is diminished insulin capacity. I'm working on it.

[lorilei]

I 100 percent agree with Subby...1.5 is autoimmune..are you aure you are 1.5...? We are bound to insulin until we are ALL cured...you can eat less carbs and therefore use less rapid insulin...but as a 1.5 you will still need insulin...sorry that you are under the illusion that you can get off of it??

[rak1978]

Originally Posted by lorilei

I 100 percent agree with Subby...1.5 is autoimmune..are you aure you are 1.5...? We are bound to insulin until we are ALL cured...you can eat less carbs and therefore use less rapid insulin...but as a 1.5 you will still need insulin...sorry that you are under the illusion that you can get off of it??

Hi Lori!
I agree with Subby too....I am in denial, but for the reasons stated in my post. Did you read my post just below his?
I think the only way to rid myself of this "illusion" is to get back to my pre-pregnancy weight and change my eating habits. Once I am there, then I can have a true assessment of where I'm at with diabetes.
Thanks for your comments. They are very much appreciated.

Rachel