Cutting out carbs / decrease insulin dose

[Carly]

Just wondering if anyone else has ever done this or something similar.

My insulin needs seem to be increasing more often lately. Happened after a few days of high bsl / ketones at the end of Dec, I then had a few days of lows so went back to my usual dose of 2u novorapid (N) at breakfast, 2u N @ lunch, 2u N @ dinner and 4 u lantus @ bedtime. Now my numbers a going back up again (esp fasting and before lunch numbers)…

I'm still on a very small dose at the max amount (16 units) if eat normally. But every time I need to up the dose it scares me, so I find I'm cutting out carbs or just not eating much at all, anything to keep my insulin needs at min dose (10 u).

Did/does anyone else find it scary when your insulin needs started increasing in the honeymoon period? Does it get better? I mean do you accept that you need to increase your TDD?

I often thought I couldn't wait till my honeymoon phase was over (this was when I was lantus then novomix 70/30). I'm on novorapid/lantus now with pretty good control and the thought of my pancreas eventually not producing any insulin, seeing my insulin needs increasing or eventually having a TDD of approx 42u (I worked out that's how much insulin I'd be on when my pancreas is producing no insulin = it's 1u per kg ? ) makes me nervous.

[Amy C.]

I can't remember your background, but you must be an adult or older teen.

It is hard to balance food, insulin, and exercise. You are doing it, by decreasing the food. You could just as easily adjust the insulin, other than your fear of going low.

It took me a while to accept the fact my son needed more insulin. If your body had a workin pancreas, it would be pumping out more insulin. You have to be the pancreas and allow yourself more insulin so that you can eat what you would like. Right now, you aren't willing to step up to the plate and be a better pancreas.

Your goal should be to eat what you want and balance with the insulin, rather than have this artificial ceiling on the limit of insulin for each day. You are denying your body what it needs.

It seems to me that eventually, you will get pretty hungry and tired of eating non-carb food. Do you have a team that you work with? I would work with them to get a ratio that works -- where you don't go low when you eat. You need to take a tiny step out and see that more insulin is not bad.

My 13 year old son uses 60-80 units a day.

[Momof4gr8kids]

I know when my DD's insulin needs increase I feel a bit hesitant, but I know in order to keep her healthy that I need to do it regaurdless. I just check her b/g more frequent to make sure I have it right.
My DH, who is also type 1 takes 70-100 per day depending on the season, and how much he eats.

[Carly]

Amy, I'm 23.

When I put in the effort, I can manage my food / insulin okay. Some foods give me a rough time, namely pasta, rice, and potatoes!

Haven't had to deal much with strenuous exercise. With long periods of walking sometimes I go high and sometimes I go low. Last month I went roller skating and let myself run a little high prior to starting. Started at 14.2mmol/l - when I got home was 11.7mmol/l and woke up the next day at 7.??mmol/l .

I got an awesome diabetes team. I've only seen the endo once (had another endo before my current one). He easy to talk to, ask questions etc ... when I saw him for the first time I was on NovoMix 70/30 and asked him about trying lantus/nvoorapid (I had poor control on novomix) he was all for it. Never would have asked my previous endo about lantus/novorapid.
My diabetes educators are terrific. I have had a call each week from one of them since my first appointment (dec 8th). They'll call to check on my numbers and if I've been having probs will call more often. Not long ago I had probs with high bsl/ketones and the DE call me everyday till the ketones were gone. So yeah, I don't have probs working on control with my DE's.

I'm on a sliding scale at the moment, but the DE I spoke to a few weeks ago suggested adjusting my insulin dose according to the amount of carbs I eat / counting carbs.

Thanks JmeB78 and Amy, both your posts have helped me feel little better about needing to increase my insulin.:)

[kel4han]

Wow. You sound like me. Dx'd March 2006, Has worked for me in this honeymoon by lots of excersize and eating under 150carbs/day. But, I fell off that track once winter came around and I find it so hard to get out of bed and excersize when it is cold outside. Havent excersized in 4mo. Lost 8lbs. Needs have gone up. Very scared. Havent admitted that yet. My 6year old was dx in Decmeber, and now I cant accept this entirely. Havent been able to eat die to this new stress, and now my avergae is way up, and everything I worked for (low numbers) is ruined. NOw I feel low at 90! Not good. You are not alone. I am right there with ya. Dont know the answer though, actually I do, but havent decided to be that "better pancreas" as the last poster mentioned. Working on that.....

[cydnimom]

Whats ironic is I get scared when my insulin needs drop for some unknown reason! I've had D for 27+ years and I tend to eat the same things day in/day out (or basically the same amount of carbs). When my needs started dropping recently I was nervous that something else was going on - like celiac, thyroid troubles, menopause, etc. Still haven't figured it out.

Being a woman there is the monthly fluctuation in you insulin requirements due to the rise and fall of hormones that goes on, so I see a dramatic drop for the first 2 weeks, then a slow increase, with a sharp increase a couple of days before my cycle starts.

I guess I never really had a honeymoon or I can't remember it. Treatment back then was so much more different then now I probably didn't notice the change like you would now.

I guess you could equate how your feeling as a continual loss of how your body used to function and its slowly losing its ability to do so. It is a grieving process.

Just so you know also, I do not take 1 unit of insulin for every kilogram of weight I am. I think doctors just use that as an indication of whether your body is doing what it should be or if there is some insulin resistance going on as well.

Just my thoughts,
Cyndi
T1-27 yrs MDI
Mom to Ryan (6.5 yrs, T1-1 yr, MDI)
and Cody (4 yrs)