For the last 11 days I haven't taken any basel or rapid acting insulin. For the first week I ate what I wanted - carb overload - and for the last few days I've eaten very little and practically no carbs. I only tested about 3 times during the first week and got readings of 10.2, 11.6 and 4.6. The last few days I've tested every few hours and I've gently moved between 4.9 and 6.0. What's going on? Why are my levels not sky high? Am I not really diabetic (and there was some confusion as to which type I was at diagnosis)? I'm worried about whether it's bad news not to have any basel insulin in you as, apparently, is used for other functions in the body aside from dealing with carbohydrate.
What happens at first is that the basal insulin has a tail and some is still there for a few days.
What happens next is that the beta cells try to respond to the incoming glucose. They overwork. The point at which they wear out will be seen when you have high blood glucose.
Then you will need much more insulin than you have been taking. The theory is that we save our beta cells somewhat by starting insulin early on.
An 11 mmol/l is 200 mg/dl, pretty high to me. At this rate you will start feeling some lousy beginning neuropathies.
Yes its bad news not to have insulin in you to allow the cells to function, pass signals and keep healthy. Your 4.6, 4.9, and 6 are great readings. And obviously, your beta cells were doing their thing for those readings. But when you eat carbs, what happens?
If you weren't "really diabetic", your blood glucose wouldn't even give a blip on eating a normal carb meal.
Your goal should be to preserve what you've got. Try not to test it too long! :)
Thanks again, for the replies. Today my b/s readings have been 4.4, 5.1, 4.3, 4.6. These are great readings. But I still haven't taken any insulin, basal or bolus. It's not that I'm avoiding insulin for some reason, but my levels don't really warrant any, or am I missing something? Surely if I take a basal dose I will have a hypo. I don't need bolus doses as eating very low carb. Can you see my dilemma? I'm fully expecting my b/s levels to go up, but they haven't yet and so I don't know what to do.
I don't pretend to be a doctor, but it sounds to me like you are T2 or are a recent-onset LADA with a significant number of surviving beta cells. There are T2's who are able to avoid BG medication (insulin and other) simply by losing weight and eating a very low carb diet. Some of them post here and will probably chime in. It could be, I suppose, possible for a recent onset LADA with lots of surviving beta cells to accomplish the same thing.
Besides seeking your doctor for real medical advice, I think you need to consider two things.
1. Is there a benefit to taking basal insulin in order to prolong the survival of your beta cells? If so adding back basal insulin might be a good idea regardless of whether you continue with your current diet or not. Adding basal won't make you hypo (you know that becuase you were doing it just a couple weeks ago) - it will simply reduce the constant load on your pancreas.
2. Are you willing and able to stick with the diet you are currently eating? Do you think you want to do it for the long term? If not, you might need to add back your bolus insulin as well - both to prolong beta cell survival and to match the food you are eating. The fact that you were hitting 10 and 11 when eating more carb indicates you will need bolus insulin if you go back to that way of eating.
(And to fully answer your question - I've had T1 for 37 years. If I stopped taking all insulin for two weeks I would be in the hospital or worse).
Somebody please translate for me. I measure my bs on the scale where its supposed to be between 80 and 120. How does 5.1 convert into that?
In the UK they use a different scale it's called 'mmol' not sure what it stands for. To convert mmol to mgdl multiply it by 18, I think. Someone correct me if I'm wrong.
To convert, multiply by 18 to get mg/dl. So 5.0 mmol/L is 90 mg/dl (US).
right on. Thx for the conversion factor.
Here you will find an online converter.
What you do is exactly what you're doing. As long as both fasting and post meal b/s readings remain where they are, you don't warrant insulin. You are treating yourself exactly right. Be sure you keep testing, write results. Keep your food book so you have a record to show your doctor when you finally go back, if you do. Don't be concerned if you're "really diabetic". Treating diabetes is all about treating symptoms, treating them promptly, and treating them appropriately. If your b/ss don't go up, if your weight stays normal on low carb, you're doing just right. Congratulations and keep at it!
Whether you are T2 or slow onset LADA T1 with some beta cell function left I agree with Jag about adding some basal back in. As long as your not adding more than your body needs and causing lows then your onboard insulin production should scale back naturally thus helping to prolong beta cell function. The trick is to find the right balance.
I would be doing what I could to find out what my correct type is. If your doctor hasn't already done so T1 autoimmune antibody testing is in order. Knowing for sure what type you are will help determine where you go from here. If you are T2 you might just be able to control with diet and exercise alone
I went to this site, HealthTap. It seems totally useless. I asked "What is LADA?" Absolutely no answer. I asked "What is the GAD test?" Again, totally useless. Then I asked "What is a Honeymoon?" Again, absolutely nothing.
How is that helpful?
There is some evidence that early and agressive control can allow some recovery of beta cells. Maybe you have had some recovery with your prior excellent control. I would say keep monitoring closely and don't be hesitant to add in insulin if things start to deteriorate again.
Maybe you can experiment and just use bolus as required to cover carbs (if you are eating many - this may not be daily seeing you are following low carb).
You could also experiment with very low dose of basal if your fasting were higher than your target. Optimally fasting is in the range of 80 - 95 (Bernstein recommends a target of 83 (4.6)!) and before meals will be back to fasting levels.
Of course you may not feel it is worthwhile to reduce fastings in the 90s - low 100 range to fastings in the low 80s.... but that is a treatment decision on you can make for yourself.. Watchful waiting maybe. :)