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Re: [IPk] Sudden change in sensitivity to insulin?

Thanks for the comments everyone. To answer a few of the suggestions that
you've made:

I do have coeliac disease (was diagnosed about 11 years ago now) and keep
pretty well to the GF diet, so I don't think it will be an absoption thing
there. I haven't made any changes to exercise/food/not trying to lose
weight or anything.

Nothing different really....apart from the fact I'm just recovering from a
really bad cold. I've had it for about 10 days now, and almost got rid of
it now. These problems started once the worst of the cold was beginning to
shift. Don't know if that would be affecting it? I always thought typically
blood sugars would go up with an illness, not erratically down though?

Have checked basal settings and clock and nothing unusual there. Hadn't
considered the 2 conditions you suggested Melissa, hopefully its nothing as
major as that!

Oh, and I don't think I'm pregnant (something that passed through my mind
yesterday as a possible cause of sudden insulin changes?). There is an
incredibly small chance I am, and I haven't tested so I can't rule that out
for definite, but is highly unlikely.

It sounds like reducing my basal at night (if not all the time) is a good
idea? But how about reducing my bolusses in general as well - any thoughts?

Thanks for your help (I only get the digest emails, so sorry if I seem to
reply slowly)


> Date: Fri, 21 Feb 2014 11:30:43 +0000
> From: Alice Monks <email @ redacted>
> Subject: Re: [IPk] Sudden change in sensitivity to insulin?
> Hi Laura,
> Poor you, sounds like a right drag, especially if you're not getting much
> sleep!
> It defintely sounds like a basal rather than bolus issue from what you've
> said.
> I wondered - have you lost any weight recently or are you exercising more
> than normal? Sometimes this can have an affect on your basal requirements.
> I also find that when I'm due on that has a big impact on my insulin
> requirements, although that tends to be that I need a higher basal rate
> rather than lower.
> If you're not doing so already, I would try and keep a diary log of what
> you're bloods are doing between now and your appointmetn with your
> consultant. I know our pumps and blood meters log it, but I always find
> seeing it written down simplistically helps me.
> Hope you manage to get it sorted and feel better soon.
> Alice x
> ------------------------------
> Date: Fri, 21 Feb 2014 11:31:17 +0000
> From: Melissa Ford <email @ redacted>
> Subject: Re: [IPk] Sudden change in sensitivity to insulin?
> Hi Laura
> The first thing that comes to mind is this: check your basal settings to
> make sure that the clock in the pump is correct. I know, it sounds silly
> but I have heard of people accidentally changing AM and PM and making basal
> changes to the wrong time of day by accident. It'll take about 10 seconds
> to rule this out.
> The next thing that comes to mind is the possibility that you've developed
> adrenal insufficiency or Addison's disease - have a read of this:
> http://pmj.bmj.com/content/76/894/230.full
> The good news is if it is Addison's, it should require just a daily pill to
> manage.
> Another possibility is hypothyoidism - see
> Again, hypothyroidism can be managed with a pill.
> If I were you I would contact my GP and request to have both a thyroid
> function test and a synacthen test (used to check for cortisol levels)
> Info on the tests here:
> http://www.patient.co.uk/health/thyroid-function-tests and
> http://www.patient.co.uk/health/synacthen-test and
> Hope this helps!!
> Melissa
> Type 1 19+ years; pump user 18+ years
> Date: Fri, 21 Feb 2014 11:38:12 +0000
> From: Diana Maynard <email @ redacted>
> Subject: Re: [IPk] Sudden change in sensitivity to insulin?
> Hi Laura
> I hate it when this kind of thing happens. What I would suggest (in
> addition to the other very sensible pieces of advice) is to aim above
> all else for stable BGs, if a bit higher than normal. And just be very
> conservative with bolusing to bring down a high. Try also eating
> consistently, at a similar time each day, with a similar amount of carbs
> (preferably fairly low carbs) so that you minimise the effect of food.
> Just for a few days until things settle. Keep everything as simple as
> you can.
> Could be any number of causes - have you changed *anything* about your
> daily life recently? Stress, exercise, alcohol, food (content or
> timing), body weight, etc? Otherwise, could be you're getting ill (for
> some illnesses, my sensitivity initially increases before it decreases),
> just randomly you happen to have picked some good sites for infusion
> sets, or other odd body changes (I go through phases of being very
> hungry, eating a lot and having much increased insulin sensitivity,
> often after a period of much increased exercise - after I came back from
> a 2 week trek to Everest Base Camp, I had this effect of massively
> increased insulin sensitivity for over a month before things went back
> to normal). Or it could just be your body being temporarily weird for no
> apparent reason (I get phases of this too,though usually with the effect
> of decreased sensitivity).
> Good luck!
> Di
> Date: Fri, 21 Feb 2014 12:09:41 -0000
> From: "Jackie Jacombs" <email @ redacted>
> Subject: RE: [IPk] Sudden change in sensitivity to insulin?
>  First thing that comes to my mind is coeliac. When was the last time the
> clinic
> did a coeliac panel test?  Do you seem to go hypo after meals when in the
> past
> you were fine with that dose?
> My daughter had no other "classic" symptoms or stomach aches but suffered
> from
>  hypos after meals and then rises later. Do you find if you treat hypos
> they are
> slow to respond?
> Jackie
> - -----Original Message-----
> From: email @ redacted [mailto:email @ redacted] On
> Behalf Of
> Laura Holborow
> Sent: 21 February 2014 11:13
> To: pump list uk
> Subject: [IPk] Sudden change in sensitivity to insulin?
> Hi
> I've emailed my consultant about this, but he's not usually very quick at
> responding, so wondered if anyone here had any ideas please?
> I appear to have become suddenly far more sensitive to insulin than I used
> to
> be. But not consistently.
> My blood is sliding downwards each evening for the last 5 nights once I'm
> in
> bed, these slides (whether they result in a hypo or not) are keeping me
> awake
> for hours, as my body is noticing the slide and won't let me sleep as it
> thinks
> I'm going low (even if my brain knows I'm not!). It doesn't seem to matter
> what
> bolus I've had beforehand, so I guess it's a basal thing?
> For example I went to bed with a blood sugar of 18, and didn't correct
> (because
> I'd been dropping the previous couple of nights). I had last had a bolus
> around
> 4pm (due to hypos at 6 and 8pm that evening as well I didn't bolus for any
> dinner) a few hours later it was 10. At that point I put a temporary basal
> on
>  reducing my basal quite a lot (can't remember if I reduced it to 50% or
> 25%)
> and
> woke up with a blood around 12ish.
> It's doing it with complete unpredictability. Some times during the day I
> also
>  seem to be dropping more quickly than previously - but not every day, and
> not
> at
> the same time of day.
> This morning I woke up (after an exceedingly bad night being awake for
> hours) with blood of 15 (due to the low basal I had on to try and stop the
> slide) and had a 2 unit correction (the pump recommended 3 units) an hour
> later
> my blood was 4 and heading lower rapidly (by the feel of it).
> I've had the infusion set in 2 different sites whilst having these
> problems, so
> don't think its just one dodgy site. I am about to start from scratch with
> a
> fresh bottle of insulin/reservoir/set as well.
> I don't know what to change but I can't keep on like this. Any help very
> gratefully received.
> Laura
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