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Re: [IPk] Sites and bg's

It's really good to know that other people experience similar things. 
In my case, although  certainly developed type 1 as an adult, and
wondered about this slow onset thing, it was fairly conclusively
demonstrated that I had virtually no functioning beta cells only a
short time after onset of diabetes - I work in a hospital where they
were looking for candidates to test a sort of vaccine which could delay
progress of the destruction of beta cells, and so I had a whole series
of blood tests to check if I might be suitable - concluded that I did
not have enough beta cells left for it to be worth trying. The doctor
running the project also said that based on his experience, the fact
that right from the start I had many days where I needed 25-30 units
insulin a day to avoid developing very high blood glucose levels indeed
indicated that there were unlikely to be many remaining functioning
beta cells.
more below.........

Date: Wed, 10 Oct 2001 13:36:41 +0100
From: "Elizabeth OShea" <email @ redacted>
Subject: RE: [IPk] Sites and bg's

>I wonder if Nanette and Judith's experiences are of 'slow onset' type
>diabetes (there's an acronym for this, but I can't remember what it 
>Apparently, the beta cells in some adults who develop type I stop 
>insulin very slowly and so you could get spurts of 'normality'.
>Bernstein maintains that if you catch this process early enough and 
begin a
>rigourous low carb diet you can reduce the stress on the pancreas and
>thereby maintain the function of the remaining functioning beta cells 
>the person may need no or very little exogenous insulin. And that's
all I know about it!


Date: Wed, 10 Oct 2001 13:51:47 +0100
From: Diana Maynard <email @ redacted>
Subject: Re: [IPk] Sites and bg's

> Sorry I don't have any ideas about the site issue, but I was so 
> by what was written below that I had to respond.  Since start of DM
> nearly 4 years ago, I have had a patches of several (3-10) days in a
> row where I need less insulin than usual, seem to have normal or near
> normal blood glucose almost regardless of what I eat, easily get 
> then back to normal or to a high insulin phase where for a few days I
> need more than usual.  I find it much easier to control with the pump
> than on injections, at least not having to deal with unpredictable
> peaking of long-acting insulins, and being able to respond quickly to
> changes, but it still is not easy to know how to deal with these
> different phases and the abrupt and unpredictable transitions between
> them.
Hi Nanette
> I've experienced the same thing, although I've only noticed it since 
>on the pump 2 1/2 years ago.
>Recently I've made 2 discoveries that may explain it.
>(1) wildly different insulin needs at different times of the month
>(2) the effect of exercise. By this I mean that if I exercise less
than usual 
>over a period of 2-3 days, my insulin resistance will increase for up 
to a 
>week afterwards. And if I exercise more than usual for 2-3 days, my 
>resistance will decrease for up to a week afterwards. Bearing in mind 
>most people don't do exactly the same amounts of exercise every day,
or every 
>week, and it's clear that these high insulin and low insulin phases
>easily occur (and it's not immediately obvious that they're 
>exercise-related). Combine that with different insulin needs at 
>times of the month, and various other factors such as the weather, and

>whole thing seems less weird.
I agree - in my case it is definitely related to physical activity (but
not in any easily quantifiable way), and weather and emotional things,
not time of the month in my case (emails do not reveal my age!) - what
I believe though is that my insulin requirements seem very sensitive to
these fluctuations, to the point that variation in blood glucose
following the same meal on different days is far more likely to be due
to some combination of those things than due to say a somewhat larger
or smaller carbohydrate portion size.  Also since the immediate effects
of exercise seem to be very dependent on level of blood sugar and
available insulin when starting the exercise, that is another factor,
and again not one that is easily quantifiable, since it depends on
insulin sensitivity at the time, which itself fluctuates.  Recipe for
extreme frustration in maintaining stable blood glucose, but nice to
know that I am not alone.
What do you do about adjusting basal rate of the pump to cope with the
changes?  any other suggestions?

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