I finally had my appointment with an endocronologist after waiting for over 8 weeks.  He explained how the pancreas and insulin work to control blood glucose.  In a normal functioning system the pancrease is able to product sufficient insulin on demand to cover the glucose in the blood.  He suggested that my pancrease may have been declining for quite some time.  However, under extreme stress ( e.g a viral infection), the pancreas can no longer keep up with demand and blood glucose rises.  As the blood glucose rises the pancreas works harder and harder but…eventually gives up.  In my case I had an upper respitory infection just a few weeks prior which may have triggered the stress on my pancrease.  Once I began insulin therapy my pancreas was able to recover a bit.

He said that right now I am doing well controlling my “sugars” but that is to be expected during the “honey moon” period. During this “honey moon” my pancreas is producing insulin almost at full capacity and I can reduce my insulin dosages to match. In fact the doctor suggested that I may even be able to eliminate the insulin altogether.

For example before each meal I was originally taking 1 unit of Novolog for every 15g of carbohydrate and my nightime basal (Lantus) dosage was about 3 units. My blood glucose before each meal was about 105. Now I notice that I can take 1 unit for each 20g of carb and I have eliminated the night time basal dosage. My bloog glucose before each meal is now abouy 88. That’s quite low and I think I may need to lower the Novolog to 1 unit per 30g of carbohydrate.

What scares me ( yes, I am afraid ) about all this is that I am basically guessing at the dosage amounts for each meal which can lead to taking too much insulin and risking hypoglycemia. For dinner last night I had slightly more than 60g of carb and 3 units of Novolog. My blood glucose before the meal (around 6 PM) was about 76 ( I tested twice to be sure ). By 10PM my blood glucose was 79. So obviously I took too much Novolog. I ended up eating a late night snack (20g carb) which I had eliminated when I droppred the basal (Lantus) dosage to zero. My blood glucose this morning was 95. This is a very scary honey moon.

My doctor suggest that in about 6 months to 2 years ( what a huge friggin range ) this will change I will need more insuling to cover my meals etc. I now understand why this is called “medical practice’.

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