Hello everyone,
for a better understanding and because I have promised to share some of my own thoughts concerning
inexplicable (right spelling?) bg levels, I decided to write this text.
Some ten years ago, I often felt ill at work and had to see doctors. I suffered heavily from nausea
and none of my doctors could figure out any reason for this. They send me to specialists who made
all sorts of expensive tests, inclusive kernspin MRT and found nothing. Finally my doc had no other
choice to make all blood values he knew and two das later he called me and saif that I had to come
to see him. Then he told me, that he thought it was all his fault and he must have noticed the
symptoms, but now I would be quite clear, because my blood values had shown that I was suffering
from diabetes.
He diagnosed Type-2a-diabetes and described me Metformin which I took two or three times for no
good. The only thing it does, was causing diarrea. I told my doc and he said that most people he
treats unfortunately react like that on Metformin. So he described me other oral antidiabetica that
were supposed to decrease my bg levels throughout the day. That worked fine and after a few weeks of
intensively measuring I cought the pattern and was doing well. All I had to do, was taking those
pills and make every 3 months HBA1c value. On average I had 6,5, my doc was happy and I thought that
it would be ok if I had to take those pills for the rest of my life. I didn't do anything special,
just forfeitet candy, colas and all this sugar-loaded stuff and felt fine. I thought that would do
for the rest of my life.
8 years later I should learn how wrong I was.
Just after my "Abitur" (highschool exam) which I passed when I was 33 years already, I woke up
having lots of pain in my stomach, and guess what, my doctors again were clueless. I had to pee very
often and told my doc that I guessed that diabetes could be the reason for that. He didn't believe
me and so I finally got into hospital were they wanted to cut out parts of my "darm" (sorry, do not
know the english word, may be Alan can help me out). I refused to let them do that and went to a
specialist who attestet that everything was fine. He wrote a letter for my doc and when I was again
there to see him, he still refused to believe that my diabetes could have interfered in such a way.
So I had no other chance any mor in order to get proof: I cooked a big meal, got my meter ready and
ate. 2 hours after eating I got 440 mg/dl. With this value on the display I went to my doc and put
it right under his nose. Then he agreed that diabetes could have been the reason for my pain and
guessed that even some sort f ketosis or even acidosis could have happened. He prescribed me lantus
and I applied it as I was told to. The day after I had bg levels of 360 mg/dl and I told my doc,
that lantus, as long term insulin would not be able to control bg level rise after meals and again
held him my meter under his nose. He then described me Insuman rapid and let me alone with it.
All I know know about factors, insulin resistance and receptor-down regulation is not the result of
the help of doctors, no, I had to figure it out alone. I startet out with 1 IU for 30 carbs which I
figured out alone. Hell, the doc just said: "Why bother with factors? Just wait until you have 250
mg/dl then apply 5 IU and see whats happening.". After 6 months I ended up with 10 IU for 10 carbs.
First I had an overall factor from 1-1 in the beginning then it was 10-1 at noon and 4-1 in the
evenings. I then hat to take 14 IU of Lantus and more than 70 IU of insulin all day.
Then I moved to live with my girlfriend and in the new town I had to search for new doctors. Most of
them told me that insulin is a bodily hormon which does not any harm. They suggested that I should
apply more and more insulin and to cite Star Trek with only the sky as a limit.
To that point I was really tired of it and wanted to get a doc prescribing me lispro or aspart, but
I dindn't find anyone to do so. They all feared that I would get rapidly into hypoglycaemia and fall
unconscious. Finally I found one and she told me over and over again how careful I would have to be
with that. I knew already how fast these insulins are and was careful, very careful, but I really
wasn't prepared for that what was coming.
So I sat down to eat my 60 carbs meal. 24 IU Insuman would have been the right amount to handle
this, but now I had to do with lispro. The doc told me that I sould not apply more than half of my
Insuman-amounts and since I wanted to be really carefull, I decided to even use less. So finally I
applied 6 IU lispro and immediately the hell broke loose. I felt my bg level rapidly falling, some
iron fist came right out of the blue, catched me and wanted to kill me, my eyesight started to
vanish and I was close to fall unconscious. In a final effort I was able to drink some cola and
started to eat immediately and in a hurry. After meal my bg levels were almost constantly at 140m
g/dl not moving a single step, then after 40 minutes lispro was over and my bg levels rose up to
200. I then let my pancreas regulate it out on her own. The next day I tried it once again, first
eating, then injecting lispro. This was way better, but the iron grip around me was there too and I
felt unhappy with that insulin.
The day after I decided to go back to insuman and ate 55 carbs meal. 40 IU Insuman was the right
amount for that time of the day, well it had been. Lispro had changed my factors which I did not
know, so I had an 8 times overdose and rapidly falling bg levels. In panic I drank liters of cola
and ate sugar and when I finally arrived at hospital, I had 380 mg/dl and the doc was ready to give
me an additional 6 IU lispro. I refused. 2 hours and 3 bananas later my bg levels werde falling
again rapidly. Again cola in panic, again in hospital, again they wanted to give me lispro, no
concerns about my overdose at all. They just don't care. I then stayed over night in order to be on
the safe side, but refused additional insulin. I woke up the next morning with 120 mg/dl having
everybody around me congratulating for my good fasting bg values.
Comments of the docs who believed I would get into keto acidosis: "Erm, ähhh, erm ...".
Due to my insulin and then sugar-overdose I recalculated my new factors and did fine again. Those
two injections of lispro decreased my insulin resistance by the factor of 8! No doc ever would
believe that unless I could proof it with numbers and values. Then they had to accept and were very
angry with me because I came up with something they could not understand. Only one doctor agreed and
told me that this was the reason why she would apply insulin directly to the bloodstream of patients
with high insulin resistance.
Another 4 months later I visited my mom and had to carry heavy luggage. When I finally arrived, my
insulin dependency was gone. It was just gone. Of course I was very cautious and just ate 35 carbs
with no insulin apllied. My meter didn't show any movement of my values. They were frozen. After 2
hours I ate 35 more carbohydrates with no effect on my bg levels. Then another 20 and another 20.
Only when I ate fruits my level would rise.
Back at home I told my doc that I ceased applying insulin. Then, now for him, the hell broke loose.
His mouth popped open, he literally froze in his movement, got white and finally he said with a
crumbling voice: "What did you do? Jesus no! You can't do that!".
I told him that I could and that I had and showed him my newest bg values. He read them carefully,
his mouth still open, and while he read I could hear "That's not possible!", or "I can't belive
it!", "hell he ate 70 carbs and it had no effect on him. None!", "oh my god!".
Finally he agreed that I could go on with no insulin and with excercises.
Thats my story.
Statistics show:
Me and oral antidiabetica: Av A1c = 6,5
Me and insuline: Av A1c = 8,0
Me and excercise: Av A1c = 6,4
Now, as I promised my own conclusions concerning spilling ketones.
Example 1:
50 carbs, no ketones. After meal 180 mg/dl no ketones, 4 hrs 130 mg/dl.
Everything is fine, although after meal value could be better. Here in GER should be below 160 mg/dl
Example 2:
20 carbs, no ketones. After meal 200 mg/dl ketones ++, 4,5 hrs 250 mg/dl no ketones. 5
hrs: 130 mg/dl
My conclusions:
In example 2 my pancreas does not do anything after meal. It does not recognize the increas in bg
levels. Lack of insuline = ketones. After 4,5 hours values too high, pancreas reacts and puts
insulin into bloodstream, no more lack of insulin = 0 ketones. And after 5 hrs values are
acceptable again.
Comments are welcome.
Michael