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March 17, 2003

Daily Care

Question from Burlington, North Carolina, USA:

I have had type 1 diabetes for seven years, am on a pump, and have a ten month old son. I was expecting my insulin dose to decrease after I gave birth, but as of a week ago it has not stopped decreasing. I have gone from 13 units per day to around 5 units per day total within four months, and it keeps dropping. I am taking about a fourth of the amount of insulin I was taking before I was pregnant. My blood sugars are okay, and my last A1c was 5.9%. I haven't really lost much weight and am exercising the same as I was before my pregnancy. Is there any possible medical reason as to why this is happening?


I recommend you speak to your physician about check how much insulin you are secreting on your own. Typically, after seven years with type 1 diabetes, you should still have very little. This can be checked by measuring the C-peptide level. You should also talk to him about your adrenal function and make sure yours is normal.

If no answers appear, you may have to decide whether it would be best to continue on the insulin pump or go back to injections. It sounds uncommon but it is what it is. Spontaneous remission from type 1 diabetes is very unlikely since the development of the disease results in a gradual and permanent loss of insulin-producing cells.