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December 31, 2001

Stress

Question from Arlington Heights, Illinois, USA:

type 1 diabetes four years ago, has been on a regimen of NPH with Humalog in the morning and Ultralente with Humalog in the evening. During times of positive stress, (i.e., having fun with friends, excitement around a favorite babysitter, most recently Christmas and Santa), he seems to run his blood sugar into the ground. He has been so low at times that we have skipped the evening shot completely, fed him extra carbs and still had him wake up at only 65 mg/dl [3.6 mmol/L]. Two different endocrinologists have disagreed with us, and say this is simply not possible, but it happens with no prior changes in his and insulin regimen. However, a handful of people who have had type 1 diabetes for 10-20 years have unanimously agreed with us. Any experiences with this?

Answer:

My best guess is excitement, running around, etc., and likely a bit less to eat than you think with all the activity. This might lead to lows. Also, although I have no data, there might be less of the “bad” stress hormones released at these times.

LD