Insulin requirements and CPAP

[John_Jason]

I am a lifelong type 1 diabetic, although there is now evidence of some resistance as well. My AHIs average about 3 and never go above 5, so the CPAP machine seems to be doing what it is supposed to do. However, I used to use 35-45 units of N at bedtime to control my massive dawn effect, but since starting CPAP on April 5 I now need 55-65 units to keep from being too high in the morning. I assume that my sleep pattern has changed so that now my liver goes into gluconeogenesis hyperdrive at a different time, but I am not happy about needing so much insulin. Is this normal? Have others experienced this?

[chunkyfrog]

I know, one would think it would be the other way around.
During the last power outage, I had a slight peak in blood glucose readings.
Now the other side of the story:
--But some people have gained weight on CPAP.
Maybe they toss around less at night, getting less "exercise".
Weird, maybe; or maybe not.
I felt so good in my first months on CPAP, I had no clue my blood sugar was getting out of control.
I had to sharply curtail my carb intake, increase exercise and drinking water.
And concentrate on a nutritious, low calorie/fat diet.
I went from 52 units of Lantus at night to 16.
I'm convinced it's not the CPAP--but feeling so good covered up the fact there was still something wrong.
Of course, not suggesting that you might be a (horrors) baby boomer; time might be doing you a number.
Still no reason you couldn't work on whatever needs tweaking.

[Goofproof]

Maybe since you are not trying to croke as many times a night, Maybe the fight or flight thing not going on causes you to burn less fuel and causes the need for more insulin.

I use 200 units of insulin daily, of mixed types as needed 60 in am, 80 in pm Supper, and 60 at bed ( I eat before bed too 4 am). I have found XPAP causes no change in my insulin requirements, I have found out I can't sleep in if my sugar is below 100 in the a.m. Jim

I have also found the insulin seems to wrok better when I am asleep.

[JohnBFisher]

No, an increase is not normal. But I suspect that you are correct that the xPAP therapy has changed your overall metabolism.

Most diabetic folks, as you know, are Type 2 Diabetics, so deal with insulin resistance. Though those of us using xPAP therapy have known for some time that untreated apneas result in increased insulin resistance, there are now studies that confirm this.

Though you might ask your doctors about this, I doubt seriously if they will know. The interaction of sleep and the endocrine system is poorly understood (little studied). But it is there.

I hope that you will find that with improved sleep you will start to see a drop in the insulin resistance and a decrease in your insulin needs. If nothing else, you will feel like doing more, which will decrease your insulin resistance.

By way of explanation, I am a Type 2 Diabetic (probably made worse by years of having untreated central sleep apnea - despite my efforts to have it addressed by various doctors). So, my response is based both on readings here and research material and my own personal experience.

[purple]

There is a rumor that aerophagia increases diabetes problems.

[xenablue]

I am a lifelong type 1 diabetic, although there is now evidence of some resistance as well. My AHIs average about 3 and never go above 5, so the CPAP machine seems to be doing what it is supposed to do. However, I used to use 35-45 units of N at bedtime to control my massive dawn effect, but since starting CPAP on April 5 I now need 55-65 units to keep from being too high in the morning. I assume that my sleep pattern has changed so that now my liver goes into gluconeogenesis hyperdrive at a different time, but I am not happy about needing so much insulin. Is this normal? Have others experienced this?

That IS quite a lot of insulin for a T1 and as I'm a T2, have no real answer for you - except as you say, you have some resistance, plus it's a progressive disease.

Have you experimented with bedtime snacks/no snacks etc? Have you tried reducing your overall daily carb intake if resistance is evident?

I would suggest asking on the ADA forums in the T1 section - I'm sure there are a lot of others who could advise you on this.

Cheers,
xena