QUESTION: My girlfriend has had type 1 diabetes since age 11 and takes 38 units of insulin in the morning and 10 units at night. She has frequent low blood glucose. Could this mean that her pancreas has started working again, and what may be causing the hypoglycemia?
Frequent hypoglycemia does not usually mean that the pancreas has recovered from type 1 diabetes. It more often means that insulin is not matching food, activity, alcohol intake, body weight, illness, or current insulin needs. Repeated readings below 70 mg/dL—and especially any reading below 54 mg/dL or an episode requiring another person's help—should prompt a rapid review by her diabetes team. She should not stop insulin or reduce doses without an individualized plan.
Answer by Dr. Albana Greca, MD, MMedSc
Hi,
Your concern is understandable, but recurrent lows are a treatment-safety problem, not proof that type 1 diabetes has disappeared. Type 1 diabetes results from autoimmune loss of insulin-producing cells and continues to require basal insulin.
A temporary “honeymoon” period of residual insulin production may occur after diagnosis, but it does not cure type 1 diabetes. If insulin needs have fallen dramatically, an endocrinologist can review the diagnosis and consider C-peptide or antibody testing without delaying prevention of further lows.
“38 units in the morning and 10 at night” is not enough information to judge the dose. The insulin type, weight, meals, timing, activity, kidney function, glucose pattern, and any mealtime insulin are essential.
She should bring the exact insulin products, doses, timing, CGM or meter report, and a food and activity record. A fixed twice-daily regimen may cause lows when meals or routines vary.
Less common causes include gastroparesis, celiac disease, adrenal or thyroid disease, and inaccurate meter or CGM readings.
Not in the way described in the old answer. A person with established type 1 diabetes does not usually develop a delayed natural insulin release four to six hours after eating. A later low is more likely related to injected insulin, exercise, alcohol, delayed digestion, or insufficient carbohydrate.
Record the glucose level, time, symptoms, insulin dose, meal, activity, alcohol, and treatment for every low. Note whether lows occur overnight, before lunch, before dinner, after exercise, or several hours after a correction.
If a CGM low does not match her symptoms, confirm it with a finger-stick when possible. Pressure on a sensor during sleep can cause a false “compression low.” Recurrent or asymptomatic lows still require review.
A blood sugar log can help identify the insulin period responsible for the pattern.
For glucose below 70 mg/dL, when she is awake and able to swallow:
Chocolate and high-fat foods are slower and are not the best first treatment. Avoid overtreating with large amounts of food, which can produce a rebound high.
Everyone using insulin should have unexpired glucagon available. Close contacts should know where it is and how to use it; ready-to-use injection or nasal products are easier than mixing kits.
If she is unconscious, having a seizure, severely confused, or unable to swallow, do not give food or drink and never give insulin. Use glucagon if available, place her on her side, and call emergency services.
Her team should review insulin timing, carbohydrate ratios, correction factor, targets, injection sites, kidney and liver function, and hypoglycemia awareness. Any level below 54 mg/dL or severe episode should trigger reassessment.
Continuous glucose monitoring with low and predictive alerts can reduce hypoglycemia. An automated insulin-delivery system may further reduce lows when available, suitable, and used with appropriate education. See our insulin treatment guide.
Call emergency services for unconsciousness, seizure, inability to swallow, severe confusion, injury, or a low that does not improve after glucagon or repeated treatment. She should obtain urgent diabetes advice after any episode requiring help, any glucose below 54 mg/dL, repeated overnight lows, or frequent readings below 70 mg/dL. She should not drive while low or until glucose and thinking have fully recovered.
Frequent hypoglycemia usually means that insulin exposure is too strong for part of the day, not that the pancreas has healed. Her exact regimen needs prompt professional review. Support her by learning glucagon and low-glucose treatment, but insulin decisions and monitoring should remain centered on her and her diabetes team.
Educational safety note: This answer is for general diabetes education only. It does not replace personal medical advice, diagnosis, or treatment. Do not stop basal insulin or independently change insulin doses, food, alcohol intake, exercise, or other medicines without guidance from her diabetes healthcare team.
Last reviewed: July 2026.
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