Hi Julie, I do think the sliding scale is for more severe CFRD meaning they need long acting insulin to cover their baseline and then the short acting insulin on top of it with meals.

I have anecdotally heard that when healthy people cut carbs, their bodies also react more sensitively to carbs when it is reintroduced so I do not think it would necessarily mean that you are getting worse, your body just becomes more sensitive...however many things can affect your sugars, illness, other medications, hormones etc. or sometimes it just fluctuates with no real explanation. If you are experiencing a big change it is of course always good to speak to your doctor. And if you can't control it with diet, then you probably will benefit from the insulin.

Regarding your other question about replacing the function of your pancreas...I think if you add 'artificial' insulin, your pancreas will produce less because it does so in response to sugar levels in the blood (injecting insulin, causes lower sugar level which will send fewer signals to your pancreas)...at least that's how I understand it. Good luck, keep us posted on your progress.