Insulin resistance

[Charisma_1630]

The past month or so my sugars keep going high. I'm having more and more insulin to the point I'm not happy having so much and most times it still isn't bringing it down! It's getting highly infuriating! This morning I woke up on 11.8 (high for me in morning but I'm also struggling to get it down in mornings too now) I had 1 slice toast (16g) Afew months ago I did DAFNE and left having 2 units to ten grams in am. So would of been like 4 units plus like 2 or 3 u it's to correct.

Well this morning I had 10 units!!!! Tested 2 hours later and was 12.7 was expecting it much lower! Same goes for lunch I'm having to take ridiculous amounts and because of this I'm eating tiny portions through fear of it going high and not eating anything I enjoy!!

It's really getting me down as I'm struggling to get it under control! Is there any reason I would be having such extreme insulin resistance or anyway to get it back to normal?? I'm not ill and haven't changed anything in my life or anything

 

[mo1905]

Have you tried a fasting test ? Could it be your basal is too low ?


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[noblehead]

I would go along with what Mo says, try doing some fasting basal tests and see if your bg continues to rise between meals, failing that you should discuss your insulin resistance with your gp/consultant and they may suggest that you start taking Metformin.

 

[Charisma_1630]

No I've recently been lowering it as I was having way to much!! I even tried to up that again the last couple days to see if it would help but it hasn't!

 

[Charisma_1630]

What is metformin?? I have an appointment with my nurse Tuesday will she be able to put me on it? Or will I need to wait till I see a consultant?

 

[noblehead]

Metformin is sometimes given to type 1's who are resistant to the insulin they inject, here is a little info about the drug:

http://www.nhs.uk/medicine-guides/p...=metformin&preparationMetformin 500mg tablets

Personally I would would discuss your situation with either your consultant or dsn, in the mean time you do really need to carry out some fasting checks to determine if it is your basal insulin that is at fault.

 

[Charisma_1630]

Ok I take my long acting just before bed so ill do some over night checks!!

Although if I'm resistant will the long acting still do what it should??

 

[noblehead]

Ok I take my long acting just before bed so ill do some over night checks!!

Although if I'm resistant will the long acting still do what it should??

You also need to do the basal checks throughout the day as you say you have the same problem at lunch, long acting insulin is just a background insulin that deals with the slow trickle of glucose from the liver, it's not there to deal with food, once you get the basal dose right your almost certainly 50% there in terms of getting good bg readings.

 

[Charisma_1630]

How do you do day time testing when you have to eat tho?? I mean I can skip breakfast but what about after that?

 

[noblehead]

Have breakfast then skip lunch, eat a low-fat breakfast and start testing your bg after 4 hours, if your basal insulin is at the right dose it shouldn't fluctuate much more than 1 mmol, just remember not to eat anything even if it's low-carb as this can effect the results, just drink plain water if you can.

I'm going out for a walk with my dog but will be back on later if you have any other qusetions.

 

[Charisma_1630]

Ok great thanks. It's just so frustrating. It seems any time I eat my sugar flies up. I don't think the long acting is the issue but I will test it. Last night my sugar was 6.5. A bit low for me to go to bed on so I had a cup of tea, no sugar, and 2 choc digestive biscuits. An hour later it was 16.5!! I've never had this issue so **** frustrating!

 

[hanadr]

The past month or so my sugars keep going high. I'm having more and more insulin to the point I'm not happy having so much and most times it still isn't bringing it down! It's getting highly infuriating! This morning I woke up on 11.8 (high for me in morning but I'm also struggling to get it down in mornings too now) I had 1 slice toast (16g) Afew months ago I did DAFNE and left having 2 units to ten grams in am. So would of been like 4 units plus like 2 or 3 u it's to correct.

Well this morning I had 10 units!!!! Tested 2 hours later and was 12.7 was expecting it much lower! Same goes for lunch I'm having to take ridiculous amounts and because of this I'm eating tiny portions through fear of it going high and not eating anything I enjoy!!

It's really getting me down as I'm struggling to get it under control! Is there any reason I would be having such extreme insulin resistance or anyway to get it back to normal?? I'm not ill and haven't changed anything in my life or anything

My T1 husband has a similar poblem. In his case it's due to kidney problems. His are failing and not clearing the insulin from his body. What he is doing is lowering his carbs severely and reducing his insulin doses. He's now down to less than half what he used to use. Even if your kidneys are fine, I'd say lower your carbs. You risk going into an insulin spiral and gaining lots of weight if you keep adjusting doses up.
Hana

 

[noblehead]

Ok great thanks. It's just so frustrating. It seems any time I eat my sugar flies up. I don't think the long acting is the issue but I will test it. Last night my sugar was 6.5. A bit low for me to go to bed on so I had a cup of tea, no sugar, and 2 choc digestive biscuits. An hour later it was 16.5!! I've never had this issue so **** frustrating!

Two chocolate biscuits at bed without insulin would put me in double figures too Charisma.

If you haven't bought it already then I highly recommend that you read the book Think Like a Pancreas, it's full of useful information such as basal testing.

 

[mrman]

Agree with others probably long acting, test it and see if its correct. Also, same as above 2 biscuits without qa would be too much for many type 1s

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[Daibell]

I agree it's worth checking the Basal. Other posters have suggested ways to do this properly. You can do a rough check by seeing what a fasting test reveals. Use your meter first thing in the morning and it needs to be between 5 and 7mmol. If not, make small changes over a few days. When that is right you can then move to getting the bolus right. Do keep the carbs down to get rid of any excess weight. Many are kept on Metformin even when on insulin as it does help a little in holding blood sugar down. It may be you have other medical conditions that are affecting your blood sugar and only the GP can investigate. BTW a ratio of 2 units to 10gms is rather high quite apart from your current ratio and it does imply you do have insulin resistance. What is your current BMI?

 

[novorapidboi26]

I used to be on 3 units for every 10 grams in the morning, the I went on the pump and I am now 1.25 units for every 10 grams......

Don't be afraid to give yourself whatever insulin is needed even if its more than you think you should be on.......

you want to get the basal spot on so as to take as little of the bolus as you can.......

 

[Charisma_1630]

I'm not overweight in the slightest. I'm in the normal bmi range. Also I did my hospital equivalent of DAFNE in September and my morning was set at 2 units to ten grams and was working fine! It's as if it's changed overnight all of a sudden. I also had my long acting set so that I went to bed around 9 every night, I woke up at 5/6 (I know that means I was having a little too much but it was working for me) and now it's not coming down at all over night! In fact last night it went up n woke up at 13. It's such a mess just when it seemed like I was controlling it :-(

 

[Charisma_1630]

I find out my latest hba1c result tomorrow. First since September so should be interesting!

 

[Charisma_1630]

Oh yes I was going to ask my nurse but you guys can possibly answer better. If I was to eat something like eggs n some veggie for breakfast and I didn't need to inject, would that make the insulin resistance for the next meal even higher?

 

[Charisma_1630]

I did an over night test. Every 3 hours. At 10 it was 10.8 at 1 it was 10.2 at 4 it was 11.0 and at 7 it was 9.0