Amount Of Insulin

[bambee3]

Hi, I have a question regarding the amount of insulin people are using. I am taking the highest dose my Diabetes Ed has under her care at the moment. I am taking anywhere from 250 units to 450 units per day..I use an Insulin pump so these amounts include basal and bolus doses per day. I was wondering is anybody else on such large amounts of Insulin??????? My recent HbA1c was 7% the lowest since Sept 2017. I am also taking Metformin XR 500mg twice a day
Thanks
Sandy

 

[Deleted Account]

I do not take such as much insulin.
But I wonder why you are asking?
We are all different in many ways such as what we eat, drink, drink or how much we exercise, any other issues and drugs we take and even our diabetes.
I you are managing your diabetes with no apparent side effects there is probably nothing to worry about.
I am not a doctor so don't take my word for it. Your doctor said your dose is high but was that just an observation or a concern?

 

[kitedoc]

Hi @bambee3, sl > 5 x what I take daily but as @helensaramay says, many factors influence insulin requirements e.g. weight, activity level, insulin resistance, insulin absorption.
What does your doctor say about your insulin doses, as opposed to your Diabetes Ed.?

 

[bambee3]

Thanks for your responses, helensaramay.181361, kitedoc.468714/
I just find my doctor is slightly surprised that I am on so much insulin. He just leaves everything up to my Diabetes Ed who he trusts to handle my diabetes care. Although a few years ago my Endo at the time did say it takes as much as it takes however the amount has just continued to go up. A few years ago when I first went on to an Insulin pump I did manage to get my levels down to 85units/day.
I guess I was just curious if anybody else was on such large amounts. I listen to other diabetics who are concerned because they are taking up to 10 units to cover a meal and they are amazed/shocked at the amount I take. Even the reps from Medtronic gasp when they hear the amount I am having.
I guess I should go with the flow as they say, esp as my last HbA1c was down to 7%.

Thanks

 

[evilclive]

There are people who take a lot. There's more concentrated insulins for them (I think up to 500u/ml rather than the normal 100u/ml - https://bjd-abcd.com/index.php/bjd/article/viewFile/119/249) for when the physical volume of the injection starts to become important - though a pump might not suffer the same problem. So although you might be on a high dose compared to most here, you're not alone.

 

[Antje77]

That's a lot of insulin you are using, but clearly it works well for you so I wouldn't worry about it. I understand you are curious, so I'll tag @ickihun and hope I remembered rightly that she's on large doses as well. If I remembered wrongly, my apologies, Ickihun.

 

[bambee3]

There are people who take a lot. There's more concentrated insulins for them (I think up to 500u/ml rather than the normal 100u/ml - https://bjd-abcd.com/index.php/bjd/article/viewFile/119/249) for when the physical volume of the injection starts to become important - though a pump might not suffer the same problem. So although you might be on a high dose compared to most here, you're not alone.

Thank you for the info. I will mention it to my Diabetes Ed next time I see her.
Even though I am on a pump I am pretty much on the highest settings we can use re bolus doses. Sometimes I have to break it down into two to get the amount I need. It may be something to look at.

 

[bambee3]

That's a lot of insulin you are using, but clearly it works well for you so I wouldn't worry about it. I understand you are curious, so I'll tag @ickihun and hope I remembered rightly that she's on large doses as well. If I remembered wrongly, my apologies, Ickihun.

Thank you, love the puppy.

 

[ickihun]

Thanks for your responses, helensaramay.181361, kitedoc.468714/
I just find my doctor is slightly surprised that I am on so much insulin. He just leaves everything up to my Diabetes Ed who he trusts to handle my diabetes care. Although a few years ago my Endo at the time did say it takes as much as it takes however the amount has just continued to go up. A few years ago when I first went on to an Insulin pump I did manage to get my levels down to 85units/day.
I guess I was just curious if anybody else was on such large amounts. I listen to other diabetics who are concerned because they are taking up to 10 units to cover a meal and they are amazed/shocked at the amount I take. Even the reps from Medtronic gasp when they hear the amount I am having.
I guess I should go with the flow as they say, esp as my last HbA1c was down to 7%.

Thanks

I hear your concerns.
Since I've stopped metformin due to not being compatable with IBS I've had to increase my units to:- 117 units of triple strength basal (which would be 351units of levemir or similiar) and 130 of novarapid bolus.

Is your Dr concerned for insulin resistance and weight gain?

 

[bambee3]

I hear your concerns.
Since I've stopped metformin due to not being compatable with IBS I've had to increase my units to:- 117 units of triple strength basal (which would be 351units of levemir or similiar) and 130 of novarapid bolus.

Is your Dr concerned for insulin resistance and weight gain?

Hi,
my Dr is concerned about my weight gain as I had to give up work about 8/9 years ago due to health issues. I was in hospital after passing out while shopping , just about every time I stood up I passed out. It took 8 weeks to find out I had diabetic neuropathy affecting my heart rate and blood pressure. I spent the next 12 mths in a wheelchair when ever we went out. I still have days now when I need to use it. As a result of not working I have gained approximately 20kg. I also feel your back pain due to damage from a car accident. He has occ mentioned insulin resistance but my Diab Ed who is really great also says I am very carb sensitive, so She wants me to try and reduce my carbs to 185g/ day. It is good to hear someone else is on such high doses, I feel better knowing it’s not just me. I thank you for getting in touch and wish you well.

Sandy

 

[ickihun]

Hi,
my Dr is concerned about my weight gain as I had to give up work about 8/9 years ago due to health issues. I was in hospital after passing out while shopping , just about every time I stood up I passed out. It took 8 weeks to find out I had diabetic neuropathy affecting my heart rate and blood pressure. I spent the next 12 mths in a wheelchair when ever we went out. I still have days now when I need to use it. As a result of not working I have gained approximately 20kg. I also feel your back pain due to damage from a car accident. He has occ mentioned insulin resistance but my Diab Ed who is really great also says I am very carb sensitive, so She wants me to try and reduce my carbs to 185g/ day. It is good to hear someone else is on such high doses, I feel better knowing it’s not just me. I thank you for getting in touch and wish you well.

Sandy

Any time Sandy.

My endo is great too. He explains to the nurses that in times of trauma, no amount of insulin will stabilise my bgs. Once I'm not so stressed the units have much better effect. Any carbs spike me (except reheated fresh potato). Unless I drowned my food with novarapid I'm left in 9s and upwards. Even basal cannot keep my bgs lower. I'm feeling Toujeo300 is giving me rebound through the night but I'm yet to investigate more as I'm enjoying no alarm through the 6wks holidays. I'd begrudge setting the alarm to investigate.

 

[Struma]

Hi, I have a question regarding the amount of insulin people are using. I am taking the highest dose my Diabetes Ed has under her care at the moment. I am taking anywhere from 250 units to 450 units per day..I use an Insulin pump so these amounts include basal and bolus doses per day. I was wondering is anybody else on such large amounts of Insulin??????? My recent HbA1c was 7% the lowest since Sept 2017. I am also taking Metformin XR 500mg twice a day
Thanks
Sandy

I don't know how diabetes services work in your country.
Were you in this country, I would suggest having a referral to an Insulin Resistance Unit. Here they seem to be in Centres of Excellence rather than DGH.
Maybe you'd like to find out more?

 

[bambee3]

Any time Sandy.

My endo is great too. He explains to the nurses that in times of trauma, no amount of insulin will stabilise my bgs. Once I'm not so stressed the units have much better effect. Any carbs spike me (except reheated fresh potato). Unless I drowned my food with novarapid I'm left in 9s and upwards. Even basal cannot keep my bgs lower. I'm feeling Toujeo300 is giving me rebound through the night but I'm yet to investigate more as I'm enjoying no alarm through the 6wks holidays. I'd begrudge setting the alarm to investigate.

I agree, waking in the early hours to check can be a challenge. My Bgl has been up to 23/25 range and it is not a place I like to be. This past few weeks I have been trialing the freestyle Libre sensor and we found I was dropping in the two range and not aware of it. It happened during night and day times, my Diab Ed was surprised as was I. Have you thought about a continuous monitoring system. I know it is expensive but you don’t have to do it all the time.

 

[bambee3]

I don't know how diabetes services work in your country.
Were you in this country, I would suggest having a referral to an Insulin Resistance Unit. Here they seem to be in Centres of Excellence rather than DGH.
Maybe you'd like to find out more?

I am in Australia, I have never heard of such a unit here. The Endo I used to see is over 4hrs drive from me. He just seemed to shrug of the amount of insulin I was taking when I last saw him a few years ago. He told mee it takes what it takes to keep in control of my diabetes.

 

[ickihun]

I am in Australia, I have never heard of such a unit here. The Endo I used to see is over 4hrs drive from me. He just seemed to shrug of the amount of insulin I was taking when I last saw him a few years ago. He told mee it takes what it takes to keep in control of my diabetes.

Its only when I'm on the right amount to keep good control do I lose weight on the low carb eating.
I'm struggling to get good numbers even thou I'm on so much. I'm seeing endo soon as I've had to stop metformin which does help me need less. I really don't want to take even more insulin.

 

[bambee3]

My low carb eating is so far not producing results in the weight loss side of things. I tend to also build up fluid which doesn’t help things.
Good luck when you see your endo.