Can you take too much insulin?

[barrym]

Well of course lows would be a possibility.

Background:

Classed as T2 as no positive GAD test, but thought to be 1.5 slow onset T1 by my consultant. Over the past 2 years since diagnosis I have 'managed' with Gliclazide, sometimes basal insulin, and a try with Metformin which did absolutely nothing!

Anyway, most recently I have been on 4 Gliclazide a day, and 7-9 units of basal insulin and still not under control, so I've now moved on to fast acting bolus, which I take ahead of meals, and dropped the Gliclazide. I have been carb counting for two years too so that wasn't an issue, and I started on a ratio of 20:1. First few days I saw quite an improvement, but still higher than I wanted, so I increased the insulin a bit this morning in the hope of bringing my lunch time reading down, but I have had quite the opposite effect. instead of a sub 10 reading which would be normal (although not good) it was 14!!!

Could this possibly be some inverse reaction to too much bolus insulin or is it straight forward and too much will give you a low?

 

[Daibell]

Hi. Are you overweight and hence a bit insulin resistant? What do you mean by 'sometimes Basal insulin?' The normal regime would be to take it every day, probably in the evening or twice a day. When I moved to insulin I suggested to my DN that I stopped the Gliclazide for 2 reasons i.e. it wasn't doing anything for me and why take both Gliclazide and insulin anyway; she agreed? Have you adjusted your Basal to have morning reading of between 5 & 7? You then take enough Bolus to match the carb count for the important meals. So the answer is you can take too much insulin and have a hypo but the key, surely, is to get the balance right during the day?

 

[barrym]

Hi. Are you overweight and hence a bit insulin resistant? What do you mean by 'sometimes Basal insulin?' The normal regime would be to take it every day, probably in the evening or twice a day. When I moved to insulin I suggested to my DN that I stopped the Gliclazide for 2 reasons i.e. it wasn't doing anything for me and why take both Gliclazide and insulin anyway; she agreed? Have you adjusted your Basal to have morning reading of between 5 & 7? You then take enough Bolus to match the carb count for the important meals. So the answer is you can take too much insulin and have a hypo but the key, surely, is to get the balance right during the day?

Sorry for being a bit vague on some of the points. I must collect all the relevant facts and stick them in my signature block like others here. Seems a good idea.

Not over weight, BMI is 22.

Regarding the basal insulin, when first diagnosed two years ago I started on lantus, but after a few months I stopped (DN recommendation) and relied on Gliclazide, diet and exercise quite well. During a spell of chemo last year I took lantus again for a few weeks. I restarted a month or or two back after a consultation because Gliclazide and Metformin weren't doing it any more. So I was then on Gliclazide only and lantus.

I was still not getting the control I needed to so have now stopped Gliclazide altogether and added bolus insulin starting at 20:1 although yesterday my DN advised stepping up to 15:1.

I understand the theory of getting the morning right and doing the maths through the day, and at the moment my mornings aren't quite good enough, and my DN has suggested a small increase in basal to settle that down.

My question really was whether having too much insulin in the blood stream was harmful, like BG is, ignoring any immediate side effects like hypos. Pretty silly question really, as getting the balance right removes the issue, although it does seem to be a fine balance at the moment but early days.

Thanks for the reply though.