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does insulin effectiveness alter with pain?

Mep

Mep

Well-Known Member
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1,461
Type of diabetes
Treatment type
Insulin
I just was thinking about how I'm struggling to control my sugar levels because of my pain levels. I don't know if anyone here knows or has heard if insulin in the body reacts differently to pain levels? I'm not sure if I'm making any sense?... sorry if I'm not.

I'm on lantus for basal and apidra for bolus.

Any thoughts?
 
Pain can either increase the need for insulin or lower the need, most find they need an increase in insulin. Being different I tend to need a lot less insulin due to burning off my oral steroids for Addison's. Today I was knocked flying by a four legged thug of a dog (not mine) and every bone in my body hurts, blood sugars have hit the floor boards and showing no sign of surfacing (2.7 @ the moment) even after extra steroids and 50 carbs extra during the day.
 
CarbsRok said:
Pain can either increase the need for insulin or lower the need, most find they need an increase in insulin. Being different I tend to need a lot less insulin due to burning off my oral steroids for Addison's. Today I was knocked flying by a four legged thug of a dog (not mine) and every bone in my body hurts, blood sugars have hit the floor boards and showing no sign of surfacing (2.7 @ the moment) even after extra steroids and 50 carbs extra during the day.
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Yeh that's what I struggle with as it keeps changing on me. Just when I think I have the basal right I get another pain storm and it all goes nuts again. I was just wondering if the insulin itself performs differently in us because I notice I swing either too high or too low... mostly high though. It's annoying when trying to figure out what my basal dosage should be.

I'm sorry to hear you're having lows :( I hope you can get it levelled out soon.
 
Remind me again. What does the body produce, when its in pain? Adrenalin or steriod? Or is adrenalin and steriod, the same thing?
I know stress can cause over production of cortisol. Some people can over produce it as a condition called cushing syndrome.
Have you been tested for cortisol lately?

Cortisol can affect your metabolism of sugar and fat, for energy.
 
Mep said:
Yeh that's what I struggle with as it keeps changing on me. Just when I think I have the basal right I get another pain storm and it all goes nuts again. I was just wondering if the insulin itself performs differently in us because I notice I swing either too high or too low... mostly high though. It's annoying when trying to figure out what my basal dosage should be.

I'm sorry to hear you're having lows :( I hope you can get it levelled out soon.
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Thanks, it looks as if things have settled now and all that's needed is a complete body transplant to stop my bones hurting :rolleyes:
The bodies normal response is to chuck out more cortisol to fight stress/infection/pain and as we all know steroids cause high blood sugars so what it boils down to is your own body is fighting the good fight in the only way it knows how ie chucking as much cortisol to fight the problem which in turns increases a diabetics blood sugar for a pass time.
So basically your insulin is working exactly as it should and your body is the one not playing ball.
 
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yeh maybe the cortisol is interfering with mine as well. I also am on a drug that has increasing blood sugar as a side effect (baclofen)... not sure if that is playing a part either. I've been increasing amitriptyline dosage and my joint are sore again on the higher dose... not sure if that alters the effectiveness of my other drugs or not. Anyhow I did drop my basal insulin by 2 units and this morning I wake up on 8.8. Not impressed. I'm not sure if I had a hypo (doesn't feel I did this morning or it's just the basal is wrong). I'll keep at it until I see my usual morning numbers..... then again maybe I don't have usual morning numbers anymore. This pain business is annoying me in more ways than one. I can't seem to get a pain free day. Again last night was bad on the pain front and I wasn't moving too well last night from it. I'm not on steroids so that isn't a factor. It has to be the pain and/or the drug.

@ickihun - no, I've not been tested for cortisol recently. There was something that was up on blood tests about my liver that my doc said he had to keep an eye on though... not sure if that has anything to do with it. But I would be interested to know if my cortisol is normal or not. I'm sure it fluctuates anyhow.

@CarbsRok - I'm glad to hear yours has settled. I can understand the desire for a complete body transplant.
 
well update - I saw my doc today. After discussion about my spasms and my meds I then said look I can't get my sugar levels to even out and they keep spiking on me or dropping. I said I had adjusted the basal dosage a few times. He said don't touch your basal, it's the pain causing the problem. He said there's still work to be done about controlling my spasms and until that happens everything else including my diabetes is probably going to be out of whack. I mentioned about the baclofen to him as well and he said well the problem is my entire health isn't factored in by all my specialists as they are only focused on what they specialise in. But he agreed that it's likely it is impacting my sugar levels too. So for now I'm on another drug dosage increase. I've notice this drug increase I'm slowly gaining more weight again... not happy. It increases your appetite this drug and weight gain is a common side effect (along with some of my other drugs). I try and stick to my usual diet though. We did discuss about use of nitrates but that is known to trigger migraines which I don't want. Fun and games.
 
yes. Insulin resistance varies with a lot of things - sleep deprivation, fatigue, temperature, stress, recent food choices, recent insulin useage (injected or pancreas production), and definitely including pain.

Sorry to hear this @Mep :(
 
Brunneria said:
yes. Insulin resistance varies with a lot of things - sleep deprivation, fatigue, temperature, stress, recent food choices, recent insulin useage (injected or pancreas production), and definitely including pain.

Sorry to hear this @Mep :(
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Thanks :)

Yeh it's frustrating. My first reaction is to adjust my basal insulin dosage. I'm going to have to not touch it from now. This has been a long journey already and not much glimmer of hope in sight as docs can't figure out how to control my spasms and they've been getting worse.
 
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