extremely high insulin needs

phil169 said:

thanks for your help in this. the next visit to the consultant is next jan when he hoped that I would be on a pump but a lass CCG say no to that one yet again. I think every one is at a loss as to what to try next have tried several tablets and insulin's mixed with tablets and yes some have dropped my bg but not enough to warrant the expense of keeping me on them ( that's what consultant said). I was told to lose some weight and bg would drop. I have now lost 5st 4 lb and bg has gone up?????. the only thing that I have found is that if I don't eat any thing then that brings my bg down. but was told off by consultant for doing that. now my ALP is up GP is sending me for moor blood test's and a liver scan yet again as last one showed a small cist on my liver. I am now at this point getting realy fed up with it all if not a hospital at GP's I don't seem to have a life any moor.

Click to expand...

It could be that you are becoming more resistant to insulin like me and my insulin needs have been titrated upwards over the year.

Brunneria said:

Hi,

are you on statins? They can sometimes raise the BG a lot.

I really feel for you.

Have you read any of Jason Fung's work on intermittent fasting?
He suggests that this is a way to bring down insulin resistance and decrease medication.
If fasting brings your BG down, then maybe fasting on a regular basis may have benefits for you.

I believe Fung has published some stuff, but most of what I have seen of him is on You Tube. Just search for his name and that should start you off.

I really hope that one of the suggestions you are getting on this thread helps - it must be a seriously difficult thing to keep on top of.

Click to expand...

Brunn, I think any type of fasting could be medically dangerous on the questioner's current insulin needs and might precipitate a hypoglycaemic event. Any solution should come from his healthcare team.

eddie1968 said:

Brunn, I think any type of fasting could be medically dangerous on the questioner's current insulin needs and might precipitate a hypoglycaemic event. Any solution should come from his healthcare team.

Click to expand...

You may well be right - but the OP did mention that he finds not eating is a way to reduce his bg and insulin needs.

Watching you tube and researching is info gathering, not changing treatment.

And I completely agree, his team would need to be involved in any decisions and supervise carefully.

Brunneria said:

You may well be right - but the OP did mention that he finds not eating is a way to reduce his bg and insulin needs.

Watching you tube and researching is info gathering, not changing treatment.

And I completely agree, his team would need to be involved in any decisions and supervise carefully.

Click to expand...

Agreed, info gathering is useful but a little knowledge can be dangerous putting into practice when on insulin. I know we can have our disagreements and I'm not looking for an argument, just a constructive debate.

eddie1968 said:

Agreed, info gathering is useful but a little knowledge can be dangerous putting into practice when on insulin. I know we can have our disagreements and I'm not looking for an argument, just a constructive debate.

Click to expand...

FWIW, I think Phil is sensible enough to not try fasting without checking with his doctor first. I agree it could be a disaster, but it could work... it definitely would need to be tried carefully.

eddie1968 said:

Brunn, I think any type of fasting could be medically dangerous on the questioner's current insulin needs and might precipitate a hypoglycaemic event. Any solution should come from his healthcare team.

Click to expand...

I don't think his healthcare team has offered any solutions so far, and there have been many discussions over a long period of time... some things have been discussed but denied due to cost. I think all we are doing is suggesting ideas for him to think and read about, and to take to his doctor if he wants to.

eddie1968 said:

Agreed, info gathering is useful but a little knowledge can be dangerous putting into practice when on insulin. I know we can have our disagreements and I'm not looking for an argument, just a constructive debate.

Click to expand...

No worries! I think we are all trying to help, and sometimes that can look different, from different perspectives.

phil169 said:

hi all and thanks for you help.
I am willing at this point to look at anything to get on top of this. today 8:00am doctors he spoke to the diabetic specialist unit to see if they could see me urgently and to ask there advice. I am not to alter anything at this time. they are going to contact the CCG as they think that a pump would sort out bg using u500. no to carb free diet. meeting with the CCG 3:00pm they have faxed the IFR request back to them to reconsider it Urgently if it come back as NO then they (CCG) will hold an urgent meeting to discuss the problem and what to do next. they say they will have it sorted by the end of this week ( think some one has kicked there but to day). as a doctor from the specialist unit was there at this meeting, he said that he has seen this before and the insulin that I am taking all though it is not controlling my BG it is stopping me from going into ketoacidosis. I am to keep testing for ketones and only up insulin when they appear by 2-3 units. they will see me in there clinic next week.

Click to expand...

That all sounds like good progress, what a relief!

I can understand them saying no to a completely carb free diet, but perhaps when there is time they might have a different view on say 20g or 50g, if that's what you think might help. I'm pretty sure that 150g or more would not be great for you (for anyone actually)... but at the moment the top priority is avoiding DKA and getting a better insulin regime to push the BGs right down.

I'm so glad things have started to change... backsides certainly needed kicking!

CatLadyNZ said:

@alaska since you are a T2 on insulin (I think?) do you have any ideas that might help Phil? Do you know of any other members who could be tagged in?

Click to expand...

Actually I'm type 1 but have as much of an interest in type 2 as type 1.

Very high insulin requirements will mean high insulin resistance. I assume @phil169 that there is significant weight to be lost?

The other factor that can significantly increase insulin resistance is steroids.

The way to combat insulin resistance, and high blood sugars as a result, is to reduce insulin intake. Calorie intake (unless already sufficiently low) should be reduced in turn.

This should be done only in agreement with the doctor.

Insulin fuels insulin resistance, so upping insulin doses may slightly alleviate high blood sugar in the immediate term but it exacerbates the underlying problem of insulin resistance and is therefore likely to cause more problems in the longer run.

If you're on low carb and it's also low calorie, I'd expect to see blood sugar levels beginning to drop at least a little after 2-3 weeks.

Taking 100s of units of insulin is abnormal but don't worry, some people do take this much. The key is to turn things around so that the insulin doses are reducing rather than growing.


As an analogy, we can look at insulin resistance and electrical resistance. This may make sense for some. If it causes confusion, just ignore. If you have a resistor in an electrical circuit, the more voltage applied, the higher the resistance. In type 2 diabetes, the more insulin produced or taken in, the greater the insulin resistance.

If you are within normal bmi limits then why not eat more calories - they don't have to be carb laden. You will just keep losing more weight. Just sitting still for me burns 30 calories in 30 minutes so just to do nothing I use 1440 calories in 24hours. I struggle to keep weight on and purposely eat lots of olive oil, olives, avocado and fish to keep at enough calories. I cannot see why if you are a normal bmi the reason for not eating enough calories to msintain your weight.

donnellysdogs said:

If you are within normal bmi limits then why not eat more calories - they don't have to be carb laden. You will just keep losing more weight. Just sitting still for me burns 30 calories in 30 minutes so just to do nothing I use 1440 calories in 24hours. I struggle to keep weight on and purposely eat lots of olive oil, olives, avocado and fish to keep at enough calories. I cannot see why if you are a normal bmi the reason for not eating enough calories to msintain your weight.

Click to expand...

I tend to agree, and 600 calories is a level people use when they need to lose a lot of weight fast. It's way below a normal maintenance level for an average weight male. It's also a level that makes it hard to ensure you are getting enough vitamins and minerals. It should be possible to increase your calories with increasing your carbs and therefore your BGs. Focus on fats more than protein as protein can turn to sugar. Fats have double the calories of carbs too.

And they are yum. I adore thickened cream. I mix in a little artificial sweetener and can eat it like ice cream, lol. 100ml of thickened cream is about 40g of fat I think, and that's about 360 calories?

I've timed myself and measured my calories burnt in that hour since getting up. Literally getting up and sitting having a couple coffees and a stroll in garden. I have so far burnt 493 calories in an hour. Of course this is according to the amount of steps and stairs etc I have done... You are not eating enough calories to stop losing weight so of course the nurses and professionals are worrying about your health.
You don't have to go bck to carb laden food for those extra calories.
Long term calorie restriction of 6-800 calories is not recommended. You also need to make sure you are getting all the vitamin and minerals to feed your body properly.

I hope you can get some result with your medication as this would help enormously but please consider increasing your calorie intake.

I'm a gardener and use the gym and I eat one meal a day (salads) so I have to watch my calorie intake to ensure I eat enough to avoid weightloss and get enough vitamins as my own diet due to stomach problems is very limited.

Low carb is enough to lose weight...and not count calories.. You do not need to do low calories...
Losing 5-6lb a week is dangerous..

phil169 said:

@alaska I have been told to try to control my weight loss my B.M is 24 I am 5ft 9 inch and I am 11st 4lb from 15st 9 lb and still dropping by about 5-6 lb a week I am on a low carb 20-50 per day and low Calorie 500-600 per day. no steroids. hospital are not happy with the Calorie intake and want me to up Calories to 1000 per day to stem the weight loss for the time being, but I am not going to as I think this would take my B.G up????. Hospital phoned to day to see if I was ok, going to ring me again to morrow.
yes I do get the electric explanation.
thanks

Click to expand...

To have a healthy BMI and be struggling with such strong insulin resistance as you are seems out of the ordinary -but there are plenty of people living in exceptional circumstances.

It is possible to have a healthy BMI whilst also having insulin resistance. This is sometimes referred to as normal weight obesity (NWO).

Just in case people think I'm making this up (I wouldn't blame anyone), take a look here: http://www.ncbi.nlm.nih.gov/pubmed/23556000

An indication that NWO may be present would be if you have a high waist circumference despite having a healthy BMI.

High waist circumference would be over 37 inches (94 cm).

If your waist is at around this size or over it suggests that whilst you've done great in all weight lost so far, there is still body fat around around your waist (and crucially around the pancreas and liver) that needs to be shifted.

Continuing to bring weight down would burn the fat from around the organs. Remember there's a fairly wide window in the healthy BMI range (18.5 to 24.9) so 24 is certainly not too low.

Sounds like you've been doing all you can. I hope you get a constructive explanation Phil. Whilst I'm assuming that the insulin resistance is most likely related to having a high waist circumference, I could be wrong.

Best wishes and let us know how you get on.

Ed

The quick weight loss each week to me is the concern... Most people with gastro bands would love this but persons without aren't advisedbwhen within seeing normal bmi to keep to this rapid weightloss. I think this is why your nurses are concerned..

phil169 said:

hi all and thanks for the advise
I will speak with clinic to morrow and see what they say about the calories. when they ring me to morrow. my waist is 32 but you may be right Alaska to me the middle is not as toned as I would like it to be (ok it still looks to be on the flabby side). i am just concerned about the calories affecting my BG's. but thanks for the advice.

phil

Click to expand...

To my knowledge the only type of food that raises BGs are carbs and to an extent protein when the body converts it to glucose. You should be able to increase your fats without it raising your BGs.

Your clinic will prob say to eat more carbs.... (Not advised)... But good that you are going to speak to them.

My hubby also down to a 32"
But still has what I would say as fat on belly.

He has been going to gym for two years but has totally ignored doing the exercises on the mats that could have helped him tone it up. He is now doing these. He got told to do them but because it wasn't on a machine decided to ignore the instructors advice.

Theres a good exercise that you lay outstretched and bring your kegs and arms up to meet over your hips. Best shown how to do it though and how many reps. I do it with a medicine ball and 2 lots of 12 reps at the moment. Boy I feel my abs work. I also use a wheely thing at home.

There are ways to tighten up those muscles.