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General Guidance on Insulin Resistance vs Blood Glucose

S

staffsmatt

Well-Known Member
Messages
320
Type of diabetes
Type 1
Treatment type
Insulin
Hi All,

Quick question, does anyone have any rough guidance (published or personal) regarding at what blood glucose level your insulin resistance rises (for corrections).

I've found recently that I need more insulin to treat a higher hyper but I've yet to work out what the "cut-off" is ( I know this will vary from person to person, I'm just after a rough starting point).

Thanks!
 
I think it's a bit more complex than even that @staffsmatt . If I am correcting in the early morning, I need much less insulin than later in the day... It's all very complex!
 
Through lots of trial and error I came up with a system for correction that took my BG level into account............on the logic that the higher your level is, the more resistant you are.....

This should be used a guide, or even just to see what i came up with, you would need to do your own testing and shouldn't use the information below as correct for you...this is a good start though....

P.S. This was the system used on injections, now that I am on the pump, the system isn't required, for reasons unknown, although I can speculate..;)

BG: 7 - 10mmol/L - Correction: 2.5mmol/1 unit of insulin
BG: 10 - 13mmol/L - Correction: 2.0mmol/ 1 unit of insulin
BG: 13 - 17mmol/L - Correction: 1.5mmol/ 1 unit of insulin
BG: 17mmol/L + Correction: 1.0mmol/ 1 unit of insulin
 
tim2000s said:
I think it's a bit more complex than even that @staffsmatt . If I am correcting in the early morning, I need much less insulin than later in the day... It's all very complex!
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Yeah good point. I gues the best thing to do is not get up there in the first place... wouldn't be diabetic then though would we :)

I've also found that if I correct between meals (ie have insulin withough food) I have to massivly cut my next meal dose to avoid a hypo (assuming I'm back in range)...

Hopefully I'll get the email from Abbot soon telling me I can have a libre, that may shed a bit of light on things!
 
staffsmatt said:
I've also found that if I correct between meals (ie have insulin withough food) I have to massivly cut my next meal dose to avoid a hypo (assuming I'm back in range)...
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Unless your dangerously high you shouldn't be correcting, as your previous dose is still working......

so the correction you have just taken will also still be working half way through your next dose....
 
novorapidboi26 said:
Unless your dangerously high you shouldn't be correcting, as your previous dose is still working......

so the correction you have just taken will also still be working half way through your next dose....
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Sorry didn't explain that bit right. Say I'm 13 at 11 (4 / 5 hours after breakfast dose - so that should be pretty much gone) and have 2 units to correct. I will then have my lunch between 12 and 1 if I had my normal insulin for the food (to cover not to drop) I would probably go low (in fact even if I knock a unit of so off my lunch time dose I'll ddrop like a brick at around 2pm (see attached from Sunday, that's with knocking a unit off what would normally be my ratio). To be honest I've started to only correct with food which seems to be working better!

Screenshot_2015-11-05-09-07-23.png
 
Yeah me too, I've been waiting since April now, I'll probably get the skin irritation on the first sensor too! :)

Trying to do it with regular checks is a bit of a pain (in more ways than one!)
 
Excellent question - I really suffer from this, particularly at night time when I need to correct and am scared about over correcting as i'm worried about hypo-ing in the night, so run high, which I can then only correct in the morning, am on the waiting list for the libre so hope this arrives soon !
 
yeah, correcting so close to another dose of bolus will result in 'stacking' which in theory is combining the two peaks of those doses together.....

if, you are high by the time lunch comes, or in your case, when the next dose is up, you should make an adjustment to the previous dose, if needed, and correct your high with the next meal...
 
Also wanted to add that this is also where I feel slightly carefree and reckless about my diabetes as i'll sometimes take a massive dose for the hell of it or not eat to just knock it back into shape but there's no science attached to it !!
 
Juicyj said:
Excellent question - I really suffer from this, particularly at night time when I need to correct and am scared about over correcting as i'm worried about hypo-ing in the night, so run high, which I can then only correct in the morning, am on the waiting list for the libre so hope this arrives soon !
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what would be a typical or more recent example of this?

what was your high reading?

how much does one unit bring you done in your day to day calculations?
 
Yeah I've looked into stacking, also got a rough calculation to work out how much insulin on board I have as well. My reaction to this seems to vary from one day to the next though!
 
Other thing to mention, I find that levels affect the ratio needed as well. Say I'm 10 before breakfast a 1:1.18 ratio would keep me fairly stable (I would actually want to drop from this but for the sake of argument...) (3.3 CP 6 units) If I was 5 before breakfast and had 6 units I'd be hypo within half an hour (I inject right before eating and always have exactly the same thing to eat).

I've always felt the my levels have "momentum" that lasts well past the effect of my last meal / bolus should have worn off...
 
staffsmatt said:
Other thing to mention, I find that levels affect the ratio needed as well. Say I'm 10 before breakfast a 1:1.18 ratio would keep me fairly stable (I would actually want to drop from this but for the sake of argument...) (3.3 CP 6 units) If I was 5 before breakfast and had 6 units I'd be hypo within half an hour (I inject right before eating and always have exactly the same thing to eat).

I've always felt the my levels have "momentum" that lasts well past the effect of my last meal / bolus should have worn off...
Click to expand...

Yes - I (and others - some people have documented it fairly well) find that higher starting blood sugars give a much more pronounced meal time "spike". If I start at 4/5 a given meal and insulin dose may keep me in range, whereas if I do exactly the same thing, but start at, say, 7.5, I will spike much much higher.
 
novorapidboi26 said:
what would be a typical or more recent example of this?

what was your high reading?

how much does one unit bring you done in your day to day calculations?
Click to expand...

Last night !!

At 9.15pm I was at 17.2, i'd had some chips for tea and taken 6 units of QA at 6.50pm, so as i'd already got some insulin on board I just took 2 units of QA, I woke this morning at 13.1, so had a few mouthfuls of greek yoghurt, took 2 units of QA for the yoghurt and 6 units to correct and have got myself down to 4mmol/l just now. In day to day calculations I take 1.5 units to correct in the morning and 1 unit in the afternoon, this should bring me down by 3mmol/l, but if i'm over about 12 mmol/l I need alot more to get back down again, I just haven't figured this out :(

I won't over correct at night as too scared to, but happy to go crazy on it while i'm awake and either take a big shot of QA or just not eat :confused:
 
Personally I become more insulin resistant when my bg levels are in double figures, also become more insulin resistant if I've eaten a high-fat meal several hours before.
 
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