Insulin doses

murrayjohn · Jul 29, 2017

Hi, I have been type 2 for over ten years, and for the last eighteen months on insulin only. First humulin I and now M3. I have been on M3 for about nine months, with steadily increasing doses. My hba1c hovers around 60, although when I first went on insulin it was 93. My diabetic clinic is thinking about changing my insulin again, as even with nearly 60 units am and pm my BG is too high (15 to 20 at bed time 10-15 am). This started getting bad when I had septic shock from a procedure unrelated went wrong. I already have awful problems with neuropathy, and have practically had to give up my three lifetime hobbies. My question is difficult, and dependent on many things, but what is the maximum dose of insulin?, if there is one.
Apologies for the long explanation, but getting rather worried about what are becoming quite uncomfortable injections.
Thank you, john

ickihun · Jul 29, 2017

John. W

murrayjohn said:
Hi, I have been type 2 for over ten years, and for the last eighteen months on insulin only. First humulin I and now M3. I have been on M3 for about nine months, with steadily increasing doses. My hba1c hovers around 60, although when I first went on insulin it was 93. My diabetic clinic is thinking about changing my insulin again, as even with nearly 60 units am and pm my BG is too high (15 to 20 at bed time 10-15 am). This started getting bad when I had septic shock from a procedure unrelated went wrong. I already have awful problems with neuropathy, and have practically had to give up my three lifetime hobbies. My question is difficult, and dependent on many things, but what is the maximum dose of insulin?, if there is one.
Apologies for the long explanation, but getting rather worried about what are becoming quite uncomfortable injections.
Thank you, john

John when a person is highly insulin resistant the limit of insulin is whatever keeps that person's bgs in good levels. Everyone's needs are different. I was on nearly 300units of m3 so I was changed to toujeo300 and novarapid. A much better threatment for me. Today im on 69units of toujeo300 and 55units of novarapid. Toujeo300 converts as 20% lower need than m3 basal action. So for me I would now need about 140units m3. I have reduced my insulin need through slowly reducing my insulin and watching my carb intake.
This week alone ive reduced my toujeo300 by 3units and last week I reduced my novarapid by 5 units. This I will allow to settle til no high bgs in my meter monitoring. Then I'll reduce again.
I would be stupid to reduce too soon and give myself higher risk of complications.
After my bariatric surgery my consultant willstop and monitor for my new needs of insulin to keep complication free. Some newly diagnosed no longer need insulin when type2 insulin resistant.
Are you type1 with no own insulin due to antibodies stopping its production in the pancreas or type 2 so insulin resistant so need extra or replacement insulin additional to your own?

leslie10152 · Jul 29, 2017

I went up to 95 units on Mixtard, but found it was ineffectual. I was switched to Novorapid and Lantus, now I am down below 62 units and falling. What ever it takes is possible, but with large doses it is a recipe for disaster if you are not vigilant.

ickihun · Jul 29, 2017

Another thing @murrayjohn is the change of insulin will stop your uncomfortable injections too. I get far less water retention but its not gone yet.
I'm very happy with my new separate insulins. Far less hypos.
Let us know when you're on your new insulins. Try and encourage the change as soon as possible.

Seacrow · Jul 30, 2017

There really is no upper limit on insulin. Up to last week I was taking 1500 units per day (yes, that's one thousand five hundred). Going on an insulin pump has really reduced it. You can get more concentrated insulin if your consultant approves it and your doses are very high. 120 units is about what I would inject to eat an apple though, so not very high.

There is a very old medical paper (1980's) on an Italian man who was taking 37 thousand units daily

Kristin251 · Jul 30, 2017

Wow!!!! Can't imagine how expensive that would be!!

Goacher55 · Aug 1, 2017

murrayjohn said:
Hi, I have been type 2 for over ten years, and for the last eighteen months on insulin only. First humulin I and now M3. I have been on M3 for about nine months, with steadily increasing doses. My hba1c hovers around 60, although when I first went on insulin it was 93. My diabetic clinic is thinking about changing my insulin again, as even with nearly 60 units am and pm my BG is too high (15 to 20 at bed time 10-15 am). This started getting bad when I had septic shock from a procedure unrelated went wrong. I already have awful problems with neuropathy, and have practically had to give up my three lifetime hobbies. My question is difficult, and dependent on many things, but what is the maximum dose of insulin?, if there is one.
Apologies for the long explanation, but getting rather worried about what are becoming quite uncomfortable injections.
Thank you, john

I asked this same question , my nurse practitioner,diabetic nurse , a fellow diabetic, told me it's what ever you need as there is no normal

murrayjohn · Aug 4, 2017

ickihun said:
John. W

John when a person is highly insulin resistant the limit of insulin is whatever keeps that person's bgs in good levels. Everyone's needs are different. I was on nearly 300units of m3 so I was changed to toujeo300 and novarapid. A much better threatment for me. Today im on 69units of toujeo300 and 55units of novarapid. Toujeo300 converts as 20% lower need than m3 basal action. So for me I would now need about 140units m3. I have reduced my insulin need through slowly reducing my insulin and watching my carb intake.
This week alone ive reduced my toujeo300 by 3units and last week I reduced my novarapid by 5 units. This I will allow to settle til no high bgs in my meter monitoring. Then I'll reduce again.
I would be stupid to reduce too soon and give myself higher risk of complications.
After my bariatric surgery my consultant willstop and monitor for my new needs of insulin to keep complication free. Some newly diagnosed no longer need insulin when type2 insulin resistant.
Are you type1 with no own insulin due to antibodies stopping its production in the pancreas or type 2 so insulin resistant so need extra or replacement insulin additional to your own?

Thank you, I cant imagine a pen a day.. I was tried on some weekly injection that is supposed to increase pancreatic cells, but I had a bad reaction. So, back to the hospital again.. I got asked about hypos. I have not had a hypo or even close, my lowest reading has been 9.5 on 120 units of m3

regards john

ickihun · Aug 5, 2017

murrayjohn said:
Thankyou, I cant imagine a pen a day.. I was tried on some weekly injection that is supposed to increase pancreatic cells, but I had a bad reaction. So, back to the hospital again.. I got asked about hypos. I have not had a hypo or even close, my lowest reading has been 9.5 on 120 units of m3

regards john

When are you back to hospital? Hopefully you can go on toujeo300 which is concentrated basal but you will need novarapid too.
Let me know what they decide. I know another type1 on toujeo300 and novarapid with very few hypos.
Toujeo300 is a good basal.

Insulin doses

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