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Type 1 Insulin need going up

N

Norman83

Active Member
Messages
29
Guys, I recently was diagnosed as type 1 ( my previous doctor qualified me as type 2 for a while). At the very beginning I was using around 38 units humalog+tresiba(54). I started feeling better and gained like 12 kg, but lately my I inject insulin around 55-65 per day, some times even more if I eat chocolates. Most of the time, after the 3rd hour without eating, my bs goes up slowly as per freestyle sensor( showing ️)
For example:
-I ate at 4:00pm
-2 hours (6pm)after my sugar still not ideal despite I injected what I thought reasonable(as per my ratio calculation). So I had to correct it
- and 2 hrs later(8pm)let’s say it is in 100 which fine
- so I don’t eat anything after those 2 hours (8pm)as I’m not hungry
- but after 9pm, it starts going up slowly ️ and but still my sensor shows is stable, when I measure around every 20 min it goes like
120️
134️
143️
147️
160️
178️
Etc.
So at some point I have to eat and correct it with more insulin.
There are days of 70 u (without the tresiba basal)

Anyone could help here?
Is it that when you gained some weight, your needs increase also?
Or maybe that the tresiba is not enough do my actual weight?
I’m desperate here, at the beginning
I thought I would be able to manage this with 38 u humalog and 54 u of tresiba but it seems that am less sensible now that I gained some weight‍♂️
Helpppp
 
Some possibilities here
1) insulin needs do generally go up with weight so it's probably worth discussing your numbers with your diabetic team
2) if you're T1 then it's possible you were originally in a honeymoon period (still producing some insulin) and this has now ended

Remember that everyone's insulin needs are different so you need to learn the needs of your own body, you can't just assume you'll need the same amount of insulin as someone else with the same weight and activity.

Ideally, you want the basal (slow acting insulin, tresiba in your case) to carry you through so that if you were fasting your blood sugar would stay level without any quick acting insulin (bolus, humalog in your case). You have 3 calculations you need to make for your body
1) work out how much basal you need. It's really hard to get anything else right till you've got this correct. Ideally, you want the same/similar blood sugar when you go to bed as when you get up in the morning (assuming you're not injecting humalog or eating at bed time or during the night. Of course, many people snack at bed time if they think their blood sugar is too low then.).
2) Work out your insulin to carb ratio. This can vary massively between people, and even (unfortunately) vary according to times of day and physical activity. But most people start by assuming one ratio. This allows you to work out how much to inject for your meals.
3) Correction factor : how much does one unit of insulin bring your blood sugar down by. This allows you to take extra insulin to bring your levels down if they are too high.

Your clinic/doctor should help you work out all 3 of the above numbers and then you can start tweaking things when you need to.

Can I ask where you're located, as though we're all diabetics different countries have different ways of organising medical care. I'm hoping you're somewhere where you can get frequent advice from your medical team, who can advise you on your current insulin numbers.

Good luck.
 
If you have been diagnosed a type 1 recently the odds are you are still making some insulin. We call this the honeymoon phase, you make some insulin until you don't.

So your insulin needs will go up, sometimes this is a slow process, sometimes it happens faster. So it is normal for your needs to go up. What amount you need varies person to person, In our type 1 world we all respond differently.

Insulin is needed for a type 1 for every carb, even broccoli, so if you eat more carbs your insulin needs go up. Also weight gain generally will make your insulin needs go up too.

There are some various things that can make your needs go up in some temporary times, like infections, getting sick, poor sleep habits, etc.

I'm not sure what you mean when you say eventually you have to eat and take more insulin after 9pm? Are you eating so you can take more insulin, or are you eating because you are hungry? You are new so they might have started you on a very simple program until you get the hang of it. But generally type 1's will take a correction dose for higher BG's without having to eat. This would have to be approached with caution at night because you don't want to drop too much while you are sleeping. But you might ask your team/doctor about correction doses or a different ratio.

You might add type 1 to your profile, if you have any other questions it lets people know easier.
 
I recommend that you read Dr Bernstein's Diabetes Solution. I'm just days into using insulin, myself, but I've been following his advice for the last two years after being diagnosed with extremely low c-peptide. My consultant supports this. I received some very vague advice from my diabetes nurse that I wouldn't have been able to manage if I didn't have Bernstein's book. I've now been able to write some very specific questions down for my nurse for Thursday.
 
Last edited:
EllieM said:
Some possibilities here
1) insulin needs do generally go up with weight so it's probably worth discussing your numbers with your diabetic team
2) if you're T1 then it's possible you were originally in a honeymoon period (still producing some insulin) and this has now ended

Remember that everyone's insulin needs are different so you need to learn the needs of your own body, you can't just assume you'll need the same amount of insulin as someone else with the same weight and activity.

Ideally, you want the basal (slow acting insulin, tresiba in your case) to carry you through so that if you were fasting your blood sugar would stay level without any quick acting insulin (bolus, humalog in your case). You have 3 calculations you need to make for your body
1) work out how much basal you need. It's really hard to get anything else right till you've got this correct. Ideally, you want the same/similar blood sugar when you go to bed as when you get up in the morning (assuming you're not injecting humalog or eating at bed time or during the night. Of course, many people snack at bed time if they think their blood sugar is too low then.).
2) Work out your insulin to carb ratio. This can vary massively between people, and even (unfortunately) vary according to times of day and physical activity. But most people start by assuming one ratio. This allows you to work out how much to inject for your meals.
3) Correction factor : how much does one unit of insulin bring your blood sugar down by. This allows you to take extra insulin to bring your levels down if they are too high.

Your clinic/doctor should help you work out all 3 of the above numbers and then you can start tweaking things when you need to.

Can I ask where you're located, as though we're all diabetics different countries have different ways of organising medical care. I'm hoping you're somewhere where you can get frequent advice from your medical team, who can advise you on your current insulin numbers.

Good luck.
Click to expand...

Hey a big thanks for your notes. I’m in Dubai, Jnited Arab Emirates.
 
Marie 2 said:
If you have been diagnosed a type 1 recently the odds are you are still making some insulin. We call this the honeymoon phase, you make some insulin until you don't.

So your insulin needs will go up, sometimes this is a slow process, sometimes it happens faster. So it is normal for your needs to go up. What amount you need varies person to person, In our type 1 world we all respond differently.

Insulin is needed for a type 1 for every carb, even broccoli, so if you eat more carbs your insulin needs go up. Also weight gain generally will make your insulin needs go up too.

There are some various things that can make your needs go up in some temporary times, like infections, getting sick, poor sleep habits, etc.

I'm not sure what you mean when you say eventually you have to eat and take more insulin after 9pm? Are you eating so you can take more insulin, or are you eating because you are hungry? You are new so they might have started you on a very simple program until you get the hang of it. But generally type 1's will take a correction dose for higher BG's without having to eat. This would have to be approached with caution at night because you don't want to drop too much while you are sleeping. But you might ask your team/doctor about correction doses or a different ratio.

You might add type 1 to your profile, if you have any other questions it lets people know easier.
Click to expand...

Thank you Marie
 
Hi. It's very likely that you are having too many carbs. When on insulin many of us have to control the carb intake unless we have a high metabolism. Insulin's job is to metabolise carbs. Have too many and the glucose gets stored as fat.
 
Hi @Norman83,
I assume that your humalog dose is the daily total, of injections before meals.
Some thoughts:
1) it sounds like you may have lost some significant weight before finally being diagnosed with TID and being prescribed insulin, in which case your diet and thus insulin dose was designed for you to gain weight. If so that seems to have happened. But now having gained weight the question maybe that you no longer need to be eating as much because you may need only now maintain weight. Yes your weight increase might dictate more insulin compared to if you were maintaining a lower weight but diet + insulin determines weight. Getting a review of your diet and appropriate adjustment of insulin sounds in order.
2) if you use the search box right upper Forum or Home page for 'honeymoon phase' you can see this described. It is where your pancreas gland is now under much less stress after insulin injections have taken the burden off and the pancreas starts to release some insulin, sporadically at times and thus complicate the picture. Often people may notice unexplained low bsls and decreasing need for insulin for a period of months, sometimes many months before the pancreas gland finally runs out of puff and the injected insulin is now all there is and the insulin dose increases accordingly.
3) you have an important opportunity at this juncture. If you google DDCT and then EDIC study, you will have information which can shape your future with diabetes. Basically the better one's bsl control, not just the 3 month tests ( caled HBAIC) but the lower the fluctuations in bsl in the first 6 1/2 years of diagnosis and start on insulin, the less diabetes complications that might arise later in life. In this regard the post by @ert above you may find relevant.
If you wish to look further at this in relation to your current dilemma and future please PM me.
Best Wishes:):):)
 
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