Insulin Resistance

[Chrissy2k]

Hello,
can anyone tell me about significant insulin resistance? Apparently I have it, my blood sugar readings are very high, between 19 and 25 usually, and I'm taking 40 units Glargine twice a day and 40 units of Novorapid 3 times a day, I have cut down my carb intake, but I don't carb count, but still I'm having these problems. I also feel quite ill, I'm very tired, thirsty and have blurred vision, are there any tips anyone could pass on to me to get my BG levels down? I feel as though I'm banging my head off a brick wall, every time I see the Endocrinologist he just increases my insulin. Oh, btw, I'm also on 1000mg of Metformin twice a day. I really hope there's someone out there who can give me some advice, I can't go on like this indefinitely.

Thanks,

Chrissy

 

[the_anticarb]

Have you tried really cutting the carbs down? eg to 20-30g a day for a bit? not saying you should do this forever but just for a few weeks to see if you can reset your sensitivity to insulin? when I was low carbing (before I got pregnant) and then went back to carbs after I fell pregnant I was incredibly insulin sensitive for a while. It may be that you could do this say one week per month to reset your carb metabolism, then eat a low-moderate amount of carbs the rest of the month

 

[janabelle]

Hi Chrissy
Next time you go to your doctor perhaps you should ask him to change your insulin to a basal that actually works for you. That's quite a large dose, and of course dose is dependent on weight, diet and other factors, but it's quite obviously not working.
This is not unheard of with Lantus , do a few google search.
When I first changed to Lantus in 2004, I thought I had good control. However when things went awry with my control after about 1 yr, ie;huge fluctuations, no consistency despite no change in routine and diet, I asked my DSN about it. I was assured that Lantus was not the cause of my erratic control. Only coming off it proved it was the culprit. For some people it just doesn't work, goodness only knows why :?
For many people Lantus works perfectly and gives them good 24 coverage, which is why when people experience problems and side-effects,including apparent insulin resistance and /or other side-effects,such problems are rarely recognised by doctors as being associated with the insulin treatment.
You need to get those levels down to avoid complications and improve your current quatlity of life, I'm not suprised you feel so awful.
If you want further support, the IDDT were a great help to me when I was contemplating asking my clinic to change my insulin. I was worried I would be facing a similar brick wall to the the one you've been banging your head on, but being forceful, stating my case and sticking to my guns was definately worth it!. Especially after 4 years of lousy control and ill health.
best of luck
Jus

 

[Chrissy2k]

Hi,
thanks for the replies everyone. I will try the low carbing as suggested, but my DSN has told me not to do this. I really do think the problem lies with my insulin, I just don't understand why I'm taking such large doses and not getting decent BG readings. I will google Lantus and read up on it as mentioned, thanks everyone,

Chrissy

 

[Disie]

Hi Chrissy,
Just read your thread about insulin resistance. Did you find out that Lantus was the problem? I too am on Lantus, have steady increased in weight over the last few years (with no change in diet or lifestyle!), so have started low-carbing. However, my numbers are still too high, and my weight has not come down at all (although I have stopped gaining). My insulin requirements reduced by a third in the first couple of weeks, but now, after 6 weeks, I am taking nearly as much Lantus as I was before I started the low-carb. Really don't understand it at all. I ate loads of carb before, and now have less than 50g per day, often only about 20-30g. Very frustrating!!
Disie x

 

[noblehead]

I'll confess that I don't know a lot about insulin resistance, but I would assume the first route to take is to change your insulin to see if this resolves the issue.

With regards to a low-carb diet (50g a day or less) I found when I first tried this diet my insulin requirements did reduce at first, but then started to creep back up where I was injecting more insulin than I did before on a normal diet! :? After much experimenting I now eat a moderate carb (120g a day on average)low-gi diet and have reduced my insulin usage by around a third to what I was taking 12-18 months ago.

Do discuss this matter with your dsn and see if they can offer some practical advice.

Nigel

 

[Chrissy2k]

Hi,
I don't know if Lantus is my problem, I have been trying to phone my DSN for 3 weeks to discuss this matter with her, but she is never there. I'm really at a loss as to what to do next, my next appointment with the endocrinologist isn't until december. I feel that things really need to be sorted out before then, it wouldn't be so bad if I didn't feel so ill all the time. I am cutting back on carbs, although I'm not counting them and I'm going to join Slimming World tomorrow in the hope that losing weight will help me, I am quite overweight and I know this doesn't help matters, but I'm sure the insulin is making me gain weight (or maybe thats just an excuse for my weight gain lol)
I just seem to be pumping myself full of insulin but not getting any benefits from it. Anyway, thanks for the comments folks, they are really appreciated.

Chrissy

 

[humph]

I am badly insulin resistant, I am producing plenty of insulin, but my sugars are high, but coming down.

I am dealing with the problem through low carbing and exercise.

Exercise reduces insulin resistance and gives results fairly quickly.

In my opinion the worst thing is to put even more insulin into a insulin resistant system.

 

[HLW]

can anyone tell me about significant insulin resistance?

Yes, it's called type 2 diabetes surely? Hence the metformin I assume? You can have both type 1 and type 2 diabetes. Yes insulin causes weight gain, and yes losing weight should help (no idea how/why, but that's what the drs and nurses said when they thought I had type 2 diabetes).
Atkins (which is no carb rather than low carb) is very dangerous with type 1 diabetes due to the risk of DKA (so says the nurse Ive seen since been diagnosed with type 1 at least), but ask if you can see a dietician, they will help you work out what is suitable to eat. Just make sure you find one that doesn't tell you to stuff your face with bread and rice, you can tell which ones they are, they are usually overwieght!

 

[bigpapalazarou]

Hi,
I was on 50 plus units of Lantus a night and anything from 40-50units of Novorapid at meals.
It just wasn't working, got changed back to Insulatard and Actrapid, all is fine and i am taking 36 of Insulatard and 32-36 at meal times of Actrapid. BM's are 4-7 all day long.
Actrapid has a life of 8hrs while in your system, novorapid expires after 3hrs.

Lantus is not the all knowing cure that they think it is, the FDA have noted problems with it and they are resistence, lack of hypo awareness and aggression.

Until the specialists over here realise that it is useless and the risks they are taking with peoples lives then we are all screwed.

Inform the doctor you have no quality of life and you want changed.

 

[alaska]

People with type 1 diabetes can also get insulin resistance too -this is known as double diabetes.

Chrissy, I'm guessing if insulin resistance is happening there's also a weight problem, is that a fair guess?

Generally speaking, cutting carbs down a bit should help and also eating the right carbs. Plenty of veggies, and if you have starchy foods (bread, crackers etc), look for those with the highest fibre values per 100g (check the nutrition labels for this). Usually insulin resistance is linked with a relatively low amount of fibre in the diet, so I'm assuming this is the case here. Keep yourself active too each day as that will help with restoring some of your insulin sensitivity.

 

[Unbeliever]

So sorry to hear of your problems Chrissy, I hope you can get some help soon.

I feel like printing out some of these discussions and taking them to my GP's practice . To listen to them you wuld think that once someone- tyoe 1 or " was given insulin here were no further problems!

I wonder if I might ask what will probably seem a very naive and ignorant question? How do they est for insulin resistance etc? Or do they ust assume it from the resuls - ie if insulin doesn't work?

I was old i had diabetes when I collapsed wih another ondition and was taken o hospital When I saw my Gp I ust had blood tests and on the strength of my father having developed diabetes late in life and my sister having pre-diabetes[plus always having been fairly slim} I was told that I had probably
been diabetic all my adult life and producing too much insulin o compensate for ny body not using it properly.

I have no reason o hink this is incorrect but is there a test o establis it?

A few years ago ,in my region there was a big "push" led by the NUrsing Colleges o put every diabetic on insulin. This was ahead of the plans to initiate insulin treatment in the Gp's Practices.
I notice that , there now seems to be a movement away from this "one size fits all" atitude.

Of course insulin is a lifesaver where appropriate but it seems to be all too easy o ust prescribe more and more of it when it doesn't work.

Perhaps it was seen as being a better option for that very reason? I can see it might well be better for your body than many medicationsbut cost must come into it too?

 

[bigpapalazarou]

Funnily enough, Glargine & Novorapid cost more than Insulatard & Actrapid. Add on the daft tablets they want to give you to help the Glargine along and you wonder what they are doing.

It's not a case of insulin resistence, it's a case of analogue Insulins just doesn't work.
You can carb count, add the fibre, balance with starchy food and it then controls your life. This should not be the case, i eat exactly what i was eating with the analogue insulins and i have improved no end. Problem is that the medical staff won't listen to what they are being told, they are given their little sheet of info and told to follow it to the letter.

This may also be of interest for all:

fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/DrugSafetyInformationforHeathcareProfessionals/ucm169722.htm

 

[swordy]

Krissy. you should ask at the clinic if you can attend the next DAFNE course at the hospital because after I attended the course over a year ago my insulin has reduced a lot and whilst on the course there is a dietician there the whole time and she was a great help on my course. The course teaches you to count the carbs you take at every meal and in between snacks if you like these. You are not restricted to say 4 injections a day you can take your insulin according to your card intake.
After attending the course my Lantus reduced from 36 units down to 25 units and my Novorapid, I take it according to my carb intake and my control has been fantastic since attending the course.

I strongly recommend that you ask about the course.
Jim

 

[viviennem]

As far as I know the way to test for insulin resistance is to do a blood test for fasting insulin. If there's too much it implies that the insulin you are producing isn't being used - ie your muscle cells are resistant to it.

I've been trying to get one done 'cos I'd like to know whether I'm producing too much insulin from a so far healthy pancreas, or if my pancreas is on the way out - still working but not producing enough insulin. I can't have one done, though - guess why? "Too expensive!" :roll:

I'm Type 2, by the way.

Incidentally, re HW's post above dated October 2010 - Atkins is not a no-carb diet. It starts off low-carb - 20g daily for 2 weeks - then gradually increases the amount of carbs you eat. If you're interested in low carb it's worth giving it a proper study and then making your own mind up. All I can say is, it works for me! My belief is that, by cutting my carbs way down, I give my pancreas a rest and some time to recover - if it's not too late.

Viv 8)