Insulin resistance

[Sophielouise]

hi, I was wondering if anyone could shine some light on how they deal with insulin resistance with Type 1 (around that time of the month). I have been getting it so badly and am not sure how I'm meant to go about it because at the moment it's really just guessing my ratios. Which is causing me to go up to 11 and I sometimes can't get it down for hours.

It changes throughout the day too, so I might randomly decide to be less resistant at random time in the day, in which case I'm quite scared to take too much insulin.

So what actually is insulin resistance? Does it mean that all the insulin will finally go in when it's ready, even if it's the 3rd or 4th hour of a dose, or should I be taking double my sensitive dose to help push through the resistance? I've not worked out a pattern either (there isn't one), sometimes 6 is not enough sometimes too much, even if I eat exactly the same thing. I've been exercising (v long walks) too which haven't helped.

i wouldn't mind if it was only for a week before my period but this goes on for about 3 weeks before and then I'm super insulin sensitive for a week when it comes on. So I'm reluctant to increase my Lantus.

Thanks

 

[Sophielouise]

Also, if I have to wait for 2 hours to eat, then my insulin will run out to cover that food. Or even waiting for 1 hour to eat can cause problems later on when I need to snack/eat a meal and can't. So not sure how I'm meant to go about that either.

 

[Natalie1974]

I'm having the exact same problem this week...no amount of insulin is touching it...to the point I'm reluctant to eat anything...when I do it goes completely out of control. I tried taking the dog for a really long walk yesterday...just made it worse . At a bit of a loss now...scared of injecting too much and hitting the floor.
I've attached today's graph from libre (which has been invaluable in this situation) where you can see my seemingly pointless attempts at correction doses which look like thick dark lines.

...

Finally back in range now...but quite sure it won't last

Anyway...I have no advice for you...but will watch with interest to see if anyone else does. If nothing else...at least you know you're not alone...big hugs X

 

[Clivethedrive]

Hi natalie1974, just a note ,dr richard bernstein covers the known causes of insulin resistance and how to treat it,he does mention ladies menstruation and its effects upon diabetics.clive

 

[Bluemarine Josephine]

I completely understand how you feel and I do relate to your problem.
About 2 days before my period and up until the 12th day of the menstrual cycle, my Novorapid ratio is 1:1.

On the 14th day of the menstrual cycle where ovulation starts, my Novorapid ratio changes from 1:1 to 1:1+1. This continues up until the 18th day. On the 18th day my ratios return to normal (and this is where I risk hypos) and last for about 2 days.

On the 20th day of the cycle and up until the 27th day, my ratios are all over the place and can easily change to 2:1.
Additionally, my evening Levemir dosage seems not enough as I have higher fasting levels.
However, as soon as my period arrives and for the next 10 days or so, my evening Levemir (of the same dosage) is causing me hypoglycemias, particularly in between 04:00-06:00 am.

Furthermore, my correction dosages do not correct. Usually, 1 unit of Novorapid lowers my blood sugar by 2.5 to 3 mmols. During these days, (according to my calculations) 1 unit of Novorapid lowers my blood sugar by 1.5 mmols.

It’s a mess, isn’t it?

The reason I am describing the pattern above in such detail is because I am hoping that it could give you an idea of what to expect. It is on the basis of my own observations.

I am afraid I have no solution as to what you can do to tackle the problem.
I tend to inject as much Novorapid with meals so as to borderline a safe hypoglycemia, I make sure to inject that much so as to get out of a potential hypo easily (considering other factors as well, of course, like planned activity.) Obviously, it is not the safe way to do things and I would not suggest this to anyone. Additionally, sometimes the Novorapid isn't always enough to cover the meal... I am not, yet comfortable to change my long-acting insulin during my insulin- resistant days because, I feel, it is better to risk a mild hypo for 5 hours with Novorapid than having to chase after hypos for 18 hours due to raising a long-acting insulin dosage.

I think we can do nothing but persevere and not be tempted to over-inject in order to correct things.
It is our aim to maintain a healthy and balanced blood sugar level but, for me, the priority is to stay safe first.
In my mind, there is not point risking safety in order to achieve a better blood sugar level.

Regards and wishes for a very happy and healthy 2016.
Josephine

 

[Daibell]

I have periods of needing more Basal (as a male) and tweak it up a unit or two for a few days or more. I know that pigging out on food on a cruise etc triggers this but also it just happens.

 

[heidibada]

I hadn't experienced an intense need for more insulin leading up to the cycle starting, until a few months ago. I created a new basal pattern in my pump but still tweaking it. I need more insulin about a week before it starts until flow is just about to end. Then i start getting super lows. Maybe I need a third pattern to cover the 2-3 day 'recovery' phase, then switch to the regular basal & bolus settings that are quite low doses.

It feels traumatic at the time, especially when it dawns on me after a while of not realizing I simply need to switch pump settings.

Thanks to those who brought enough conversation to this subject for me to see it, and start paying attention to what might be happening day to day, with new insight.