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Type 2 Needing more and more insulin

Kats666

Kats666

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Hi all,

Sorry in advance for a long first post, I’ve been putting it off!

I’ve been on insulin - Levemir and NovoRapid - since last November after being in hospital for 8 days with DKA (my admittance blood sugar was 42).

I have a fair few other health issues and am on a lot of meds including anticoagulants and strong pain meds. I have serious mobility issues also. I don’t feel very supported by the diabetic nurses but that may be me finding it hard to talk to them. I’m a ‘I’m fine’ kind of a person.

I’m finding that my insulin doses lower my blood sugars for a few days but then it creeps back up despite my sticking to the same routine. I recently upped the Levemir (45 units 2x daily) to try and lower the spikes upon eating. My logic being if it starts at 9 before I eat (for example) then it is going to be much higher after I eat than if I start at 6. This worked for about a week, combined with 20 units of NovoRapid three times a day before meals. But now I’m back to fasting rates of 9 or even higher, despite sticking to eating the same thing at the same time and injecting in the same general area.

I guess my question is, how much insulin is too much and why does eating the same thing at the same time of each day produce such differing blood sugar readings, always in the one direction? I’ve put 20kgs on since being on insulin, despite making positive changes to my diet). I realise that the more insulin I need the more weight I might gain and thus increase insulin resistance- a continuing spiral. But my fasting levels are just too high to take less insulin and therefore my HbA1c (which was 69 or 8% in Jan) will remain too high. I’m not sure I want to up my units any more, it seems like such a high dose already.

Does anyone else have this problem or know what causes it. I assume I’m type 2 diabetic as I haven’t been told otherwise and I’m in my 40s and fat! I also assume I’m insulin resistant to some degree as I’ve had PCOS for 20years+.

I have to be honest and say I’m finding the whole thing pretty depressing and frustrating. I am fighting a fairly strong urge to stop taking the insulin, which I do know of course I can’t do.

TIA for any help.
 
You really need to know if you are type one or two as the advice might be very different.
If you are type two then reducing the amount of carbs you eat might do the trick and you might indeed be able to stop taking as much insulin or even none at all, but a type one, or other non producer would find that impossible.
 
Thanks both, I was told to assume I’m type 2 and would be told if otherwise and I’ve not been told I’m type 1 so... that’s why I’m assuming type 2
 
I find stress affects my readings massively - I’m type one but on days I don’t work my lunch time reading is much lower so that can be a contributing factor. I know you have mobility issues but maybe the current situation as reduced this even more? I’ve been having more insulin that what I have in the last 19 years since lockdown.
 
It might pay to check which tests they did to rule out type 1. Antibodies? GAD? C peptide? Insulin?

In the meantime you say you’ve improved your diet? What changes have you made? What is a typical day?

Diet makes an enormous difference to type 2. A lot more than many health professionals realise or know how to guide. Lowering carbs, not fats and not just sugar, is vital. It leads to blood glucose control, lower meds and weight loss for most of us. But if already on insulin you will need to monitor very carefully and get your dr to regularly assess insulin needs if you lower carbs to avoid the chance of hypos.
 
Hi. It sounds like you aren't carb-counting which is essential with the Novorapid? This means adjusting the amount of Novorapid injected at each meal based on the carbs in the meal. Did your nurse explain that to you? If not do ask or come back so we can help. The fact that you have gained weight makes me guess that you are eating too many carbs; can you clarify what you mean by improving your diet. Having DKA with very high BS makes me think you would be LADA and not T2. Do ask for the GAD and C-Peptide tests for T1.
 
Typically, in essence, type 2 is a disease of too much insulin. If you are genuinely type 2, then more insulin is only going to take make the underlying problem worse. Even if you are now underproducing your own, you'll still be resistant to anything you inject, and you'll still have hyperinsulinemia as a result (excessive insulin in the blood).

To save rambling further, the single best piece of advice I can give is to read The Diabetes Code by Dr. Jason Fung. In my opinion it's the gold standard in helping T2s to understand and fix their condition. It should be available on prescription.
 
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