Questions about insulin

[rosemaree]

I have been trying to write a post all afternoon and am just not getting anywhere - I am feeling quite hopeless.

Perhaps I can just ask some questions;

Is there much difference using a vial and syringes versus using a disposable/refillable pen for insulin? I saw a comment somewhere about it being more stable, and am wondering if it is something I should try,

Also, does using different length needles make much difference?

Has anyone experienced an even higher increase in blood sugar after increasing their basal insulin? I am on tresiba and have been increasing my dose slowly, but lately it seems like my blood sugar gets even higher with each increase,

I feel like I have developed very severe insulin resistance these last few months, my blood sugar was up and down a lot, but now it is just staying high, with spikes up to the 20's, and I feel like I am losing myself - I am so exhausted and my mind is just not working,

I am hoping to get in to see the doctor soon, although she has admitted she knows very little about diabetes. I have avoided getting an hba1c test done in a while because I know it will be so high, but I would like to try ask for another c-peptide or insulin test to see where my levels are - they were borderline low with a blood sugar of 22 mmol when I started insulin,

 

[lovinglife]

Hi @rosemaree & welcome to the forum

Sorry you’ve had a bit of a struggle posting, I can’t help with any of your questions as I’m T2 diet control, I will tag one of our forum members @Antje77 as she is LADA and may be able to help with some of your questions

 

[Antje77]

Hi @rosemaree , sorry to hear you're struggling at the moment.

I'll start with a question before trying to answer yours: How long have you been diagnosed, and how long have you been on insulin?

Is there much difference using a vial and syringes versus using a disposable/refillable pen for insulin? I saw a comment somewhere about it being more stable, and am wondering if it is something I should try,

I've never used syringes, but pens seem to give me mostly predictable results so I trust they work fine.
From the rest of your post, it doesn't really sound like things are unstable, but more like you haven't found the right dose yet.

Also, does using different length needles make much difference?

I haven't found a difference in the effect of insulin (I tried everything between 4 and 8 mm), but for the more stinging insulins (Lantys and Lyumjev) I prefer 5 or 6 mm because the sting seems less than with shorter needles. For the other insulins I tried I really don't care which needle length I use.

Has anyone experienced an even higher increase in blood sugar after increasing their basal insulin? I am on tresiba and have been increasing my dose slowly, but lately it seems like my blood sugar gets even higher with each increase,

I'm assuming you're still in the honeymoon phase, where your insulin production is dwindling.
It's very common that this reduction of insulin production is not a steady thing. Instead, it's an up and down thing: insulin needs can increase very quickly suddenly, or they can stay stable for a bit until things change again.
If your needs increase quickly, it's hard to keep up, leading to increasing blood glucose despite increasing your insulin.
Finding the right dose again and again takes time.

I feel like I have developed very severe insulin resistance these last few months, my blood sugar was up and down a lot, but now it is just staying high, with spikes up to the 20's, and I feel like I am losing myself - I am so exhausted and my mind is just not working,

Being high all the time is very exhausting!
What short acting insulin do you use, and are you comfortable with using correction doses as well as increasing your basal?

What makes you feel you have very severe insulin resistance, and not simply a lowering insulin production?
The amount of insulin we need is very different between people. Some only need 10 units a day, others need 300. It doesn't matter, the right dose is the dose that works for you.

I am hoping to get in to see the doctor soon, although she has admitted she knows very little about diabetes. I have avoided getting an hba1c test done in a while because I know it will be so high, but I would like to try ask for another c-peptide or insulin test to see where my levels are - they were borderline low with a blood sugar of 22 mmol when I started insulin,

What country are you in?
In both the UK and my own country, T1's are usually referred to an endocrinologist and not treated by a general practitioner. Especially not if they don't know much about diabetes.
Can you get a referral to a specialist?

I'm not sure how another C-peptide test would help you.
You've already been diagnosed with T1, for which the treatment is insulin.
The amount of insulin you need to inject is not based on C-peptide but on blood glucose levels, so knowing how much (if any) you still produce wouldn't make a difference in your treatment.

I hope this helps, good luck, and let us know how you get on!

 

[rosemaree]

Hi @Antje77

Thanks for the response,

I was diagnosed 5 years ago and started insulin 3 years ago - I haven't been on the forum in a long time.

I have never really been able to find stability or my correct dose - just varying degrees of kind of coping to not coping. I use syringes to get the last bit of insulin out of the pen refills so maybe I must just try them for a week and see if it actually makes a difference.
I struggle with disordered eating and find the basal testing very challenging to do, the last few times I tried (using the mysugr guidelines) I had such wildly differing results - like stable one day, climbing the next and then crashing. The only thing I noticed from it is that my blood sugar only seemed to stay stable at a slightly higher level around 7 mmol. If it was less it would either keep dropping or I would get crazy spikes, and if it was higher it just gradually kept going up.

I wanted to do the blood tests just to see where my natural levels are actually at - if it is still honeymooning or if something weird is going on. I still question my diagnosis and have a lot of blame echoing in my head. Doctors never seem able to see past weight and I have had so many tell me that ideally I want to come off insulin - they say this with my test results in hand showing positive GAD, blood sugars in the 20's and a lowish c-peptide.

With the insulin resistance, I was told that I have it from the get go, as my weight has always been an issue. I had lost over 50kgs, then fluctuated for a while, and then regained most of it since starting insulin - initially I was grateful as I had lost so much muscle and I felt like I was getting some strength back, but then I just kept gaining, and mostly around my middle. Aside from that though, my novorapid insulin can take up to 1.5 hours to start working (esp in the mornings), my skin is not healing well, I have been getting darker skin and tags under my arms which I have never had before, I have been getting dry mouth, etc. I know a lot of these can also be from high blood sugar too.

I am in SA, we have quite a few diabetes specialists who have given me the some bizarre recommendations but very little guidance. I have asked about getting to see an endocrinologist but have never been given a referral. The one closest to me is part of a bariatric surgery team and given my past experiences with doctors and my weight the thought of going to him makes me rather exceedingly anxious - it also would not be covered by my insurance.

On another note: I have seen people mention getting higher blood sugar when they have a cold or infection of sorts, what sort of range does that look like? I sometimes wonder if my sinus or dental or gut sensitivity issues could be causing a problem, but I feel like it wouldn't cause such drastic numbers,

Thank you,

editing to add: I am on novorapid, and do take corrections and make adjustments on my own - I have never really had any guidance from healthcare professionals on it, so have had to try to figure it out myself,