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Should I Be Worried?

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Pneu

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Hi All...

First post so please be kind! I found this forum a couple of weeks back (wish I had found it sooner!) and have been reading a number of the posts and people are fast to offer good advice so I am hopeful that you can do in my circumstance!

Firstly a bit of background! I am type 1 diabetic (11 years) I have good control my last HbA1c was 4.6%. I have noticed over the last three - four months that the amount of insulin I need to inject (mixtard 30) has doubled.. I average around 150g - 170g carb intake a day (I am a big lad around 6'6'' / 195cm) over 5 'meals'.. typically this was controlled with 3 - 5 injections totalling a maximum 80 units per day.. now I am still injecting 3 - 5 times but now some days I am injecting 200+ units..

The only change in lifestyle is eight months ago I gave up smoking.. but I can't see how this is related given the increase in insulin has occurred three months later.. I did put on some weight but I am now back to a similar weight to pre-quitting around 95 kilo's (just over 25 BMI, so a little over weight) yet no reduction in the amount of insulin I need..

Having gone to my GP their solution was a blood test (which showed everything was fine).. and to prescribe bigger needles / more insulin?!

Do I need to be concerned? I am going to have to change insulin soon anyway (given they are discontinuing mixtard 30) and have an appointment with the diabetic consultant to discuss changing but it seems odd to me that I am now having to inject so much more... the GP's view is your HbA1c is very good so no need to be worried... I am not so sure!
 
Hi Pneu,

That's an awesome HBA1C, well done!

What are your injection sites like? do you rotate where you inject? if not that may be one reason why you need more insulin, smoking does lower your BS I beliebve buit not to a degree that would need double the insulin.

I wouldn't be too concerned since your test results are so goofd but it's definitely something to keep an eye on
 
Dollyrocker,

Thank you for responding.

I was a complete idiot when I was diagnosed at 17 and didn't really pay any attention to my diabetes (head in the sand approach!)... this ended up with a touch and go hospital stay five years ago... No visible damage yet for my five years of neglect but I am sure it will come in the future.. hence my tight (some may argue obsessive!) regime now.

I do rotate where I inject although probably not as much as I should (stomach is so easy!). I will try being more religious about rotation but I haven't noticed that insulin injected in other sites is not any more or less effective and I haven't had any visible reactions at my injection sites to the insulin.

Thanks for the reassurance its nice to find a place of people in a similar situation!

Edit: sp
 
Hi Pneu :) You're doing well with your levels. Careful you don't go too low though.
Welcome to the forum :)
 
You should be giving me advice!

How are you otherwise? Could you have an infection etc that is raising you insulin requirements?

I know that insulin resistance is soemthing to watch out for, but with suh good results, it wouldn't come on so fast. I am similar, and I am now paying for my mis spent youth..and I do have eye damage. i was told though, although some ofthe damage is sone, being "good" now helps a great deal.

I would discuss it with the consultant at your appointment...but that HbA1C result is so fabulous!
 
Other than having to inject more insulin I am fine (well no different to normal)... which is why I have found the sudden change a little disconcerting. I guess keep an eye on it and discuss with the consultant.

Yes I was really pleased when it came back at 4.6% :)

Thanks for the feedback
 
Well I thought I should update you all..

I visited the diabetic centre at the hospital yesterday to move my care back there from the GP. So good news was my HbA1C came back at 5.0% so well within my happy range and please both nurse and consultant.... so after much review of my current regime and amount of insulin vs carbs, etc... Consultant said my mixtard30 regime was very odd but, obviously worked and was some of the best control he had ever seen :D (got one of the junior consultants in to review it with me as well... apparently I am interesting!)..

Anyway's long and short of it he wasn't happy with the GP and agreed I definitely have some insulin resistance.. I have now changed onto a Levemir / Novo Rapid combo, along with some metmofin to try and increase my insulin sensitivity..

Feels like starting all over again although lucky my trusty spreadsheet had given me a good idea of the split I need between the two insluins and so far so good with two fasting readings at 5.5 and two hours post breakfast today at 5.7.. going to run a little lose on the BG's just to be on the safe side
 
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