Sudden unexplained change in insulin requirements

A

aseriesofunfortunateevents

Active Member
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28
Hey all,

I was diagnosed as diabetic in August 2022. There is still some confusion around my diagnosis as I tested negative for antibodies (twice, the second time a year later). However a stimulated c-peptitde test showed I had low insulin production. My endo (who ive spoked to once since diagnosis) has therefore said that I should be treated as if i was type 1.

My insulin / carb ratio has remained constant throughout this time, and I had my routine 6 monthly appointment with my diabetic nurse this week and she was very happy with my progress.

However, suddenly the next day I found myself needing twice the amount of insulin I had previously needed. I am not displaying any symptoms for any illness, something which I understand can temporarily affect insulin requirements.

Has anyone been through something similar?

Thanks
 
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Jaylee

Jaylee

Oracle
Retired Moderator
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18,232
Type of diabetes
Type 1
Treatment type
Insulin
Hi,

What insulins are you prescribed?
 
Jaylee

Jaylee

Oracle
Retired Moderator
Messages
18,232
Type of diabetes
Type 1
Treatment type
Insulin
aseriesofunfortunateevents said:
That was my first thought also, the cartridge was 80% finished.

I swapped to a new pen but it was the same as the old pen.
Click to expand...
How long approx have you had this change in insulin to carb ratios?
Is it consistent during the day or only at a certain mealtime/s.?

& I was about to say. If you change a cartridge after a change in dose on the last one be wary on the possible potency..
 
In Response

In Response

Well-Known Member
Messages
3,485
Type of diabetes
Type 1
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Whenever my insulin requirements change, I do a few checks
- is my insulin ok? I usually just change my cartridge as you have.
- is my insulin pen ok? If you have a spare pen, it will be worth changing to that. If you do not have a spare pen, request one because pens break.
- are my injection sites ok? You should be rotating your injection sites. If you are not, you can build up (I think) fat/scar tissue which affects insulin absorption?
-Is my other insulin ok? You mention that you have changed you bolus insulin but if your basal is not working properly, it can look as if your bolus is not working properly. Try changing your Lantus and pen.
- have I done less exercise than usual? Exercise within the last 48 hours can affect your insulin sensitivity
- have I changed any medication?
- is my body fighting off some lurgy? My body could be quite successful at this and often the only symptom is a temporary insulin resistance.
 
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aseriesofunfortunateevents

Active Member
Messages
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Jaylee said:
How long approx have you had this change in insulin to carb ratios?
Is it consistent during the day or only at a certain mealtime/s.?

& I was about to say. If you change a cartridge after a change in dose on the last one be wary on the possible potency..
Click to expand...
I've had the change since November 4th and I switched to a new Lyumjev pen the next day.
 
A

aseriesofunfortunateevents

Active Member
Messages
28
In Response said:
Whenever my insulin requirements change, I do a few checks
- is my insulin ok? I usually just change my cartridge as you have.
- is my insulin pen ok? If you have a spare pen, it will be worth changing to that. If you do not have a spare pen, request one because pens break.
- are my injection sites ok? You should be rotating your injection sites. If you are not, you can build up (I think) fat/scar tissue which affects insulin absorption?
-Is my other insulin ok? You mention that you have changed you bolus insulin but if your basal is not working properly, it can look as if your bolus is not working properly. Try changing your Lantus and pen.
- have I done less exercise than usual? Exercise within the last 48 hours can affect your insulin sensitivity
- have I changed any medication?
- is my body fighting off some lurgy? My body could be quite successful at this and often the only symptom is a temporary insulin resistance.
Click to expand...
Thanks, interesting I will change my Lantus to see if there is any difference.

WIth regards to pens/cartridges, both my Lyumjev and Lantus always comes in a fresh pen (I don't use a pump). Apologise if there is some confusion with my terminology.

I do take care to rotate my injection sites and I have not noticed any change in my skin tissue.

There hasn't been any changes in my level of exercise, nor have i changed any medications.

Yup, im hoping that my body has some undetectable low grade infection that has temporarily changed my insulin / carb ratio.

Either that or my pancreas has suddenly given up for unexplained reasons (given that ive consistently tested negative for antibodies and my stimulated c-peptide showed i had some, but limited insulin production).
 
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plantae

Well-Known Member
Messages
830
Type of diabetes
Type 1
Treatment type
Insulin
I had this a few weeks ago. I'm on novorapid and lantus. My BSL went from 4-9 mmol/L into the 20s with no changes to anything. I didn't feel sick except for I couldn't sleep and ended up with a headache (which I put down to not sleeping for 3 days). I even went and got brand new pens even though the others hadn't expired. I still can't explain it :(
 
In Response

In Response

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Type of diabetes
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aseriesofunfortunateevents said:
WIth regards to pens/cartridges, both my Lyumjev and Lantus always comes in a fresh pen
Click to expand...
Both of your insulins are available with reusable pens which I would recommend unless you have dexterity problems.
The pens are more robust. The cartridges take up less space in your fridge. They produce less waste and better for the environment.
I think they use the Sanofi AllStar Pro pens

I hope you get to the bottom of your insulin rise.
 
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aseriesofunfortunateevents

Active Member
Messages
28
plantae said:
I had this a few weeks ago. I'm on novorapid and lantus. My BSL went from 4-9 mmol/L into the 20s with no changes to anything. I didn't feel sick except for I couldn't sleep and ended up with a headache (which I put down to not sleeping for 3 days). I even went and got brand new pens even though the others hadn't expired. I still can't explain it :(
Click to expand...
Are you back to normal now?
 
A

aseriesofunfortunateevents

Active Member
Messages
28
In Response said:
Both of your insulins are available with reusable pens which I would recommend unless you have dexterity problems.
The pens are more robust. The cartridges take up less space in your fridge. They produce less waste and better for the environment.
I think they use the Sanofi AllStar Pro pens

I hope you get to the bottom of your insulin rise.
Click to expand...
Interesting, wasn't aware of this. Ill check that out.
 
Rokaab

Rokaab

Well-Known Member
Messages
2,161
Type of diabetes
Type 1
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Pump
There are of course a variety of reasons (including well your body just felt like it!)

A couple of others come to my mind:
Temperature changes - I know I need less when its warmer - and well it has suddenly got colder .....
You've been diagnosed about a year correct? could be the end of the honeymoon period or something like that

Noting that whilst many start off on 1unit to 10 carbs that is only a point to start at, doesn't mean you'll stay on that forever, I bet many don't - I'm not on 1:10 for any time of the day (it varies dependent on time of day - many need more in the morning)
 
Fenn

Fenn

Well-Known Member
Messages
1,405
Type of diabetes
Type 1.5
Treatment type
Insulin
Hi, weirdly after a week of man flu and no change to bg, I am now over it and my Bg is all over the place, I am accepting higher bg for a while because I don’t want to mess with my nice levels (for me) hopefully it will settle down, you could be fighting off something invisible, might be worth waiting to see what happens before drastic changes, best of luck.

(edit, my numbers are in the 9’s not 6’s, I may have sounded like numbers were awful, I eat keto so not easy to adjust because I often only need one unit, two units would be huge in comparison)
 
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