Too much insulin?

[LemonTree]

Hi,
I was diagnosed with Type 1 diabetes over 14 years ago (I am now 32). After my last HbA1c in August came in at 8.4% (I really hadn't been looking after myself) and retinopathy present in my last 2 eye tests, I decided I needed to stop ignoring it and sort it all out - particularly as I might want to start a family... Better late than never :roll: Don't get me wrong, that is the highest my HbA1c has ever been but similarly it's never been below 6.9% either.

I have an app on my phone where I record all my blood tests so I've really tried to turn it all around and after 4.5 months and testing at least 4 times a day the app is now telling me I could have an estimated HbA1c of 6.3% (Yay!). I have noticed that my basal is good but I need twice the amount of bolus for my evening meal as for breakfast, I assume this is because my basal is tailing off a bit as I inject this at night for best results for me. I use Novorapid and inject 5-6 units in the morning, 9-10 at lunch and anything from 14-18 for my meal depending on how carb/sugar heavy I consider it to be, and 12 units of Levemir at night.

I've never been told how much insulin is too much and I know it's probably different for everyone because some people will exercise or maybe even metabolism has an effect but does anyone know if too much insulin is actually bad for you?

 

[Elc1112]

Hi lemonTree,

The more insulin you use the more likely you are to out on weight. This isn't the case for everyone but I have certainly found that I put on the pounds if I start using more insulin. So, in that respect, too much insulin is bad for you. However, if you need x units to keep your sugars under control then you are not using too much insulin. The amount of insulin needed depends largely on how many carbs you are eating and whether you need to add a correction dose if your sugars are high before a meal etc. Weight can also affect how many units you need and you can become resistant to insulin if you are overweight. To put it another way, there isn't a simple 'this is how much insulin you should be using' formula.

To give you an idea, I am 29 and have been diabetic for 22 years. I inject 4 units of novorapid in the morning, 6 at lunchtime and 8-10 before dinner. I take 28 units of levemir before going to bed. I try and stick to a low carb diet as this means I need less insulin and it is therefore easier to control my weight. I exercise a lot so often find j need carbs to give me enough energy to be able to function.

Sorry this isn't the clear answer that you were looking for but I hope it helps anyway

Em

 

[Ambersilva]

As a starting point the Total Daily Dose is calculated as one unit of insulin for every two kilograms of your weght. So if you weigh 76 Kg your TDD would be estimated at 38 units. That 38 units is divided equally between the long and rapid acting insulins.

Using that formula, slow acting would be 19 units and the remaining 19 units divided between your meal-time injections of Novorapid. The slow acting insulin is supposed to keep working in the background to keep your blood sugar levels at a consistent level above 4 mmols/L. The rapid acting insulin deals with the meals.

I am sure one of the experts will be along shortly to give their advice.

 

[LemonTree]

Hi Em

Thank you so much for your response, it is actually very helpful. I do think that part of my increased insulin 'issue' is because I've been SOO lazy lately. I really need to do some exercise :roll:

Over the years I do feel I've been left to deal with it on my own and my 'professional' team not particularly interested in pushing me to do better even though my GP encouraged me to attend the clinic at my local surgery, rather than attending the hospital for my clinic appts. Sometimes I wonder if the GP surgerys have a quota to fulfil of diabetes patients...

I should have another appt and HbA1c test in the next few weeks so with any luck it will have come down and I will request to be referred to the hospital to start the prep for having a family... :shock:

 

[LemonTree]

As a starting point the Total Daily Dose is calculated as one unit of insulin for every two kilograms of your weght. So if you weigh 76 Kg your TDD would be estimated at 38 units. That 38 units is divided equally between the long and rapid acting insulins.

Wow, I never knew that. I actually thought that was good until I worked out that I weigh 68kg so I'm having too much insulin. :lol: I do think this is an exercise issue on my part. I did weight watchers for a few months in 2011 and managed to cut down my insulin quite a bit and lose 20lbs in the process although I have found my cholesterol has increased since then... Ups and downs...

 

[Ambersilva]

LemonTree,

We are all different and what works for me will not necessarily work for anyone else. If you decide to increase the Levermir only do it by 10% and wait three days between increments. Your waking glucose level should be an indicator of whether your slow acting insulin is adequate. Be sure to take a reading about 5 hours after the last fast acting injection to compare late evening and morning levels.

 

[AMBrennan]

The amount of insulin needed depends largely on how many carbs you are eating and whether you need to add a correction dose if your sugars are high before a meal etc.

That is grossly misleading; people who need lots of insulin (there is a reason Humalog pens go up to 60u and Lantus to 80u) don't do so because they are eating 20x as much as I do (that would be 2kg of carbs per meal... ) but because insulin sensitive varies wildly between people.

 

[noblehead]

I've never been told how much insulin is too much and I know it's probably different for everyone because some people will exercise or maybe even metabolism has an effect but does anyone know if too much insulin is actually bad for you?

Nor me, I suppose awe are all different and much depends on weight, activity and sensitivity to insulin, diet can also determine how much insulin we inject.

5 years ago I was injecting 60-70 units a day and never seen that as a problem, nowadays I'm between 34-36 units a day.