Type 1 diabetics, have you ever experienced this?

[kevinmartinuk_]

Dear all,

I really, really need your help please? I have been a Type 1 diabetic for 16 years, after inheriting it from my mother when I was 39. She also experienced problems that diabetes endocrinologists could never answer. She was happily used for testing new devices & for diabetic trials from Guy's Hopsital in London in the 1980's, I now live in Sheffield.

My huge problem, that is currently destroying my life, is this. Four months ago, I had my Medtronic 640G insulin pump upgraded to the closed loop Tandem Slim x 2 insulin pump. The same problem has occured with both pumps, so i'm guessing this is not a pump problem?

At several times in the last 2 years, I have experienced what can only be called unimanigable insulin resistance, where my insulin is simply not working! Normally I inject 1 unit of Novarapid for every 10g of carbohydrates. The problem I'm having, is at some times after injecting 15 minutes before my meal my sugars just keep rising & will not come down. I change the canular position around my abdomen & stomach area but admit there are some signs of lipohypertrophy (lump of fatty tissue under my skin).

When the sugar keeps rising I am forced to pump more insulin! I wait a couple of hours & when it still keeps rising, I go to my emergency "plan b" & inject more novarapid with my insulin pens. Many times even this has not worked, my sugars have risen to 25mmol/L!

It is important to say all the insulin (cartridges & vials) have always been in the fridge & are in date. Of course after my BG rapidly rising, I changed the canular posiion to less used sites. I changed once to my upper thigh & once to my buttocks. Even though the canular (autosoft 90) seems to have been perfectly inserted, the novarapid insulin pumped has once again had no effect on lowering my sugars! On 2 occasions I had injected a total of 60 units of insulin (pump & pen) for just 2 slices of brown bread, instead of the normal 4. About 6 or 7 hours later (when the insulin should no longer work) I have a hypo!!

I have just changed the canular position to my upper buttocks, where the insulin is currently working & i'm so relieved. Many times after the insulin has not functioned, a few days later, it suddenly starts works normally again?

Please please, has anybody else out there, had any similar problems or have any advice for me on how to resolve this nightmare problem, that is impossible to live with? A top endocrinologist in my area Dr ****** cannot give me the answer, so I am hoping somebody on here can?

Thanks in advance,

Kevin

Edited by mods to remove medic name to conform with forum rules.

 

[EllieM]

Hmm, 57 years of T1, 2 years on a tandem. Some lipohypertrophy on my lower left stomach, but I don't inject or cannulise (Is that a word?) near there.

I find that if my bg goes over about 10 I can get much more insulin resistant ie a ratio of 1 unit to 1mmol/L instead of 1 to 3.... This happened pre-pump, but I notice it more with the pump because the tandem algorithm can't cope. If I go over 16 then the insulin seems to act like water (and yes this happened on MDI too)

Luckily I can take control of the bolusing when this happens and over-rule the pump and inject more anyway. The thing that sets me off the most is having a meal when my bg is already rising (eg over 8 at the beginning).

How have I improved my situation? I found that increasing my basal rate on the tandem kept my bg generally lower (in the 5s and 6s) and if I start there I the unexpected rises are much less frequent. And the overall amount of insulin is less because I need less correction doses...

I didn't notice cannula or injection position making much difference. For me the issue is the rapid increase of insulin resistance with higher bgs. So I try not to eat with a raised bg...

I stress that this is my personal experience and is not medical advice

 

[Fouad777]

Dear all,

I really, really need your help please? I have been a Type 1 diabetic for 16 years, after inheriting it from my mother when I was 39. She also experienced problems that diabetes endocrinologists could never answer. She was happily used for testing new devices & for diabetic trials from Guy's Hopsital in London in the 1980's, I now live in Sheffield.

My huge problem, that is currently destroying my life, is this. Four months ago, I had my Medtronic 640G insulin pump upgraded to the closed loop Tandem Slim x 2 insulin pump. The same problem has occured with both pumps, so i'm guessing this is not a pump problem?

At several times in the last 2 years, I have experienced what can only be called unimanigable insulin resistance, where my insulin is simply not working! Normally I inject 1 unit of Novarapid for every 10g of carbohydrates. The problem I'm having, is at some times after injecting 15 minutes before my meal my sugars just keep rising & will not come down. I change the canular position around my abdomen & stomach area but admit there are some signs of lipohypertrophy (lump of fatty tissue under my skin).

When the sugar keeps rising I am forced to pump more insulin! I wait a couple of hours & when it still keeps rising, I go to my emergency "plan b" & inject more novarapid with my insulin pens. Many times even this has not worked, my sugars have risen to 25mmol/L!

It is important to say all the insulin (cartridges & vials) have always been in the fridge & are in date. Of course after my BG rapidly rising, I changed the canular posiion to less used sites. I changed once to my upper thigh & once to my buttocks. Even though the canular (autosoft 90) seems to have been perfectly inserted, the novarapid insulin pumped has once again had no effect on lowering my sugars! On 2 occasions I had injected a total of 60 units of insulin (pump & pen) for just 2 slices of brown bread, instead of the normal 4. About 6 or 7 hours later (when the insulin should no longer work) I have a hypo!!

I have just changed the canular position to my upper buttocks, where the insulin is currently working & i'm so relieved. Many times after the insulin has not functioned, a few days later, it suddenly starts works normally again?

Please please, has anybody else out there, had any similar problems or have any advice for me on how to resolve this nightmare problem, that is impossible to live with? A top endocrinologist in my area Dr ****** cannot give me the answer, so I am hoping somebody on here can?

Thanks in advance,

Kevin

Edited by mods to remove medic name to conform with forum rules.

Hi Kevin,
I’m really sorry you’re going through this. That sounds so stressful and exhausting.

I just wanted to reply because my son has diabetes he is 11years old , so I know how frightening and frustrating blood sugar problems can be.

From what you described, I wonder if it could be related to absorption issues, especially with the lipohypertrophy and the fact that the insulin seems to work better when you use a different site. Sometimes it seems like the insulin does not work properly in certain areas, then suddenly starts working later, which could maybe explain the very high readings and then the hypo afterwards.

It might be worth asking your diabetes team again about avoiding the overused sites for a while, checking carefully for scar tissue or lipohypertrophy, and whether a different cannula or infusion set could help.

Best wishes to you.