Type 1 - insulin seems to have less effect lately, really struggling

[LSwifeofT1D]

Hi, my husband is 39 and has been type 1 for 5 years. The past few months he is struggling to get his blood sugar down.

Yesterday he had super low carbs and then had one slice of pizza and it was up at 14 over night. It’s like insulin is having less effect on food now. He is a bit overweight but he is smaller than he was this time last year and he’s using more insulin now.

His 3 month average glucose level is 10 and his hb1ac was 58 and is now 68…

Has anyone had this or can offer advice please?

 

[EllieM]

Hi @LSwifeofT1D

If your husband has only been T1 for 5 years it is possible that his own insulin production is still reducing, therefore needing more external insulin.

In general I find that my insulin ratios change according to various factors, including time of year, exercise, weight, illness and many others. You have to be prepared to adjust both basal and insulin ratios.

Is your husband able to contact his team for advice on adjusting his doses?

 

[CheeseSeaker]

Might not be related but worth a thought - if your husband injects into the same area (or if on pump uses the same site for the cannula) he can build up insulin resistance as the subcutaneous fat starts to go like 'cotton wool' under the skin and doesn't absorb well.

Try changing site to somewhere he doesn't usually use, and see if it starts working better - just watch for lows as if the insulin does work well, the current amount will work 'too well' for the carbs.

 

[Juicyj]

@LSwifeofT1D

Insulin needs can and do change over time, it's best to start with basal tests first to check his background doses are right as this is the foundation for good control, you can see how it should be done here: https://www.mysugr.com/en/blog/basal-rate-testing/

Also good to cross check with his Diabetes team too and if he hasn't already done so get onto a Dose Adjustment for Normal Easting (DAFNE) course as education and knowledge is key with T1d,