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type 1 severe insulin resistence

megan

megan

Well-Known Member
Messages
369
Location
weymouth
Type of diabetes
Type 1
Treatment type
Insulin
Dislikes
dishonesty and ********
i have now been switched from gliclazide back to metformin which i had a few years ago.

i have split my dose of glargine....14 morning and 16 evening to try to help

i have been following a diet of very little carbs.
a small banana in the morning and then no carb lunch or dinner
i'm taking anything from 4 to 8 units of novorapid for my lunch with no carb
each meal i am on 2 units for 10g and a correctional each time. I follow the DAFNE program
I am on a regime or intensive blood tests and insulin doses
seen my diabetes team this week and finally they have accepted that i am severly insulin resistent.
i have been told there is no other help for me.
i go to the gym and exercise regularly.
i feel awful and sleep loads
i can barely function some days

any thoughs please?
 
I'm sorry to hear you're struggling, Megan. I haven't suffered from insulin resistance so I can't offer any help I'm afraid. I am surprised, however, that your diabetes team have said they can't do anything else to help :(

Hopefully there will be some people on here who can offer some helpful advice. Hope you get things sorted soon.

Take care

Em
 
Megan how much long acting insulin are you taking and what sort? What sort of blood glucose readings are you getting?
 
Hi there, I used to be in the same position where I was taking around 120 units of insulin per day and still had a hba1c of 11%. Metformin really didn't agree with me either. I eventually got approved for an insulin pump and things have changed dramatically. I'm now on around 60-80 units per day and my last hba1c was 6.9% so maybe a pump could help?

Gill x
 
Hi Megan,
have you tried a different type of insulin? It might just be you have a problem with the insulin you are using. So if you are using analogues try a non analogue insulin and see if this helps.
 
Hi Megan

For weight loss and insulin resistance it looks as though the Endo Barrier is starting to make waves in the UK at long last. Hyponotherapy might also be beneficial and is easily obtained. Definately worth discussing if it would make your bg levels drop a bit better.
 
CarbsRok said:
Hi Megan,
have you tried a different type of insulin? It might just be you have a problem with the insulin you are using. So if you are using analogues try a non analogue insulin and see if this helps.
Click to expand...



Certainly worth a try Megan if you haven't tried this already, failing that I would ask about changing to a pump.
 
just to give an idea of whats happened recently

BB........CHO.......BASAL.....BOLUS....CORR......MM.....BL..CHO....CORR...BOLUS...MA....BD...CHO...CORR...BOLUS....BED

18.1.......20..........14...........4............8.....................13....0.........3..........3........15.1...16.8..0........6............0...
10..........20..........14...........4............2...........14.9....15...0..........5..........4........11.....6.8....0......................4........7.5
15.2.......20..........14...........4............6.....................11.9.0..........5..........5........7.1....9.6....0......................4.......12.2
13.8.......30..........14...........6............4........16...10...7.8...0.....................4........4.1.....5.8...30.....................6........3.4

I forgot to add in that as well as the morning glargine of 14 I take 16 in the evening. I have 1 metformin tablet with breakfast and one with dinner.

whilst my insulin daily dose isn't that high, I am eating very little carb. the 'o' above are not me missing meals, this is eating green salad and poached fish or chicken and so no carb.

if i were to include regular carb in my diet the insulin abviously goes up massively. i have been battling to get my insulin levels down so i can try to lose weight in stead of constantly putting it on.
my weight has just gradually increased year after year and its really depressing!...hate using that word but there it is, i've done it now!
 
Hi, i always thought you had to be type 2 to be insulin resistant ????
 
Megan, it's a bit hard to read your figures, unfortunately this forum doesn't make it easy to create a chart, but if I'm reading things correctly I think that you may be using fast insulin corrections to make up a shortage of basal insulin. You really need to get the basal correct before you can work out your carb ratio. People who are eating very low carb tend to have relatively higher basal requirements (according to J Walsh this might be about 60% basal, 40% bolus... and I actually don't think he is talking about people with very very low carb intakes)
You need to do some basal testing and see what happens to your levels in the absence of food and bolus injections. It might be that you then have to raise your basal so that your levels don't rise significantly when fasting.
This is a good account of how to do a basal test.
http://www.diabetesdaily.com/forum/arti ... injections
 
megan, sounds like the big D is really treating you rough at the mo, and making you feel yuk. massive hugs. for the first time since my diagnosis nearly 12 years ago, instead of just 'living with it', lately it has completely dominated my life. i've developed a few worries about what high bg levels do to us over the years, and am thinking i have got a few complications. it has turned me into a worrying, panicy, constantly anxious person and i HATE how i'm behaving. hope this helps you to not feel alone in how you feel.

i am really hoping pursuing a pump will help, i completely welcome the extra work it will involve, i'm quite angry i have never been told to balance carbs with insulin. have you considered pestering for a pump? it really sounds like it could be helpful in your situation?

mistee - my mum who has been t1 for 37 years is very insulin resistant. she is taking about 100u of levimir (background) a day (split) and between 30-50 novorapid for meals (can't remember exact amounts) - sounds like you gill, and she can't get a hbA1c in single figures. she doesn't seem that worried, i am terrified for her. i keep asking her to pester for a pump, she's quite happy to do all the working out etc, but no one is in a hurry to ever get back to her. her consultant told her not to worry about metformin as it really didn't agree with her. she's happy to be told what to do and if no-one chases her she assumes everything is ok...i really must insist she pesters them.

i am no expert, but shouldn't increasing background help you lowering your levels?
 
thanks guys....its me listening to my diabetes team again!

over the years i have done what i'm told again and again believing that they surely know right...??my gut feelings and eventually my own evidence show me time and time again that they are wrong but they are quite arrogant with it.

so recently they finally agreed that 2 units of novo for 10g cho was necessary. about 9 years they have been telling me it is too much and i shouldn;t be taking it!...this was during pregnancy too!
so now they say its quite normal!
and again, when i was on the byetta the end of last year, the team said that it was very clear that i was taking a bad ratio of insulin as i was on far more basal than bolus. i tried to say that i was on so little bolus because the byetta made me feel so sick i could hardly eat!
so i was told to change my ratios again. i was on around 32 for a while. then one day the diabetes nurse told me to put it up to 40 that day. i did and had a terrible night of lows and fear!
when i told her she was pleased to hear this as she wanted to prove it would be too much!
so today I started the day with a blood of 13. i corrected this and took for my breakfast carb. my blood stayed at 14 then 13 for the rest of the day and i didn't have lunch. so i will try tomorrow to increase my morning glargine.

it is a worry. over the years i was scrutinized for how hard i was really trying... then told i obsessed over it!....just trying gets you labled with anxiety...now told by the diabetes team and gp that there really isn't much else i can do.
also.......as i left the clinic and the diabetes nurse asked how did i get on with the dr, we spoke about my hands again. i get tingling and funny feelings in them. the dr had been told numerous times. he's always said that it is not neuropathy as i dont have it else where and am in good health.
the gym instructor for the 'life fit' group suggested it could be connected to my chronic fatigue.
the nurse there and then in the waiting room just blurted out that its probably hand neuropathy!!!!

i was shocked.....even if thats what you suspect, is it not something you are meant to sit down and discuss with dr too in a room

i could write a book on her insulting tackless moments!
 
my background insulin (insulatard) is 24u morning 18u night...i'm not insulin resistant. how about increasing yr morning basal by 2u and monitor for few days, if still high inc evening by 2u? give it a go! "far more basal than bolus" sounds like me! but it works for me. i haven't restricted carbs from my diet yet and take between 4-10u of quick acting (humalog) depending on what i'm having (but usually between 6-8, only 4 or 10 in more extreme cases).

yeh, they're good at fobbing us off ain't they! grrrr
 
Megan... firstly odd question but why do you think your insulin resistant? 30 units of Lantus doesn't seem to be a massive amount? (unless you are a wafer?!) Even if that does look a little short..

Secondly if you are injecting Rapid to cover zero carbohydrate meals then in effect what you are doing is covering a short fall in your lantus.. I would suggest you need to increase the background insulin probably by a similar amount of the amount of rapid you are injecting to cover a very limited amount of carbohydrate intake..

Finally you should find if you can get your blood glucose down then your actual requirement will drop as well.. insulin is more effective when your blood glucose are lower.
 
good advice pneu...

forgot to say - last few times i've seen anyone who remotely knows what they're talking about (DSN) i've been told i am on too much background. told to reduce it and increase boluses...when i try this my BGs always rise! so i always end up eking it (basal) back up, and surprise, my BGs level out again (not always poifect, but that's another story!)
 
What needs to be remembered is that the advice given by HCP's reference dosage is based on 'Joe Average' and none of us here last time I checked was 'Joe Average'...

The first thing all type I's should do is understand how their bodies work and what their insulin does.. by all means listen to the advice of HCP's but at the end of the day most of them aren't diabetic and I am yet to find one that has an understanding of my diabetes that is anything other than guess work based on averages..
 
Pneu said:
Megan... firstly odd question but why do you think your insulin resistant? 30 units of Lantus doesn't seem to be a massive amount? (unless you are a wafer?!) Even if that does look a little short..

Secondly if you are injecting Rapid to cover zero carbohydrate meals then in effect what you are doing is covering a short fall in your lantus.. I would suggest you need to increase the background insulin probably by a similar amount of the amount of rapid you are injecting to cover a very limited amount of carbohydrate intake..

Finally you should find if you can get your blood glucose down then your actual requirement will drop as well.. insulin is more effective when your blood glucose are lower.
Click to expand...


Hello Megan

I completely agree with the above comment that Pneu has made about insulin resistance. Just because you need to use a lot more insulin than other people doesn't necessarily mean that you are insulin resistant. It is true to say that the more we all weigh will mean that we will need to use more insulin but no one should be made to feel odd one out.

Like Pneu and Phoenix have advised I too would say that you need to inject more of the Lantus which will then of course start to also affect the amount of bolus insulin you will eventually find yourself needing to alter because of having lower bg levels. Once youve got the balance correct between the effect the basal has with the effect the bolus also has, you will then start to be in much better health and you will have got your control figured out 'Your Way'. It is a bit of a game with the need to do loads of bg tests but I can't emphasise enough really how so important testing bg levels is for all of us using bolus/basal regime. In the end we all find our own 'true mix'.

Let us all know how things start to pan out for you. Look at the 100 rule in determining your average correction factor which works fairly well I think. Until you find your true TDD, it might be wise to use the correction factor of 1u will lower your bg by 1 or 2mmol and use the target of 10 to correct to as you dont want to lower your bg levels too drastically. More like lower them bit by bit over a few weeks just to be safe.................
 
When low carbing, it is a different ball game to the DAFNE approach.

DAFNE assumes that people are getting a relatively large percentage of their energy from carbohydrates. (by relatively large I mean significantly more so than on low carb)

When low carbing, you can't base your insulin requirements solely around carbohydrate intake as proteins will play a larger role in raising blood glucose.

In most cases, you will need to take carbohydrates into account in your insulin dosage and then add a little bit more to account for proteins and your liver releasing glycogen. Getting this 'extra amount' right will need a bit of care and recording your results should help with this.

Looking at your insulin doses Megan, I really don't think you're insulin resistant :)

Ed
 
thanks everyone....its so good to talk :)
i have increased this mornings basal by 2 units from 14 to 16

my bloods started the day were 12. i had 15 g carb. i took 3 novo for the bolus and 3 for the correctional.
11am my bloods were 14.
i was at the gym taking it gently at this point. i had injected in my legs today and hoped going on the treadmil would help to get the novo to work quicker.
12 o clock my bloods were 11
then 1pm lunch my bloods were 14

i felt shaky and weak at this point. i had a very light salad lunch with some cheese and 3 ryvita. 20g carb. so i took 4 novo for the bolus and 6 for the correctional.
i have based this on the fact that i've needed a lot of insulin for carb over lunch recently.

am i doing wrong?
i took the ryvita to try to keep my strength up as over the past few days i've felt weaker and more tired.

my bloods stayed round 14 all day yesterday with no lunch....its all so gobbledy gook to me at the moment i can't even think straight.
i can't ask my diabetes team as they don't believe in lots of testing or analysing or looking for patterns :(
 
Hi Megan

You may well weak and shaky if you are on a low calorie daily intake, which I'm guessing you will be here.

If I ate 15g of carbs in the morning I know I'd have to inject more than 3 units of my bolus insulin because I know my liver would release glycogen to help bolster my blood sugar levels and provide me with energy. This factor needs to be taken into account when low carbing.

I think when you're injecting 3 as a correction dose, all this is actually doing is coping with the reaction from your liver and is not therefore able to help correct the high BG level you're starting the morning with.

Ed
 
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