why does'nt my insulin work anymore??

I am at present on 26 levemir in the morning and 20 at night. 2 units for 10g CHO. 2 metformin with breakfast and two with dinner in the evening.

on thyroxine and prozac.....insulin resistent. double diabetes.....struggling...

seem to always be in the cycle of trying to lose weight and trying to get the insulin down and the blood sugars down...and so on and so on....


its a constant battle...I have this week changed my dose slightly as in increasing the morning levemir.....its made a difference but I'm still bouncing around too much to say I'm on the right track...

I am on reduced carbs....and have increased the exercise more...am very active....but very over weight and utterly fed up..

please can anyone shed any new light on their experiences of what they have done in this situation....any little changes no matter insignificant it may seem, I would love to hear about...

I am on levemir and novorapid. have tried glargine.....came off that 2 years ago.

am wondering about changing insulin as have heard some reports on this...however.....there must be a way of getting my body to cooperate with my meds better now..

this has gone on for years.......help needed

Megan,

Ever thought about a pump?

yes I have thought about the pump....loads......I liked your writing by the way....its good to see straight talking from the mouths of people who are struggling like me and because of not conforming to the 'norm' in the diabetic clinic world...don't fit... :roll:

any way....the pump......I did DAFNE several years ago ready to go on to the pump....I did all I could to get funding.....not possible.....my dr at the time was really pushing for it ...then after a couple of years he said that I was too far away from him and so in an emergency it would be dangerous for me to be on the pump...

if I had the money I would go on it...

I went on the 3 day blood monitoring thingy that is plugged into your tummy the whole time......before and a year later when I first went onto glargine....they wanted to compare what was happening 24hours a day....

that slight improvement didn't last forever and then I went to levemir and then I split it and got metformin....

so mmmmmmmmm.....what to do next......not that I ever go along with it..but I am desparate....a friend has suggested herbal pills that help with weight loss....I was going to ask my gp if I could take them.....maybe I could do that and give the resistence a chance. as nothing else seems to be working....I'll pop that on a post under its own title to see if anyone has any experience of that..

what about ollistat......know anything about that?

Mine seems to have stopped working too.

I'm on Novorapid and Lantus and over the past week or so I've had to give myself massive doses of Novorapid (a ratio of 1 unit of insulin to 2g of carbohydrate) and have also slightly increased my Lantus, to try to bring down sugar levels of between 13 and 20 mmol.

Could it be the insulin itself, as quite a few people seem to have developed this problem recently? :?:

Hi Jackie, the answer is yes.
can say this with toal confidence, as I was in exactly the same boat. A switch to porcine insulin proved it. Ithe unexpected ups and downs did not relate to doing or eating anything differently on subsequent days, Lantus that did not work; it also seemed to prevent my humalog working on some days aswell
. I stayed on Humalog when I changed to Porcine Isphane, and it worked fine.
The proof of the pudding is in the eating, so the only way to find out if an insulin is not working for you is come off it and try something different- real insulin is your best bet, as these erratic control probs don't seem to be specific to just one long-acting analogue, as you've noticed.
Jus

janabelle said:

Hi Jackie, the answer is yes.
can say this with toal confidence, as I was in exactly the same boat. A switch to porcine insulin proved it. Ithe unexpected ups and downs did not relate to doing or eating anything differently on subsequent days, Lantus that did not work; it also seemed to prevent my humalog working on some days aswell
. I stayed on Humalog when I changed to Porcine Isphane, and it worked fine.
The proof of the pudding is in the eating, so the only way to find out if an insulin is not working for you is come off it and try something different- real insulin is your best bet, as these erratic control probs don't seem to be specific to just one long-acting analogue, as you've noticed.
Jus

Click to expand...

sorry just trying to get this straight.....if i can get hold of one of the animal insulins to make the change first...which would i start with??? the levemir or the novorapid?

i know i probably sound a bit dim now, but i'm so tired, i can't think straight....my sugars have been getting even higher.........i feel awful...but the dr has allowed me to go from 175 to 200 thyroxine......and told me to just get on with my life and be happy......bit hard when i feel so ****!!!

is the porc isophane you mention the quick?

I have been a type2 insulin dependant for 10 years, at first all was ok but after two years the insulin ceased to work I have been using up to 150units a day of novorapid and 140 of lantus at night with little or no results, I was taken into hospital where they put me onto an insulin pump for a week hey presto down to 7.5, I was recomended for a pump.

That was 4 years ago I was then told that NICE does not recomend pumps for type2 diabetics so no pump, my readings were off the scale, so I have been taken into hospital again on my notes it says Badly controlled type2 diabetic, they took me in for two days they said to get my levels down I was in for a week attached to an insulin infuson the lowest it got down to was 23.6 with it going down to 17.3 when I did not eat for a day.

I have been up down and sideways I now am taking 3 (with meals) shots of Novorapid each 25 one shot at night of Levemir 56units in the morning 45 units of Levemir before breakfast 10 units of Byetta and before evening meal anothe `10 of Byetta results between 22 and 27 constant.

They have put me back on Metformin again although I took the for years with no results.

I now have damage to my feet hands and stomach, where now!!!!

Hi Megan
When I changed to animal insulin, I changed from my basal, Lantus, to Hypurin Porcine Isophane,and split the dose for longer coverage. Although I was prescribed Hypurin Porcine Neutral,short-acting, i decided to stay on Humalog for a few months till I got the basal dose right.
If you changing I would suggest you do as I did, that would mean changing your Levemir first. it's unlikely that Novorapid is causing your control probs and making you feel ****.
Doctors will try to put you off animal insulin by saying it's "old fashioned" or that you have to wait ages after injecting before you can eat. The neutral takes a bit longer to work, but I've often taken it close to meals and not had huge peaks afterwards. It's gentler action has resulted in less hypos for me.
Fletcher, I was so shocked by your posting. 140 units of Lantus! How did you feel on that dose? I'm asking because I've often wondered whether the side effects are worse for people with high doses. My worse days were when my doses were higher, but only 44 units.
Long-acting analogues are notoriously unpredictable,and how they work for some and not for others I'd love to know. If there's no possibility of you getting a pump, then I'd recommend getting your doctor to prescribe animal insulin; and you need to get your sugars sorted asap, so how can your doctor possibly refuse? Clearly Lantus and Levemir have not worked, and unless your doc's got any better ideas, I'd see what he has to say-but expect resistance :cry: My husband said I should edit this and state I mean resistance from your doctor, not the insulin!
Please keep us posted on how you get on and take care
Jus

Re: why doesn't my insulin work anymore??

Sorry to hear that you are so distressed!The only advice I would give is this.....
1. Go back to basics,check and measure everything you do with balance.
2. Discuss the problems again with your Doctor,or contact your Diabetic Clinic who can advise,and also suggest courses, that help you control your blood sugar better.
3. Most of all be honest with your self,the Doctors don't measure and control,you do.

Good luck!

Type One Devil :evil:

i continue to measure and check everything...and although i don't wish to speak too soon, when people keep mentioning hypo's, that is not me and has not been so for some time....verry little if anything at the moment are able to get my blood sugars down.....

it sounds like its more insulin needed, but that isn't making much difference either....its like its just not working....

very tired....fed up!!!!....each day is no better

Megan,
In Fletcher's post he said when he came off Lantus and went on a pump his sugars were controlled. Now on Levemir, he's got lousy control again. Long-acting analogues are the problem for many of us.
If you're doc won't agree to animal insulin, ask him about a synthetic "human" long-acting insulins suchas Insulatard-although a lot of them have been discontinued :cry:
I'm so sorry you're feeling so lousy, but trust me, there will be an end to it-you WILL feel better.
Jus

thank you....i will do that.....as my thyroxine has just been increase to 200 i am supposed to wait a little while to see what that does before changing anything else...

my TS went from 2 somthing to 4 something from last sept to now......i have increased weight too, but that has been quite normal for me for a few years....i use the term 'normal' lightly.......gaining weight is horrible and not justified to this extent...

i am always on the go ( well until recently when these sugars have made me feel even worse).....an eat healthily....so what gives......

The lady who started this thread has gone on to a pump,yet another example of someone getting off long-acting analogues and getting control back.viewtopic.php?f=19&t=12864
Is there anyone who's on Lantus or Levemir and got good control of their BGs-honestly? Be interesting to hear from people who arent having these probs-or mayb I should start a new thread?? :?
Jus

I was on Lantus and Levemir before starting on Animal.
My control was excellent on both. Unfortunately they became highly poisonous to me, so that was the end of that !

Tried lantus and Novorapid for 7yrs after having perfect control with Insulatard and Actrapid.

Problem with Novorapid is that it's effect only lasts 3hrs, Lantus phases out after 12hrs.

I got put back onto Insulatard and Actrapid, Insultard lasts 20hrs and Actrapid has an 8hr window.
My control has improved immensely, why should type 1's have to take the tablets as well as inject? About time they accepted the fact that only a small minority benefit from the analogue insulins, mainly those that start their diabetic control with them.

OK, here is my rundown on stuff, not sure if this will help but I thought that you could juudge or learn from my own routine as an example.
I have been on Levemir for several years now and have split my dose to a morning and teatime injection. I also take 150 gms of thyroxine and also take venlafaxine (37ml) which is quite a low dose.
I hadnt heard much about insluin restistance and I am sorry that you are having problems. I really hope that you can sort it out soon.
However, you wont be pleased to hear that i take a small dose of insulin = 6 units of Levemir morning and evening, and 5 untis of actrapid for meal times. I dont know why this is, and why others take much more?
I count carbs, 9 portions (or 90 grams) of carbs per day, but sometimes I eat more in the evening because Im more hungry . I dont know if this is a low amount or not. I couldnt go lower than this though. Ive had type 1 for 42 years, so you can judge for yourself my experience of diabetes anarchy. :twisted:
On a good day I have fairly good control of blood sugars. However, on a stressful day or time, and during and after menses, my bs are horrific. I was yo yoing from 3.5 to 30 and back to 5.0 and 24.2 the other week. I was also very tired and opened a thread here on how hard it was to manage my bs and energy levels.
So, OK, I wonder whether your age has anything to do with your insulin increase.? I am assuming that you are female, but I do wonder about female hormones, and whether these are interfering or causing insulin resistance?
I suppose it might be just a mad idea, but it is curious how my own bs and amount of insulin vary when Im having a time of the month, and possibly pre menopausal.
You can get blood tests to check this but I dont know the correct term used for the test.
I now feel abit silly writing this here but something is happening to not help your insulin function and this could be something for you to look into if necessary.

Very Distressed Rav,

It is time to get tough with your medical team, believe me things will only get worse. One of the problems some of us long term diabetics, that have led healthy active lives and maintained good control, is that your body starts to reject the insulin. After 4 years of going through very, very, dangerous lows followed by equally dangerous highs I 'sat in' at my diabetic clinic! Result! Eventually after spending a week in hospital I was issued with a pump. The situation immediately improved and I began to feel safe again. This is the only way forward. Please take control and make sure that your medical team do not palm you off with 'easier' solutions. I am here if you have any questions or need any support. Good luck.

Well I'm having the same problem and I'm pretty sure it's because you've been given drugs that raise your insulin levels, and yes this includes insulin. High insulin levels damage your beta cells even more causing gerater and greater insulin resistance. It's funny how type 2s here talk about you might have insulin resistance. Insulin resistance is what causs type 2 in the first place - WE ALL HAVE IT AND THAT'S WHY WE'VE GOT TYPE 2! Have any doctors checked your insulin levels? I'd guess no. So your insulin resistance is probably just getting worse from high insulin levels - exercise, cutting high glycemic carbs., and taking suppliments that can lower insulin resistance and insulin levels are the only things I know of that can help you.

Have you considered the possibility of you taking too much insulin and your liver compensating by producing Liver Glucose/Glycogen?

I have been Type1 for 63 years now and am on a pump so I get good feedback from BMs because the readings are not complicated by fluctuations from long lasting insulins. I get the same problems as you but very little help from the professionals; they have only one solution to high BMs - more insulin!

But if you Google the above you will find that LG is Glycogen (a hormone - do you really think the liver has a hidden 1kg bag of sugar secreted away?) and quite capable of producing the effects you describe.

Certainly, in my case, I do not suffer hypo's. I get vague warnings of low blood sugars but usually when the level is ridiculously low. I have 15g of carbs and then find the level is high, around 13.0, which is not possible from only 15g (the long described bounce?). So what causes the bounce? In my opinion Glycogen and sometimes it can be injected away and sometimes not.

I find it better to ignore the bounce as a false reading, reduce my insulin/carb ratio and hope that the level will gradually reduce. It usually does after a few days but if not then a small dose of insulin often does the trick but don't panic!

I have been suffering thus for around 5 years and have had to develop my own treatment which is of course highly irregular.

When you next have a high reading inject a small amount of insulin, don't consume any carbs and retest after an hour. If the reading hasn't reduced then the problem isn't glucose/sugar; you may find that the level has risen so what is the cause? The next thing is consume twice as many carbs as the injection yoy had previously would treat. You may be surprised and find after 4 hours that your BM has reduced.

You've got nothing to lose: if the BM is high and the insulin brings it down then it is sugar and, surprisingly, that is good. If the insulin has no effect then you're no worse off and the carbs might actually bring it down.

The blurb on LG/G says that once the liver starts to release it it does so for 12 hours and becomes the only source of energy for the body. Which raises the question - what happens to any carbs you consume in the meantime? For me I think the release goes on longer than this (well the bod is faulty after all) and there is one main rule - eat before exercise and avoid low blood sugars as much as possible.

If all else fails DON'T PANIC.

I sincerely hope this is a possible solution
David

I am experiencing the same thing right now, 11-18 in the morning and highs up to 29 in the day despite injecting more and more insulin, not eating any carbs and doing moderate exercise and I have been a Type 1 diabetic for 25 years. I can only tell you what I have done so here goes. I reduced my long acting insulin last night. I also split the doses like the good old days because I experienced a trailing off of potency, despite assurances that the new insulin doesn't peak! (I have levemir), I was back to 6.5 this morning and so far no highs. You are probably having a hypo at night, this is my theory and is the reason why I reduced it. It might not be a big drop, just maybe in the 3-4 range but enough to trigger a liver surge of free sugar!! I also have metformin slow release 500mg tablets that don't make you feel sick unlike the short release that I tried and handed back pronto! They definitely do help to reduce the amount of insulin you have to inject, I am living proof of that. Try the night time reduction for a few days and see if it helps, it may take a while to sink in. My hormones make me high too, and stress induced lows always follow with a rebound. Hope this helps.