Having trouble understanding insulin resistance and sensitivity

[gillrogers]

Hi, im having trouble understanding the differances between insulin resistance and sensitivity. DB nurses say I'm both.

More often than not I am sat at a desk working, I'll get up and potter about and I'll do a walk. But my insulin drops to where I started by 4 hours so I'm told my ratio is correct. Then on a day where I have to be on my feet all day or even just the morning then my insulin drops fast after a peek. It's frustrating because it's causing me to be spend most of the day above between 15 and 10 most days. Even with corrections it seems for the most I'll only bee in the green for and hour or two a day. Most of the time during the night I get back to 7 or 8 and a straight line . It makes me wonder if I need 2 differant 12 hour basal doses .

I get too hungry to do this basal testing during the day to see what I'm really like during the day with it. Though my suspensions are that's it's too low even though it's fine at night.

Then to confuse matters more for me, I have dB nurses telling me I need to be back to where I start after 4 hours BUT the dB dietitian says nooo it's after 2 hours.

Pulling my hair out still!.

 

[Leadinglights]

Hi, im having trouble understanding the differances between insulin resistance and sensitivity. DB nurses say I'm both.

More often than not I am sat at a desk working, I'll get up and potter about and I'll do a walk. But my insulin drops to where I started by 4 hours so I'm told my ratio is correct. Then on a day where I have to be on my feet all day or even just the morning then my insulin drops fast after a peek. It's frustrating because it's causing me to be spend most of the day above between 15 and 10 most days. Even with corrections it seems for the most I'll only bee in the green for and hour or two a day. Most of the time during the night I get back to 7 or 8 and a straight line . It makes me wonder if I need 2 differant 12 hour basal doses .

I get too hungry to do this basal testing during the day to see what I'm really like during the day with it. Though my suspensions are that's it's too low even though it's fine at night.

Then to confuse matters more for me, I have dB nurses telling me I need to be back to where I start after 4 hours BUT the dB dietitian says nooo it's after 2 hours.

Pulling my hair out still!.

But my insulin drops to where I started by 4 hours ? Do you mean blood glucose?

What is the difference between insulin resistance and insulin sensitivity?
Insulin resistance and insulin sensitivity are two sides of the same coin. If you have insulin resistance, you have low insulin sensitivity. Conversely, if you are sensitive to insulin, you have low insulin resistance.

Does his definition clarify what you DN said?

I have dB nurses telling me I need to be back to where I start after 4 hours BUT the dB dietitian says nooo it's after 2 hours.
I think the 'rules' are different for people on insulin about where you should be after food.
Hopefully some other folk on insulin will be able to clarify for you.

 

[Inka]

@gillrogers The Type 1 target is to be back in range by the next meal. I’m confused by your comment about insulin resistance as your meal ratios and basal dose don’t suggest that. If I remember correctly, you were saying your bolus took a while to work? Is that what you mean regarding resistance?

If I were you, I’d dump the Semglee and get a twice-daily basal insulin as a start. If you really get too hungry to basal test in segments, then you can still carefully adjust your basal and see how you go. I do this sometimes rather than basal test.

 

[gillrogers]

But my insulin drops to where I started by 4 hours ? Do you mean blood glucose?

What is the difference between insulin resistance and insulin sensitivity?
Insulin resistance and insulin sensitivity are two sides of the same coin. If you have insulin resistance, you have low insulin sensitivity. Conversely, if you are sensitive to insulin, you have low insulin resistance.

Does his definition clarify what you DN said?

I have dB nurses telling me I need to be back to where I start after 4 hours BUT the dB dietitian says nooo it's after 2 hours.
I think the 'rules' are different for people on insulin about where you should be after food.
Hopefully some other folk on insulin will be able to clarify for you.

Yes sorry I meant blood glucose. Thanks leading lights. Two sides of the same coin make sense.

 

[gillrogers]

@gillrogers The Type 1 target is to be back in range by the next meal. I’m confused by your comment about insulin resistance as your meal ratios and basal dose don’t suggest that. If I remember correctly, you were saying your bolus took a while to work? Is that what you mean regarding resistance?

If I were you, I’d dump the Semglee and get a twice-daily basal insulin as a start. If you really get too hungry to basal test in segments, then you can still carefully adjust your basal and see how you go. I do this sometimes rather than basal test.

Hi Inka,. Well that's what I have always know to be the case, by next meal. Which as you say doesn't suggest that about the resistance from what I was originally understanding and why I've got tumbling round my head this resistance and sensitivity that my dB nurses have now said I have. Now I'm on the Lyumjev I'm not prebolusing with the exception of breakfast which is down to a few minutes rather than half hour. So I know that's not the problem. I think my confusion has been started by my dietitian saying I should be back down 2 hours after meals "as that's the profile of Lyumjev" she said .

Yup I think I'll push to dump the semglee again. I have asked to once before but didn't get anywhere.

Oh btw Happy New Year to you all!

 

[Robin]

I think my confusion has been started by my dietitian saying I should be back down 2 hours after meals "as that's the profile of Lyumjev" she said .

Sound like she hasn’t studied the manufacturer's info. It looks like it’s faster, but not that much faster.

Mealtime Insulin Formulation | For HCPs | Lyumjev™ (insulin lispro-aabc)

Read about Lyumjev, a formulation of Humalog designed for fast absorption that begins to work quickly and helps to control blood glucose spikes after meals.

www.lyumjev.com

 

[gillrogers]

Sound like she hasn’t studied the manufacturer's info. It looks like it’s faster, but not that much faster.

Mealtime Insulin Formulation | For HCPs | Lyumjev™ (insulin lispro-aabc)

Read about Lyumjev, a formulation of Humalog designed for fast absorption that begins to work quickly and helps to control blood glucose spikes after meals.

www.lyumjev.com

This was after a meeting they had with the rep that day she spoke to me. I turns out I'm their first patient on it. It has actually bought my post prandial spikes down by 3 mmol sometimes 4 which is a big improvement for me. I was having to prebolus half hour and still hitting massive spikes of 18!

 

[Inka]

You’re entitled to have insulins that suit you @gillrogers Put your foot down about the Semglee. I had to be very firm to get my insulin changed.

 

[gillrogers]

Thanks @Inka

 

[SB2015]

Interesting to read that you are finding the Lyumjev is effective in reducing the amount of time you need to pre bolus. I am still wavering over switching to that from Novorapid.

I wonder whether some of the nurses stick to the ’be back in target by before the next meal’ because before sensors being more readily available we were limited to the pre meal tests so had little idea what was going on in between meals.

It was using the Libre sensor that showed me the spikes that I was getting. I used this info to fine tune my timings of bolus injections, and also to identify some of the foods I was eating as being very spikey for me. I eliminated some problematic meals and as,o reduced my portion sizes. We now work to a target number of carbs per meal, which a,ing with timing of boluses helped me to get spikes a lot smaller (apart from most recently when offered Christmas cake, mince pies with that essential brandy butter, ….).

There are so many things that we are juggling each day and all we can do is do our best with the data that we have available. I certainly expect to be back in range again after four hours (when I can) and try not to snack between meals to avoid topping up the highs (apart from the chocolates, Christmas biscuits, … I am only human.) I hope that you get some joy in changing from Smeglee. We each need to find what works for us. Let us know how you get on.

 

[gillrogers]

Interesting to read that you are finding the Lyumjev is effective in reducing the amount of time you need to pre bolus. I am still wavering over switching to that from Novorapid.

I wonder whether some of the nurses stick to the ’be back in target by before the next meal’ because before sensors being more readily available we were limited to the pre meal tests so had little idea what was going on in between meals.

It was using the Libre sensor that showed me the spikes that I was getting. I used this info to fine tune my timings of bolus injections, and also to identify some of the foods I was eating as being very spikey for me. I eliminated some problematic meals and as,o reduced my portion sizes. We now work to a target number of carbs per meal, which a,ing with timing of boluses helped me to get spikes a lot smaller (apart from most recently when offered Christmas cake, mince pies with that essential brandy butter, ….).

There are so many things that we are juggling each day and all we can do is do our best with the data that we have available. I certainly expect to be back in range again after four hours (when I can) and try not to snack between meals to avoid topping up the highs (apart from the chocolates, Christmas biscuits, … I am only human.) I hope that you get some joy in changing from Smeglee. We each need to find what works for us. Let us know how you get on.

I don't snack in between meals, can't, although I have been told I can have a substantial snack with insulin as I'm hungry most of the time, but I don't as I'm not coming down to the green. I cannot for love nor money get low enough for long enough during the day unless I've been on a higher basal that has started to change and I find myself then going low very quickly before meals and dropping to far during a meal. Now I'm on 8 units for basal but in pretty sure during the day I'd be better off on 9 but definately not for the night. My meals are 5 to 6 hours apart so if it's taking that long to come back down then I'm sure I need that higher basal during the day and perhaps shave half a unit or even a whole unit off my bolus.