High dose insulin

[Amity Island]

Hi Everyone,

Just thought I'd ask this question because I don't know anything about it and was just curious.

When I was diagnosed with Type 1 25 years ago, my initial insulin doses, from what I can remember, the consultant based it on my weight and turned out to be typical for my weight from the charts used, it was then fine tuned from there.

I've noticed some diabetics require, in comparison to what I use, much bigger doses, particularly basal. Above and beyond what you'd work out based on weight.

A guy I know (type 2) for example was diagnosed 4 years ago. The nurse has had to keep upping his dose week after week, up to 50 units twice a day. The nurse said a few weeks back that increasing his dose has made absolutely no difference to getting blood sugars down. The nurse has said to start again at initial dose and try again from there. She said too much insulin can just disappear into the body.

Be it type 1 or type 2 what are the reasons for requiring large doses of insulin (above and beyond general range of doses)?

Thanks

 

[Robin]

I think that for insulin to be effective, the body has to be able to use it efficiently, or maybe just use it full stop. If you have a high degree of insulin resistance, the body just won’t use the insulin, leading to more and more futile increases in dosage,

 

[everydayupsanddowns]

Yes, I think it’s to do with insulin resistance, and also perhaps partly absorption. Plus the type of insulin itself - some people seem to need much more of some types than others.

 

[Pumper_Sue]

I noticed the higher the fat content of my diet the more insulin I require. Also activity is another factor.
The more active I am the less insulin I need. So perhaps lifestyle has a big factor in things as well.

 

[Ljc]

Could be all or any of the above . But I am wondering if he is on MDI or Basal and other T2 meds, I was for a time and it didn’t work for me.
Also as a T2 if he is getting the best help and advise from his nurse , quite a few of us don’t

 

[mikeyB]

My guess would be odds on insulin resistance. Adding Metformin might be an idea. I agree with Ljc, advice from a higher authority might be needed. It's perhaps outwith her experience and knowledge.

 

[DaveB]

Hi. Your friend will almost certainly be eating too many carbs and have high insulin resistance. The solution is not more insulin which the body can't use but weight reduction thru low-carbs. Many in the NHS don't seem to understand the connection between these things.

 

[Amity Island]

I think that for insulin to be effective, the body has to be able to use it efficiently, or maybe just use it full stop. If you have a high degree of insulin resistance, the body just won’t use the insulin, leading to more and more futile increases in dosage,

Robin,
That certainly makes sense. It doesn't matter how much insulin is given, if someone is highly insulin resistant, no amount of insulin will be used/absorbed.
Thanks.