Insulin resistance

[Kirsssty]

Hey all, I'm new here I wondered does anyone suffer insulin resistance? I'm type 1 on Fiasp and this morning I had a stressful situation which my levels rose to 18.0 and I have been struggling to get them below 14? I have taken so much insulin and nothing really changes. I'm not stressed now but they still seem to not want to come down. Is this normal?

 

[Kirsssty]

Hey all, I'm new here I wondered does anyone suffer insulin resistance? I'm type 1 on Fiasp and this morning I had a stressful situation which my levels rose to 18.0 and I have been struggling to get them below 14? I have taken so much insulin and nothing really changes. I'm not stressed now but they still seem to not want to come down. Is this normal?

I usually take 1 unit to correct and I have taken about 8 units since this morning. They won't drop below 14!

 

[Lucyr]

High blood sugars make you more insulin resistant. Are you checking blood sugar with a fingerprick meter?

 

[Robin]

I usually take 1 unit to correct and I have taken about 8 units since this morning. They won't drop below 14!

I’m tagging @rebrascora as she takes Fiasp, and I think she has problems with it not seeming to work as well when her blood glucose is high. I’m sure there’s someone else, but I can’t think who at the moment.
Ah, brainwave, @helli , although I think her problem is the speed at which it works is slower, the higher her starting blood glucose is.

 

[Inka]

Google “Fiasp like water” @Kirsssty Fiasp can struggle with high blood sugar and make it seem like you’re injecting water.

If this is a one-off - ie you’re not usually insulin resistant - you’ll just have to roll with it, but if you do have insulin resistance all the time, there might be meds that can help and/or things you can do to help.

 

[Kirsssty]

I’m tagging @rebrascora as she takes Fiasp, and I think she has problems with it not seeming to work as well when her blood glucose is high. I’m sure there’s someone else, but I can’t think who at the moment.
Ah, brainwave, @helli , although I think her problem is the speed at which it works is slower, the higher her starting blood glucose is.

It seems as soon as my levels go above 10 it doesn't want to work, it takes hours sometimes for them to come down. Wondered if this was a common thing with Fiasp and if there's any solutions thank you for your response too ❤️

 

[Leadinglights]

It seems as soon as my levels go above 10 it doesn't want to work, it takes hours sometimes for them to come down. Wondered if this was a common thing with Fiasp and if there's any solutions thank you for your response too ❤️

I assume you are also taking a basal insulin which one would that be as that may influence what is going on.

 

[Inka]

It seems as soon as my levels go above 10 it doesn't want to work, it takes hours sometimes for them to come down. Wondered if this was a common thing with Fiasp and if there's any solutions thank you for your response too ❤️

One solution is to change insulins or have an additional fast insulin, eg Humalog, that can cope with high sugars.

 

[nonethewiser]

It seems as soon as my levels go above 10 it doesn't want to work, it takes hours sometimes for them to come down. Wondered if this was a common thing with Fiasp and if there's any solutions thank you for your response too ❤️

Did same happen on previous bolus insulin or is fiasp your first one?

I'm fiasp user of 3 years now & tbh it's works as fast at reducing high bg levels as did novorapid I'd used previously, but don't have same experience as yourself as my bg will eventually come down in a hour or two, if this continues for you ask for a change of insulin as that would be your best bet.

 

[rebrascora]

Sorry to reply to this post so late but I have been out all day.

I find exactly the same as you in that once my levels get above 10 my Fiasp which is ordinarily brilliant, turns to water and sometimes I have to stack several corrections sometimes even just half an our apart to get it down. I have learned to be very heavy handed with it in order to get a result. On odd occasions I have had to inject 20 units or more in small stacked doses to get it down from mid teens. I tend to be very proactive in keeping it below 10 as much as I absolutely can and will often inject corrections at 8 if they are rising when they shouldn't be. Fiasp is great below 8 for me, a bit wishy washy between 8 and 10 but will work if I give it time, usually hours. Above 10, I need stacked corrections which I know are frowned upon but I always keep a very close eye on my levels if I do this and jelly babies at the ready in case I start dropping quickly.... which almost never happens even will silly amounts of stacked corrections. I have documented a couple of occasions here on the forum. It is scary how ineffective it becomes for me. I believe @helli finds corrections above 10 work eventually but can take hours. For me, it just doesn't want to know and I could wait all day and night and one or even 2 stacked corrections don't have any impact at all. I am guessing it is something to do with body chemistry as to why it acts differently with different people because as @nonethewiser says, it works fine for him. I am pretty sure that Novo Rapid was better at high levels but very slow to work even at normal levels and I used to have to wait 75 mins prebolus time at breakfast to prevent spiking, so there are daily benefits to Fiasp and I personally would not go back to NR now, but you do have to be prepared to up the doses for corrections once above 10 and in my case, stack them.

I think it is quite comforting to know that others have similar experiences as well as knowing that other's like @nonethewiser don't, so thanks for posting. It can be quite scary when you have jabbed increasing amounts of insulin and nothing is working. I find it much more scary than hypos because I always respond to carbs very quickly, plus it isn't all that unpleasant eating a jelly baby or two (unless they are green ones 🙄 ) but when you have jabbed 4 corrections amounting to more than 10 units and you are still stuck on 14 after 4 hours you start to get a bit concerned that something has gone horribly wrong and even more so when you get to 8 hours and 20 units and still not budged. My basal is Levemir so I sometimes increase my next dose of that to deal with it but if you have a longer acting basal that isn't always a good idea. I absolutely love my Levemir as it is totally trusty as well as wonderfully flexible but Fiasp can be fickle.

 

[everydayupsanddowns]

I tried Fiasp for a few months.It started OK, with rapid action, and looked pretty promising. After a few weeks my doses ticked upwards, but I’d seen blogs from early adopters who had experienced the same. After a month or so, the speed of action kinda evaporated, and the doses were climbing higher… By the end of the second of the three vials I’d had doses were behaving more erratically, and I was getting soreness around my infusion sites.

I saw out the last vial and switched back to Novo(not very)Rapid, at which point my doses became much more reliable again.

It works well for lots of folks here, but there are a few that it just doesn’t seem to work well for - and I’m one of those 🙂

 

[Lucyr]

Fiasp is great below 8 for me, a bit wishy washy between 8 and 10 but will work if I give it time, usually hours. Above 10, I need stacked corrections

I don’t want to be critical but, why do you stick with an insulin than works like this? Why not change to a more reliable one that’s a bit quicker than novorapid, but still works at high bgs, like apidra?

 

[rebrascora]

I have never tried Apidra but there is no guarantee that it will work quicker than NR for me as FIasp isn't a lot quicker that NR. If I can keep between 4 and 7 it works great and most of the time I can do that and I have developed a good routine with it that works for me the vast majority of the time, so the odd occasion when things go haywire is acceptable now that I am learning how to cope with it. Also changing would be a big upheaval (I would have to unlearn all the strategies I currently employ with Fiasp and learn new ones) and I don't really want to go through that disruption again. I spoke to my consultant about trying other faster acting insulins, like Lyumjev a year after moving onto Fiasp but he felt I would have the same difficulties and it is probably just how my body responds which was what I also suspected, but there is no way of knowing without trying and having spent 4 years learning how to make Fiasp work, I don't want to change.
I really have no knowledge of Apidra at all. I also really like what is for me. a very short action time with Fiasp in that it is gone in 3 hours (for me) sometimes even less, with no nasty surprises as some people experience with the likes of Humalog, which I understand can have a sting in the tail at 5 hours. Basically, the benefits of Fiasp outweigh these odd occasions when it appears not to work at all.

 

[helli]

I don’t want to be critical but, why do you stick with an insulin than works like this? Why not change to a more reliable one that’s a bit quicker than novorapid, but still works at high bgs, like apidra?

My experience with Fiasp is the same as @rebrascora.
It was frustrating at first but now I know how it works for me, it just motivates me more to stay in single figures.
I have NovoRapid as my pump back up so always have the option to revert if I need.
The advantage of working faster in single figures far out ways the annoyance when higher as I spend over 90% of my time in single figures.

I mastered Fiasp before Lyumejev was released so never felt the need to try it.
For me Humalog made NovoRapid seem like NovoSuperSpeedy so was definitely not worth bothering with.

 

[Jasmin2000]

Hey all, I'm new here I wondered does anyone suffer insulin resistance? I'm type 1 on Fiasp and this morning I had a stressful situation which my levels rose to 18.0 and I have been struggling to get them below 14? I have taken so much insulin and nothing really changes. I'm not stressed now but they still seem to not want to come down. Is this normal?

I think these are counter-regulatory responses (induced by stress, periods of low BG and other triggers). These spikes are different to carb spikes, as the responsible hormones (glucagon, epinephrine, cortisol, etc) seem to induce a period of insulin resistance - I guess that's the point of it. I get them on Apidra - no response to 8-10 units and after about 4 hours it trickles down.

Then I solved it (at least for me) - exercise bike! When I see them coming (a sudden jump despite no carbs) I take 2 units and burn 200-300 kcal and that's all I need to stop the climb. If I start later it's going to need more exercise.

BEWARE - if you try this don't inject the huge amounts you did before, because the resistance will disappear quickly when you exercise and the insulin will drive you into a hypo. What fun

 

[rebrascora]

I don’t want to be critical but, why do you stick with an insulin than works like this? Why not change to a more reliable one that’s a bit quicker than novorapid, but still works at high bgs, like apidra?

Like @helli I average 90+%TIR and usually no more than 5% above 10mmols, so I have learned how to make it work for me, but it is important for each person to figure that out for themselves and sharing these experiences helps.

I would also add that the Novopen Echo has to feature as a significant reason for sticking with a Novo Nordisk insulin in it's own right. They really are great pens and few others offer a half unit option let alone the memory function and Libre scan option, not that I personally use the latter, but many people do.

 

[rebrascora]

I think these are counter-regulatory responses (induced by stress, periods of low BG and other triggers). These spikes are different to carb spikes, as the responsible hormones (glucagon, epinephrine, cortisol, etc) seem to induce a period of insulin resistance - I guess that's the point of it. I get them on Apidra - no response to 8-10 units and after about 4 hours it trickles down.

Then I solved it (at least for me) - exercise bike! When I see them coming (a sudden jump despite no carbs) I take 2 units and burn 200-300 kcal and that's all I need to stop the climb. If I start later it's going to need more exercise.

BEWARE - if you try this don't inject the huge amounts you did before, because the resistance will disappear quickly when you exercise and the insulin will drive you into a hypo. What fun

Yes, I meant to add that exercise can be a real help although I personally don't like to exercise when my levels are mid teens or above as it seems to put my body under strain and then I can end up going higher, so I need to catch it at 10 or 11 for that option. A moderate paced walk is OK if mid teens but I need well over an hour and of course exercise is not always an option. I hit 17 once in the cinema due to the suspense generated by the film. I had a car journey home afterwards so no opportunity to exercise in that situation for several hours.

 

[Jasmin2000]

Yes, I meant to add that exercise can be a real help although I personally don't like to exercise when my levels are mid teens or above as it seems to put my body under strain and then I can end up going higher, so I need to catch it at 10 or 11 for that option. A moderate paced walk is OK if mid teens but I need well over an hour and of course exercise is not always an option. I hit 17 once in the cinema due to the suspense generated by the film. I had a car journey home afterwards so no opportunity to exercise in that situation for several hours.

Sorry to lol but that cinema story is hilarious - what does a diabetic do when faced with a scary film, bring your own treadmill? I demand that NICE look into this.

Indeed exercise will drive up BG from a standing start but with a 1.5 mile walk or half an hour on the exercise bike I find I can get 10 down to 6. Never been as high as 17 but with an insulin + exercise combo I'm sure it can be done.

I once sprinted 500 kcal in 20 mins after a stress high and - nada. Similarly 8-10 units Apidra and no change. But 3 units + 300 kcal and I'm looking at the BG drop fast and reaching for a banana. Exercise really kills those stress hormones and makes insulin work again.

 

[Inka]

I find increasing basal helps highs from stress. I have a pump so it’s a bit different, but I find a temporary basal increase can push it down.

I go high in cinemas too @rebrascora but I blame the sugary fumes from the buckets of caramel popcorn being eaten all around me

 

[Tdm]

Sorry to lol but that cinema story is hilarious - what does a diabetic do when faced with a scary film, bring your own treadmill? I demand that NICE look into this

A reasonable adjustment