Insulin resistant

[everydayupsanddowns]

They have no idea why I'm so insulin resistant and that's why they don't know what to do with me anymore

I wonder if Diabetes U.K. have any information or contacts about extreme insulin resistance? @everydayupsanddowns might know.

It’s saddening to hear you say that it feels like your Drs have given up on you

I will ask if there are any breaking research projects about significant insulin resistance at normal weight.

In the meantime, this general page does say that while resistance is more common with overweight or obesity (and visceral fat around organs) it can happen in normal weight individuals too.

Insulin resistance

What is insulin resistance? Insulin resistance is when your body’s cells don’t respond properly to the insulin that your body makes or the insulin you inject as a medication. Because your body cannot use the insulin as it should your blood sugar levels can increase.

www.diabetes.org.uk

I also remembered the reTUNE study, which looks at people with T2 who are normal weight, who are also able to tackle insulin resistance through weight loss (even though they are not overweight/obese)

ReTUNE study shows type 2 remission possible for people with lower body weight

While we know that obesity increases the risk of developing type 2 diabetes, 10% of people with type 2 diabetes have a BMI that is not in the obesity or overweight category.

www.diabetes.org.uk

I also half-remembered @trophywench recalling a conversation with a DSN when insulin doses were spiralling upwards who recommended reducing doses, even though it was counter-intuitive. And it worked! I’m sure TW will correct me if I have misremembered.

 

[debinfrance]

So sorry to hear of your struggles. I didn’t know what MODY was so I just read an article about it and thought I’d post a link for anyone else who doesn’t know ( I hope that’s okay). It definitely seems worth finding out what type you have as it seems to be quite rare which may explain some of the difficulty you’re having with getting the right treatment regime. https://www.medicalnewstoday.com/articles/mody-diabetes

 

[Laura0194]

Thank you i appreciate that

 

[Laura0194]

It’s saddening to hear you say that it feels like your Drs have given up on you

I will ask if there are any breaking research projects about significant insulin resistance at normal weight.

In the meantime, this general page does say that while resistance is more common with overweight or obesity (and visceral fat around organs) it can happen in normal weight individuals too.

Insulin resistance

What is insulin resistance? Insulin resistance is when your body’s cells don’t respond properly to the insulin that your body makes or the insulin you inject as a medication. Because your body cannot use the insulin as it should your blood sugar levels can increase.

www.diabetes.org.uk

I also remembered the reTUNE study, which looks at people with T2 who are normal weight, who are also able to tackle insulin resistance through weight loss (even though they are not overweight/obese)

ReTUNE study shows type 2 remission possible for people with lower body weight

While we know that obesity increases the risk of developing type 2 diabetes, 10% of people with type 2 diabetes have a BMI that is not in the obesity or overweight category.

www.diabetes.org.uk

I also half-remembered @trophywench recalling a conversation with a DSN when insulin doses were spiralling upwards who recommended reducing doses, even though it was counter-intuitive. And it worked! I’m sure TW will correct me if I have misremembered.

Thank you for the links I'm not obesed my weight is just fine I've been told that and my BMI is good to

 

[Leadinglights]

I wonder if this description fits you and you could ask for the OGTT to clarify your extreme insulin resistance.

Although most doctors are aware of insulin resistance as a feature of diabetes (which means high blood glucose levels), many people with severe insulin resistance experience significant problems with hypoglycaemia, (or low blood glucose), particularly before diabetes develops, and often this can be unrecognised or attributed to faints or even epilepsy. Most commonly hypoglycaemia may occur around two hours or more after eating. Early symptoms as blood glucose falls include sweatiness, a feeling of hunger, palpitation, or light-headedness. When it becomes more severe it may lead to drowsiness or blackouts. A characteristic feature is that these symptoms resolve quickly after eating sugary food or having a sweet drink. A prolonged oral glucose tolerance test (OGTT) with measurement of insulin will provide a strong clue to this diagnosis and will also permit diagnosis of severe insulin resistance.

 

[Laura0194]

I do suffer with high blood pressure but it's been stable for a while now I also have high cholesterol levels, non alcoholic fatty liver disease and I have conanary artery spasms in my chest if any of this helps could they be related to the insulin resistance

 

[Amity Island]

I do suffer with high blood pressure but it's been stable for a while now I also have high cholesterol levels, non alcoholic fatty liver disease and I have conanary artery spasms in my chest if any of this helps could they be related to the insulin resistance

Hi,

Could you explain how you got upto 600 units a day? How much were you put on in the first instance and what difference did it make going from say 570 units to say 600 units as an example.

 

[Laura0194]

Hi,

Could you explain how you got upto 600 units a day? How much were you put on in the first instance and what difference did it make going from say 570 units to say 600 units as an example.

I was on 6 units when I first started but then they just kept putting it up and up because it wasn't doing anything then they put me on the toujeo morning and night injections then the ozempic too having all three of them didn't make no difference I had to come of the ozempic but was making me sick so they just kept upping all my doses didn't make a difference at all as soon as I hate breakfast in the morning they stayed HIGH all day

 

[Inka]

Yes, it does sound like food is the major problem. Obviously you need to eat! Have you tried skipping breakfast one day just to see what happens? Have you tried eating a very low carb breakfast, eg a couple of eggs plus some mushrooms or tomatoes?

 

[Amity Island]

I was on 6 units when I first started but then they just kept putting it up and up because it wasn't doing anything then they put me on the toujeo morning and night injections then the ozempic too having all three of them didn't make no difference I had to come of the ozempic but was making me sick so they just kept upping all my doses didn't make a difference at all as soon as I hate breakfast in the morning they stayed HIGH all day

Hi,

Did you notice any difference in blood sugars as they kept increasing the insulin dose?

 

[Laura0194]

Yes, it does sound like food is the major problem. Obviously you need to eat! Have you tried skipping breakfast one day just to see what happens? Have you tried eating a very low carb breakfast, eg a couple of eggs plus some mushrooms or tomatoes?

Sometimes I do like skipped breakfast doesn't seem to make a difference and yeah I did a carb counting diet so I only had so many carbs with each meal and again nothing worked

 

[Laura0194]

Hi,

Did you notice any difference in blood sugars as they kept increasing the insulin dose?

Nope they just stayed the same and HIGH didn't make no difference and I was on a lot of insulin also didn't work

 

[Amity Island]

Nope they just stayed the same and HIGH didn't make no difference and I was on a lot of insulin also didn't work

It seems evident that they plan to keep upping the insulin. Did they say what this plan to keep increasing the insulin is based on? Do they have something in mind, some evidence?

I have never known of these levels of insulin doses (in type 1 or type 2), but I did out of interest find this article about, "how high can you go with insulin dose". Apparently the sky is the limit, with one mention of 35,000 units a day.

Insulin Dosing: How High Can You Go?

What is the highest dose of insulin that can be used in a patient whose diabetes remains uncontrolled on a regimen of insulin plus an oral antidiabetic agent?

www.patientcareonline.com

 

[Inka]

Sometimes I do like skipped breakfast doesn't seem to make a difference and yeah I did a carb counting diet so I only had so many carbs with each meal and again nothing worked

How few carbs did you eat for each meal?

 

[Inka]

It seems evident that they plan to keep upping the insulin. Did they say what this plan to keep increasing the insulin is based on? Do they have something in mind, some evidence?

I have never known of these levels of insulin doses (in type 1 or type 2), but I did out of interest find this article about, "how high can you go with insulin dose". Apparently the sky is the limit, with one mention of 35,000 units a day.

Insulin Dosing: How High Can You Go?

What is the highest dose of insulin that can be used in a patient whose diabetes remains uncontrolled on a regimen of insulin plus an oral antidiabetic agent?

www.patientcareonline.com

That talks about lowering the dose too, which interesting. They must have used concentrated insulin for that massive dose.

 

[Laura0194]

How few carbs did you eat for each meal?

I have 20/30 for breakfast if I have lunch which is very ware it would be like between 30/40 and dinner is about 50

 

[Inka]

Ok, so you do have room to cut the carbs further. Breakfast is when most people are usually the most insulin resistant, so I’d go for minimal carbs for that meal, eg eggs and tomato or mushroom, or Greek yoghurt and a few blueberries. If you do have lunch, you could go for 15 or 20g carbs to start with, and your evening meal could be say 25g carbs.

I know you’re not eating a lot of carbs now but with your particular difficulties, reducing them more might help. If it were me, this is something I’d try over a period of weeks and months, eg so many weeks at the carb levels I suggested above, then look to see where further reductions could be made if needed.

I know you said you weren’t overweight but maybe reducing your BMI will help a bit too. Here’s a BMI calculator so you can see what your BMI is now:

Calculate your body mass index (BMI) for adults - NHS

Check your BMI to find out if you're a healthy weight for your height, and get advice on what to do next. This BMI calculator is for people over 18 years old.

www.nhs.uk

.

 

[Amity Island]

I have 20/30 for breakfast if I have lunch which is very ware it would be like between 30/40 and dinner is about 50

Hi @Laura0194

Ok, so we (diabetics) know that 10g of carbs can raise blood sugar by 3mmol. So 30g of carb will have the ability to raise blood sugar by 9mmol and 50g of carbs would have the potential to raise blood sugar by 15mmol.

If insulin is not working, through the day these blood sugar raises could accumulate/stack on to each other. For one day a total carbs of 120g would have the max potential to raise blood sugar by 36mmol.

With this in mind, I think @Inka suggestion to reduce carbs could be a big help to you, certainly worth a try.

 

[Laura0194]

Hi @Laura0194

Ok, so we (diabetics) know that 10g of carbs can raise blood sugar by 3mmol. So 30g of carb will have the ability to raise blood sugar by 9mmol and 50g of carbs would have the potential to raise blood sugar by 15mmol.

If insulin is not working, through the day these blood sugar raises could accumulate/stack on to each other. For one day a total carbs of 120g would have the max potential to raise blood sugar by 36mmol.

With this in mind, I think @Inka suggestion to reduce carbs could be a big help to you, certainly worth a try.

To be honest when I've been doing it on my pump I'm actually having less carbs then I thought

 

[Laura0194]

Hi @Laura0194

Ok, so we (diabetics) know that 10g of carbs can raise blood sugar by 3mmol. So 30g of carb will have the ability to raise blood sugar by 9mmol and 50g of carbs would have the potential to raise blood sugar by 15mmol.

If insulin is not working, through the day these blood sugar raises could accumulate/stack on to each other. For one day a total carbs of 120g would have the max potential to raise blood sugar by 36mmol.

With this in mind, I think @Inka suggestion to reduce carbs could be a big help to you, certainly worth a try.

To be honest I'm actually having less carbs then I thought, and I don't really eat lunch anyway either because of my levels being so high and I did a carb counting diet for months and nothing made a difference in weighted all my food out and still didn't make a difference