Type 1 and insulin resistance

[Rachel_1989]

Is anybody type 1 on insulin but have to take metformin too for insulin resistance?

im currently taking just under 100units of levemir 😱 with my novorapid too(i carb count so novorapid doses are different everyday). so my dr and dsn are concerned that im still high with this much insulin and hardly hypo at all. so they have started me on metformin last friday.

just wondering how long did the metformin take to work for you? ive luckily never had any side effects up to now either 😉

 

[Northerner]

Hi Rachel, you're not alone in needing a large amount of insulin, and also metformin - in fact I was talking to someone just the other day who was in a similar situation. It may be that your insulin requirements will decline in time, and hopefully the metformin will give you some additional help. I'm not on metformin, but as I understand it, it can take a week or two before it starts having a noticeable effect. You're very lucky that you aren't suffering the side effects most common to metformin!

It can be so much harder to gain good control when your requirements are very high or very low - those with tiny requirements are the opposite, they are prone to many hypos because just a small adjustment makes a big difference. With you, it is difficult to estimate just how big an adjustment you might need to make to have the desired effect.

Insulin reuqirements on pumps are generally smaller, so this might help if you are offered a pump. Do your ratios change throughout the day?

 

[margie]

Rachel, don't worry. At the clinic I attend I was told it was common practice to start people on metformin after about a year on insulin, as they believed you became resistant to the insulin you inject.

I wasn't even on particularly high levels when I was prescribed it, my basal is about a quarter of yours. Anyway since I was ill earlier this year I have not taken any metformin and my levels have improved. I think this was because I had a dodgy fridge more than anything else which was causing the insulin to degrade before I used it.

One thing to know though is you are ill and start to produce ketones you should stop the metformin and increase your insulin. This is because there is a risk of lactic acidosis with metformin which if you are producing ketones is likely to be more likely to happen - and you don't want to risk lactic acidosis and keto acidosis at the same time. This was the advice from a Dr at the diabetic clinic though many a Dr had not bothered to mention it,

 

[numbnuts]

seems alot but what you need is what you need

 

[Northerner]

...One thing to know though is you are ill and start to produce ketones you should stop the metformin and increase your insulin. This is because there is a risk of lactic acidosis with metformin which if you are producing ketones is likely to be more likely to happen - and you don't want to risk lactic acidosis and keto acidosis at the same time. This was the advice from a Dr at the diabetic clinic though many a Dr had not bothered to mention it,

A very good point margie, thank you 🙂

 

[Marc]

I have been on Meformin since I change from Human mixtard when I was on 160 units a day to Apidra and Lantus. As I said on a previous thread I started on 60 units of lantus and 60 units of apidra. Just gone down to 28 units of lantus and carb counting for apidra with about 1.5 units per 10 grams of carbs. per meal so give or take about 45 units per day.

Marc

 

[Rachel_1989]

Thanks for all your replies and ill keep the ketone thing in mind. my dsn never told me that and i wouldnt of thought to stop taking it =/

xx