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Type 1 with Insulin Resistance

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R

Ref

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Hi

My son (aged 29) was diagnosed as type 1 diabetic on the 5th anniversary of my total pancreatectomy - 26 September. He's doing ok, bit of a wobble when the honeymoon period ended but overall ok. The main problem he has is that if his BG goes above 9.5 then his insulin resistance goes through the roof. Below 9.5, 1 unit Novorapid drops him by around 3 mmol/l. Above 9.5, 1 unit drops him by around 0.2 mmol/l. He is managing by constant scanning which is obviously physically and mentally tiring.

Has anyone else experienced this and can suggest a way forward?

Thanks
Andy

PS - I hope you all had a good christmas and wish you all a happy, healthy New Year.
 
Hi. Even though my measured body fat and visceral fat is low, I also find my insulin needs go up fast if my BS rises. I don't know of any easy solution. If I know I'm going to have more carbs than usual during the day I will increase my Basal for the day and use a higher Bolus ratio with corrections as needed.
 
Exercise usually helps to improve the effectiveness of corrections for me. If I am just sitting at the computer my body seems to ignore the correction dose but if I get up and go for a brisk walk and get my lungs and muscles working a bit, it is much more effective, but I think many people find that their correction ratio gets much larger (ie they need much more insulin) as their BG gets higher.
As regards constant scanning being a physical and mental strain, it is infinitely better than having to finger prick and the extra information Libre provides is invaluable. That said I wonder if teaming it with something like miao miao might be helpful for your son. I am not familiar with the system myself but I believe/understand it is a second sensor which piggy backs onto the Libre but provides alarms for lows and possibly high levels. Hopefully someone else can explain it as I am not very tech savvy and personally very happy to scan as many times a day as necessary to keep my readings in range. @Paulbreen could you elaborate a bit on miao miao or correct me if I am totally off the mark?
 
Hi @Ref and Happy New Year to you too 🙂

I think needing more insulin for corrections when you’re high is normal. I find that too - it’s almost like the insulin ‘isn’t working’. For me, that happens around 12mmol but it depends on many factors.

I second @rebrascora ‘s advice about keeping active. If I’m high, I correct then try to keep moving. Even things like jogging on the spot, running up and down the stairs, tidying up, etc can help.

If your son is recently diagnosed then it’s likely things are still settling down anyway eg his basal needs and meal ratios. Does he have a half unit pen for boluses? Is he carb counting?
 
Yeah - we've had a brief chat about this on another thread very recently and it was something that was touched on during the carb counting and dose adjustment course I went on years ago. (over 10 years now) As to 'how much more?' - it's something that's personal to each one of us so we need to experiment - start low and work our way upwards until it's enough.
 
For me, time of day also has a bearing. If my BG is high and I spot it during the night, then I need less Insulin to bring it back down than I do during the day. This is the reverse of the comments from others about exercise helping as I am at my most passive when I am asleep. Equally, first thing when I get up I need more insulin to bring my BG back down but that is because I am also needing to offset the dawn effect which can be quite pronounced for me. Keeping good notes of food, exercise and insulin taken helps at the start until you get to know your own body's quirks.
 
Thanks everyone. I too have an increase at higher BG levels but given how slim he is I was surprised at a) how low his resistance kicks in and b) just how much extra he has to take.

He uses a libre and we've discussed the miao miao but he doesn't want to go down that route - he's happy just to scan regularly.

The other thing he has noticed is just how much an impact fat has on his BGs. He did a carb free day with the exception of a single bag of crisps, which had no impact for 4 hours. I have no pancreas and take creon and I manage to absorb carbs with fat quicker than that.
 
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