I just can’t believe how much insulin I have been using this last year. My C/I has gone from about 2.5 to .66.
This was yesterday. Red line is low (70), blue line is target (100), yellow line is high (140). The track is pretty good, but look at the insulin usage and C/I. S.D. is ok at 14.2. Looks good but it took 137 units of novolog, (and 72 units of Toujeo) to cover just 110g carbs! This is what my average day has been looking like lately.
Afrezza sounded like something that might help, but I can’t take it because of moderate asthma. But if I inject much more insulin I feel like I’m going to pop!
Doc, this is a really good-looking track!
But I must say the amount of insulin you take is shocking to me. Is your endo working as hard as he/she should on your insulin resistance? This increase in your C/I is concerning.
I know you have discussed several drugs to treat insulin resistance in the past. I am wondering if your endo has been as attentive to this aspect as he should.
@Michel As I’ve mentioned before my doc replaced the metformin I was taking with an SGLT2 drug, Jardiance. It really cut down my upper limit (now at about 220-230 from 300+), but the switch was about the time my TDD started to go up.
I am definitely going to talk to my endo about going back on metformin in addition to Jardiance.
Either that or it’s U500 here I come
I’m not usually big on polypharmacy, but you seem a likely candidate for not only double – but perhaps even triple therapy.
Have you tried T3?
I honestly don’t wish to push my diet, but have you considered cutting carbs further – even temporarily – to regain some insulin sensitivity?
Edit to add:
Have you considered genetic testing?
Any chance that you have inflammation or a disease process/condition?
@britt_j I would definitely go for the double therapy of metformin and SGLT2 inhibitor, but the DPP-4 inhibitor wouldn’t really do anything as I’m T1.
I think I’m stressing over this more than my endo. When I first brought to his attention that I was taking 100 units of novolog per day, he told me to just take as much insulin as I needed to maintain tight control and not worry about the number of units it was.
As far as a keto or Bernstein diet is concerned, that may be a bridge too far for me. I’m pretty much at a low carb diet and that’s hard enough for a bread lover
Just saw your edit: I’m pretty familiar with where all this comes from. My maternal grandfather had T1 as a young adult and died because of a lack of insulin commercially available. The rest of my maternal side all had T2, and my paternal grandfather had T2. I’ve actually been expecting this insulin resistance to kick in, but it just came on like a lion!
I’m otherwise quite healthy, no complications after 46 years, labs are consistently within normal range.
I’m really not complaining about taking so much insulin, I’m just amazed.
A diabetic my wife and I ran into at her last job, sounds a lot like you. It was amazing how much insulin he was taking, i.e. 100 units of basal twice a day, plus over 100 units of fast acting insulin. These numbers are shocking coming from a perspective of an adolescent T1 with little to no resistance.
That said, I hope the drug combo’s work for you. Heart failure patients improve their ability to move large amounts of fluid via their lymph system, so I bet your subcutaneous fluid movement is world class.
I had a previous patient a few years ago who was taking U500, and he was taking over 100 units of it daily. He was in terrible physical condition, but his insulin resistance was epic.
I never want to end up like that.
I know this is a super old post, but I’m wondering how things are going, Doc? Have you found a regimen that helps with your IS?
Disclaimer: I know everyone is different and my opinions should carry very little weight.
But, if it’s helpful at all, I usually like to primarily focus on proteins and veggies and have found eating within every 2.5 hours to be helpful because empty stomach has required much more insulin than the grazing approach. Getting to bed early has made a world of difference too. Hope that things go evenly and smooth out.