Post-Covid insulin needs

I’m recovering from my first bout of Covid and have noticed my insulin needs have changed drastically.

Normally, I’d need 3-5 units for breakfast, 4-5 for lunch, and 4-5 for dinner. I’d keep most of the day in range (70-180) with a few momentary peaks above and below range. My basal rate was great and came to about 5u a day. My last Hba1c was 5.6% (just before switching to a pump) so I was doing something right.

Now, I wake up and have to immediately set an extended bolus for 6u over an hour. I repeat this until my blood sugar has come down to 100 which can take 2.5 hours. If I eat breakfast within that first hour (about 20-30g carbs), my blood sugar skyrockets to 200-250 and takes even more insulin to bring down. If I wait to eat until it’s 100, I go a little low, need to treat with about 20g carbs, then bounce around 80-100.

The morning extended boluses usually put about 15u in my system. Even though my pump says I have no IOB by lunch, I don’t need to bolus for lunch. Same for dinner, although I can slowly creep up to 150 by the time I go to bed if I don’t correct. But 150 is still a lot lower than I’d expect with no IOB.

My daily usage has gone from 24 units/day to 38 units/day.

The insulin seems to be taking a lot longer to start working.

Is this a common post-Covid blood sugar issue? How long has it lasted for others?

I’ve got an endo appointment next week and I’ll definitely be bringing this up, just wanted to see if I wasn’t alone.

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Just like everything else with diabetes, it varies. My own experience with Covid vaccination and infection is that I became very insulin resistant. Vaccination resistance lasted 5-7 days. Actually infection was worse both when positive and for 2-3 weeks after testing negative.

I feel lucky that I had no long term damage from Covid. I did have a short period of exercise induced shortness of breath.

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Thanks. I’m sure everyone’s experience is different, but it’s good to know that I’m not alone.

Insulin seems to take sooooo long to start working. And I feel extremely hungry most of the time (that’s unusual for me, so I’m guessing it’s a Covid thing).

This is my first illness since diagnosis, and it’s been a learning curve. The hardest day was peak symptoms where I needed to change my infusion set and my Dexcom. Neither of which is hard or time-consuming, but when combined with an illness are really annoyed ngm luckily, I’ve got a helpful partner and they were recovering as my symptoms were peaking. Oh, and to add to the annoyance, that site only lasted one day as I hadn’t grasped my increased insulin needs by then.

Today has been 100% under 180, so I’m pretty pleased I’ve spotted some patterns and found tactics that help.

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Humalog and Novolog have a duration of insulin action around 6 hours. It’s common to set much shorter times in a pump to get more aggressive dosing behavior, so “the pump says 0 iob” has to be taken with a grain of salt. From your description, I’d guess the last insulin from those multiple extended boluses was still active at lunchtime.

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Good point. I usually end my final extended bolus around 1pm so still active by lunchtime and maybe still active enough by 7pm when I have dinner.

It does seem like the insulin might be working a bit slower than usual. The amount of insulin I’m doing on those morning extended boluses would have been way too much pre-Covid. Now, they seem to do nothing until hours later.

Hopefully everything gets back to normal in the next few weeks.

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Wow. Didn’t even consider my change in insulin requirements were secondary to Covid. I am an RN and never got Covid during the epidemic. In March went on vacation and got a pretty intense case of covid. Still dealing with lung problems. I have been dealing with dawn phenomenal which I never had before. Your post made me consider the covid/diabetes connection. I am on MDI and was even considering going back to a pump which i have been happy without being tethered to a device with tubing. See my Endo next week. Will definitely ask.

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