I am searching for a quick answer. Has anyone ever experienced a sudden insulin resistance for any reason?
I am T-1 for about 30 years. Well adjusted, according to dexcom, in the 5.9 GMI range for the last 90 and for the last 14 days in TiR 86% for a setting of 70-150 mg/dl. As of last night after a very light dinner and what I thought was a very normal bolus shot, I started to climb at around 1am steadily to 184 in the morning. First I suspected the Omnipod being defective without giving me any warning, obviously double checking results over and over. I started to counter act with direct bolus shots, from a kwikpen, changed pods with insulin from a new ampule. The climb continues up until now to 283. I usually do about 20-25 bolus units with food. I am up to 80 units by now without food trying to counter the rise. The pod units are unchanged. Checking obviously constantly now with 3 different meters.
Any one with an idea?
no meds, feeling fine as usual, no stress, no changes at all, not feeling sick at all. I am totally baffled, I just have zero explanation for this. I usually can tell pretty accurately of what my levels are, and my âfeelingâ coincides with 2 different meters and the dexcom (+/- 10). Wrong readings are probably safely eliminated with that.
Little nervous now with that bolus insulin in larger than usual amounts in my body since 6am. Even though humalog should not be active for more than 4 hours, I donât want to top of on an already large amount in the last 9 hours.
I switched the ampule and a pod in case of malfunctioning. And will use a new KwikPen for bolus in 3-4 hours.Just in case I had the bad luck of 2 different sources of insulin being bad. If that does not show any difference, I have to come up with Plan C since 4 sources of bad insulin are very unlikely.
Found something. A little far-fetched but we had a very nice summer-like weekend and it could be a delayed âhypertonic dehydrationâ. I thought I did drink my regular share of water but we were out a bit more then usual. I never knew that dehydration could have such adverse effects like adrenaline and other hormones.
[Causes of insulin resistance in type 1 diabetes].
[Article in German]
Abstract
Insulin resistance is a well-known phenomenon in diabetic patients. Its occurrence in Type 1 (insulin-dependent) diabetes is thought to be due both to metabolic and immunological disturbances. In this context, a key role is attributed to the augmented release of the âdiabetogenicâ hormones, adrenaline, glucagon, cortisol and growth hormone, as well as to hypertonic dehydration and to the presence of insulin-binding antibodies. In this connection it is noteworthy that among the âdiabetogenicâ hormones adrenaline exerts the strongest insulin-antagonistic effect and that hypertonic dehydration is associated with impairment of insulin action and of non-insulin-dependent hepatic glucose uptake (in vitro), while hypotonic rehydration reduces the elevated hepatic glucose production in dehydrated Type 1 diabetic patients. By contrast, the generally only slightly elevated serum insulin-binding capacity in insulin-treated diabetics is probably of least importance in the development of insulin resistance, unless excessively high insulin antibody titres prevail.
EH has had a similar issue lately. I didnât connect it with the weather. I just gave up trying to figure it out. Stubborn high for a few days, used 2x as much insulin as normal and it didnât bring it down. Not sick. Not overly stressed. No idea.
I would suggest more water (which is now always my suggestion - low or high!) and consider some brisk exercise if possible. Sweeping and vacuuming seem to make EH go low.
Also, he gets canker sores (these are not the same as cold sores, not at all related to oral herpes). Those always jack up his BG and cause stubborn highs. Do you get those?
I think youâre on to something with the dehydration though. I hope it resolved soon!
@john, for us insulin resistance increases a lot with upcoming sickness such a a cold
My sonâs basal need typically go up 20-30% a day or two ahead of a cold, then a lot more during sickness (+100% is not uncommon). As MM2 mentioned, stress will also increase our insulin resistance, for instance the week of finals or a large paper due soon.
A few month ago, while traveling, we also saw high insulin resistance from dehydration for over 2 days. We had to drink a ton of water to be rid of it, and worked on it hard afterwards.
Another source, for us, is having an intense run, or some other forms of sport: we can go to 300 after a run if we donât treat the sport activity just so.
Let us know what you find!
Btw, for us, we tend to wait about 2 hours before stacking insulin.then, when we stack, for dosing we assume that some insulin is still present from the previous injection.
I would imagine fighting off the start of Lyme disease could cause insulin resistance, so itâs just a good idea to make sure that the most common transmitter of it (little tick buggers) arenât hanging on to you anywhere
My son got a flu a few weeks ago. He usually uses 10 units of insulin. He used 25 units a day for several days. BUT the interesting thing is that the insulin resistance preceded the onset of noticeable illness by a few days. The day he puked was the day his insulin usage started to come down.
So insulin resistance can definitely be caused by illness, and not necessarily when you seem to be sickest.
Have you gained weight? Your mealtime doses sound to me like significant insulin resistance. I gained about 15 pounds but over a period of two years so I didnât really think it could be an influence. But I have had significant rise in BG in the last few weeks and have been slowly raising my I:C ratio, basals and ISF to get it in control.
For me, more significantly, I am working on lowering my carbs and working on losing the weight because as I Type 1, I need IR like I need a hole in the head. (Which I donât need!).
I assume youâve checked your basals to see if there is a pattern of when it rises? I always look to the food and sometimes that isnât the answer.
To answer a few question:
I am on a fairly low-carb diet, not Keto but low carb and have lost weight and I am still in the process of shedding more pounds. The amount of units has grown over the decades but with eating low-carb it has come down a significant percentage.
I am reasonably sure that I was not ill. Nor were we out in the woods, in regards to ticks and lyme disease but beach.
Stacking of insulin is obviously something to be very careful with. I usually try to keep about 3 hours in between âstackingâ.
I am reasonably sure that it was this funky form of dehydration, âhypertonic dehydrationâ that did not establish it self as normal dehydration would with dark urine or not peeing, headaches and such. I actually felt very normal and was drinking regular water in a normal amount. However that did not do anything to bring down the results but a large bottle of sparkling mineral water with 10mg of Sodium. Tuesday evening and night was finally fine and Wednesday started out good but began to climb late morning again unexplainably. I immediately went for another bottle of Pellegrino, burping my head off, but the results normalized within an ½ hour.
Even after 30 years of being a t-1, it amazes me that I am still learning.
I was T1 for 53 years, and I had gained much weight after changing from animal insulin to synthetic insulin. I was diagnosed with insulin resistance (IR) in 1998. I realize this was not a âsuddenâ IR, but I wanted to mention it. I used Metformin for 7 or 8 years, and I lost the weight. I stopped the Metformin for almost a year, and I am slowly gaining weight again, 8 pounds this year. I have reduced my carb intake, but I am not losing weight. I may have to start Metformin again.
We all know that with certain types of insulin weight gain is something unavoidable after a certain amount of time. The only thing you can do is continuing the fight against those pounds. Low carb is absolutely a good thing, just give it time. And it actually reduces your insulin need since you are lowering your carbs. And the easiest form of exercise might be walking walking walking even though you donât see immediate drastic results. But it works in the long run with whatever time we have left.
@John - I have had similar experiences of insulin resistance due to dehydration. Like you mentioned, I thought I was drinking enough despite warmer weather, being outside, etc. In my cases, I couldnât get enough fluids in orally, and became sick to my stomach. So I ended with an IV. It doesnât happen a lot, but maybe 4 or 5 times? Iâve had type 1 for 47 years. I never knew this problem had a name or that anyone else had experienced it. Hope you are past it now and feeling well again.
Thank you, feeling pretty good. Results are back in order after rehydrating. Sodium content in the Mineral Water seemed to do the trick. Slight headaches delayed about a 1 ½ days after the incident
You could be developing an illness? I have had my BGs spike like crazy, a first sign of a minor flu shot reaction a couple days before the symptoms hit. If your adrenals are still working, (mine are not) High BGs can be an early warning of an illness.
After developing Addisonâs disease (primary, autoimmune) I last year, I no longer get early warning or dawn phenomena etc.
I get those, especially when I have been chewing the inside of my cheek (a nervous habit). My bgs skyrocket for days as the pain increases, and when the pain starts to abate my bgs drop back to normal.
This happened to me. and I had such a hard time figuring out why⌠it was like that for a month and a half no matter what I did my sugar would go into the 300âs ⌠What I ended up doing and totally am not endorsing is I did a 5 day water fast and whatever that did brought me back to where I was before⌠Iâve done a few of them before that time. just for stem cell and flushing reasons so I was familiar with how to do and how my body would react⌠so do not do without looking into it and getting expert advice.