Can Type 1 Diabetics also be insulin resistant?

I have been Type 1 for 36 1/2 years and see all the time about Type 2 diabetics being insulin-resistant. I am wondering if, as a Type 1 and getting “Over the Hump” (age almost 43), that is something to possibly consider when going to the doctor on my b-day? I have been using Apidra now for a little over 6 months and have steadily seen my insulin demand go up, even with no infections. I get into problems sometimes where I have Highs, then treat, go hypo, treat with as little as possible, then go High again. This happens for 3-5 days sometimes as many as 5-6 times a day. Last time, doc took me off all insulin for 2 days and could only have clear, non-caloric beverages. Re-introduced insulin to body and things were ok for about 2 years. Just wondering if we can be resistant as well. Any thoughts?

Yes, it’s possible. It’s often called “double diabetes.”

Sure doesn’t seem fair, does it.

I’ll have to ask the doc when I see him on my b-day if he has ever heard of it. If not, then I may need to do some educating. Wondering if we could use some of the drugs for insulin resistance that Type 2’s use because it says not to use them for Type 1 or if you are currently taking insulin by injection?

Could you be reacting badly to Apidra? Some people don’t like it.

Competent in NW PA…not happening. Been from Erie, PA to Pittsburgh, PA and most still blame non-compliance for all issues. Anyone in Western PA, have any good endos to share?

Not sure. Basal is now set at 1.0 for daytime and .8 for overnight, but daytime begins for me at 4 AM, and overnight about 9-10 PM. Could be pain too since I have been fighting a severe shoulder injury for 6 years now and am in constant pain no matter what I am doing. I refuse to take narcotics though because they completely mess up my mind which in turn messes up my control.

Sounds to me like most of you in CA seem to have some pretty decent doctors. Seems like no one wants to practice in rural communities anymore. Too bad for them that they can’t see what a great practice they could have when there was only one of them.

Think that may be due to the population of overweight people wanting a quick fix for obesity with gastric bypass? My Type 2 next door neighbor just had gastric bypass done to “cure” his diabetes. Did absolutely nothing to try to limit his eating or increase his exercise. It’s completely insane. His wife will be going in to have a Lap Band put on because she is now 150 lbs. overweight and Type 2 within the last 3 months.

I am an insulin resistant Type 1 diabetic. It is not as uncommon as one might think.

Then, why don’t phycicians recognize and treat it like they do for Type 2’s? If it isn’t uncommon, do the physicians need to learn about it in school or take a few continuing education classes about diabetes? I have never heard or seen a physician that would even address this issue even though I ask many questions. All I want is 1. day without hypo-hyper and back. I feel like no matter how insanely careful I am about everything, my blood sugars still don’t cooperate and it drives me absolutely NUTS!

Yes. I use an Animas IR 1250 pump with two regular basals set and boluses based on blood sugar and carb counts 30 minutes prior to meals. I use square boluses for meals with both carbs and high fat proteins (Cheese, Steak, Fried Chicken–don’t like this but husband and kid do so I usually don’t eat it). Like I was saying before, I can do things exactly the same time, eat exactly the same thing at each meal and not even change my site and my sugars can be way off! I’m thinking of changing my middle name to NUTCASE!

Not quite in your neighborhood, but I go to a good endo in Mentor, OH. That’s about 81 miles from Erie, anyway. If you’d like to look at their website it’s:
http://www.yourdiabetes.net/
Mind you I’ve had Type 1 diabetes for 53 years, and have trained some endos over the years. Think I’ve got them in the swing of it there, and least the newest endo. I also used an Animas 1250.
I’ve never tried Apidra, find Novolog works well for me. Used Humalog before that, but find Novolog is more efficient, and dropped dosage about 15% when I changed both my insulin and pump (from a MiniMed 507c) not quite 4 years ago.
Yes, we can have insulin resistance, particularly when bg is high. At lest with my pump I don’t have to take Metformin (though I actually took Phenformin before Metformin appeared) twice a day with insulin shots which kept me VERY stable from '62 to '75.

After 11 years now on a pump I’ve found that even with good rotation, there are spots on my abdomen that don’t work so well. Could that be part of the problem? Also, I have many basal rates. Just as an example, my day goes like this with the dawn phenomena:
4:00 a.m. .55
7:00 a.m. .60
9:00 a.m. .50
11:00 a.m. .45
12:00 noon - 12 a.m. .35
This is what is working for now. In a few days/weeks/months, things will change and I will be adjusting things again slightly one way or the other at different times. Numbers always change. that could be the problem too.

I’ve just found someone like me and it is actually a MAN! I thought it was hormones and female things cuz I’m not menopausal yet. Can’t wait for that to happen cuz then I’ll actually be warm most of the time like all the other old ladies at church! LOL

We all experience the glucose levels being way off. That is why we test so often. I like the one where I am exercising in one day I end up with a super high glucose level and the next I am bottoming out. I just think that it makes life a little more interesting.

If you want to be warm all the time just move to the south. LOL Texas is having a record breaking year of triple digit temperatures this year. LOL

I know how you feel about not wanting to take narcotics my problem is that I am allergic to most of them. I have a frozen shoulder. I know that if my glucose levels are well controlled then I am in less pain than when my glucose levels are not being controlled. I use 2.0 units an hour which is down from 2.4 units.

I would wonder if your body is not liking the insulin you are using.

Apidra users often need more insulin or less insulin. Have to start from scratch. We gave it a one-week try and DN was high all the time. We realized we would need more time to completely refine basals, correction factors, ISF… everything. As far as insulin resistance goes, yes, insulin resistance can be caused by growth hormones, such as cortisol, secreted early in the morning and during the evening hours (for children; not sure if adults still secrete a lot of growth hormone evenings; most likely they would secrete some). And in general there are times when she needs a lot less insulin, normal amounts or greatly increased amounts of insulin. Not at all static. There is also such a thing as “double diabetes” where a Type 1 can also have a lot of the problems as a Type 2. There are drugs to help combat this, Symlin, for one, to reduce after meal spikes and help with overeating. Ask your endo to check this out for you. Confused by doc taking you off all insulin for two days. How is that possible? My niece would go into DKA by the time eight hours without insulin had elapsed. Do you mean the doctor took you off all BOLUS insulin? If it worked once, and treatment was only for two days, I would ask if he could try it again. Keeping all BASAL insulin going, of course…

This happened while in hospital situation when I was going through the high-low-high rollercoaster. I was off insulin completely for 2 days and had blood sugars checked every hour during that time. My sugars stayed relatively stable as I was only permitted saline IV fluids and water. As soon as sugars hit 200, insulin was restarted in very small doses by injection. I have never heard of Symlin. Can you give me information about it? I do not have problems overeating, actually I prefer to eat in very small amounts only a few times a day. My pancreas at the time was beginning to completely stop producing insulin, but I still have days yet, when it still produces small amounts and throws everything off for a couple days. I’m still not sure I am up for Apidra and all its hassles.