Extreme insulin sensitivity all of a sudden

So, I haven’t been on here in a long time and I will post an update about my life, but first, I got to talk about an extremely stressful and terrifying thing I’m going through. It all started a little over a week ago. I’ve been on Tresiba since April, 16 or 18 units at bedtime, and it was wonderful! One night, though, I injected into my rear end and something didn’t feel right with the pen. When I took it out I saw that it only injected 8 units. No big deal, I’ve dealt with pen malfunctions before, so I drew up the other 8 units with a syringe. The next day I was fine all day and took my Tresiba with a syringe that night. All heck broke loose. I couldn’t keep my blood sugars up for anything. I was at work so I would over correct my low, shoot up to 200-250 then crash back down to the 50s in a matter of an hour or two ( I was mixing carbs with protein for low treats). So that night I only took 14 units or Tresiba with a syringe thinking I hadn’t been getting the full dose with the pen this whole time. Nope, I couldn’t keep my blood sugars up the next day either. I had to leave work because I was blacking out and couldn’t control my emotions (not a good mix when working in a long term care facility). That night, I took 10 units with a syringe, same thing the next day but not as bad. After a couple days of still battling not too bad lows, I had a very scary experience Sunday morning. I woke up and was 48 and had fruit snacks and went to the bathroom. I started blacking out in he bathroom. My blood sugar had dropped to 32. I ate another pack of fruit snacks and poured a glass of pop then sat down on the kitchen floor. I either passed out a little or dozed off for a few minutes. Anyways, I decided to cut my dose again and work my way up. After a couple days of fasting here and there to check my basals as well as I can, it seems 5 units in the morning is the right number.

What on earth is going on here?! I’m not pregnant, I’ve not lost any weight, nothing has changed except I’m now taking my Tresiba with a syringe, but I can’t imagine it would make that much of a difference. I’m going to try to get into the doctors (this is really scary for me and I don’t want to keep doing this myself), but does anyone else have any suggestions or have had something like this happen?

I haven’t had the kind of experience you’re describing since I went through puberty… I’m guessing that’s not your issue. BUT… hormonal issues CAN and DO create severe swings in insulin sensitivity - are you sure you’re not pregnant?

But seriously - I’d keep the dose low enough to avoid the lows (especially nighttime lows) and see the doc ASAP… then your next adjustment will be based on real medical advice.

What kind of basal insulin were you using before the tresiba? And what kind of bolus insulin are you using? It’s quite fine to “replace” basal with bolus insulin - by which I mean, use more bolus (fast acting) insulin during the day, and less bolus. At times, when I’ve had issues getting my basal insulin, but had enough bolus - I’ve use ONLY bolus insulin. The difference is simiply the speed of action - so you could replace all of your basal insulin with four doses of basal over the course of the day to cover your basal needs - just add the necessary units for your bolus needs before meals. I wouldn’t suggest that - I’d just keep the tresiba at the level you can tolerate without going low, and use your bolus insulin to correct any highs, as well as cover meals.

I’m sorry you’re experiencing this - and hope you can get it settled. Good Luck!!

w.

I use Tresiba 20 units per night. Never any problems. The buttocks seems like a place with a lot of fat (mine anyway). Could it the paucity of veins there causing the “resistence” ? That is me wondering to myself, not making any scientific statements.

I don’t think my butt is the issue (haha). Since I started on Tresiba I’ve almost always used this sight, rotating up, down, left, and right.

I’ve suffered spontaneous and dramatic changes in insulin requirements all my life, so perhaps you have just evolved into the state I’m always in. If a total of 39 units is just fine for Tuesday, a minimum of 60 units is required for Wednesday, even though the amount of the calories consumed, the kind of food eaten, the timing of meals, and the level of activity is kept identical. You can imagine the lows that emerge from this condition. I suspect many more patients have this problem than me, but they don’t notice it as much because they don’t keep their food and activity so constant from one day to the next, so they can’t detect the size of the purely spontaneous changes.

Is your Tresiba pen U100 or U200? Make sure your syringe matches which one you are using. I use the U100 Tresiba and also inject my butt and have not had any absorption issues. I hope you figure it out real soon.

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So, I felt a little stupid, since I didn’t consider that. My pens are U200, so I’m assuming 5u in my syringe is the equivalent to 10u from the pen? This still means I’ve had a 6-8u decrease in my insulin out of nowhere, which is almost half. The decrease still doesn’t make sense to me, but I’ve had fantastic blood sugars all day so I’m going to roll with it for now.

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@MissMargie - Just wondering if the decreased insulin continued or if it “went away” and you are back to your typical insulin levels?
We have seen drastic insulin reductions that last about a week and then go away as mysterious as they arrived. Maybe twice we have seen this? Lots of speculation - no hard answers.