Has anyone experienced, over a sustained period of time, a situation where insulin is REALLY unreliable? Over the course of the last month or longer, I feel like I’ve had about a 50/50 chance of my insulin doing much of anything. I use Omnipod and I’ve seen this across 6-7 sites, with different types of insulin (switched between humalog and novolog).
Today has been the perfect example-- I had grilled chicken and lettuce for lunch (practically no carbs) and gave myself 4 units of insulin, which is double what I would have normally used. A couple of hours after the bolus, my blood sugar had shot up by 100mg/dL (!!!). I gave myself another 4 units, and in a bout of rage I jumped on my treadmill and ran a mile and a half, walked another mile, and did 30 pushups in between. This amount of exercise would usually have cratered my numbers with 4 units on board, but I only managed to lower my blood sugar by 60mg/dL. (my normal correction is 1 unit > 30 mg/dL)
I’m really frustrated, and hoping someone has had experienced anything like this. I’ve had incidents like this happen sporadically over the years, but not for such a sustained period of time.
I went through a period like that about six years ago. What I learned is that it wasn’t the insulin that caused my bout of bad control. Instead it was a series of sites with poor absorption combined with some kinked cannulas and pump occlusions. I was also using using Omnipod at the time.
I had switched to Omnipod due to site absorption problems with my Animas pump. To fix it I returned to the Animas pump but experimented with some other infusion sets. I tried steel sets and some cannula sets with various depths.
Perhaps your preferred infusion sites are tired and have built up some scar tissue. The scar tissue resists insulin absorption. You could test this idea by using sites you have never used before.
Thanks Terry, an excellent suggestion. I felt like I was rotating enough-- I have roughly 6 areas around my abdomen, on my legs, and occasionally I use my arms as well. But perhaps they are getting to the point where I need to get a little more creative. I’ll give it a go next rotation. Thanks!
Have you tried delivering your corrections via syringe? Have you gained any weight in the last 6-12 months? Has your total daily dose of insulin been increasing over the last year?
I haven’t tried anything other than the pump, though I may give syringe/pen a shot if this persists. No weight gain, and I can’t say insulin dosage has changed at all, other than what I’ve been experiencing over the last month or so.
Did you recently reduce the amount of carbs you’re eating? You mentioned going very low carb in a previous post.
I’ve read posts of people having trouble with insulin resistance when they restrict their carb intake. Others don’t seem to have a problem with this at all.
Not really, I’d say I oscillate between the 25 and 125 daily I mentioned above, so no drastic swings from say 300 to 30 or something like that.
The second dosage of 6 units a bit ago seems to be behaving normally and I’m headed low now, so it really does seem hit or miss. At this point I’m leaning towards the site/scarring theory @Terry4 mentions.
The value of giving a syringe correction is that, if it works, then you know the insulin is good and the insulin delivered from the Omnipod is impaired, either from poor site absorption or pump delivery trouble.
Intrinsic insulin requirements in type 1 diabetes vary enormously on the basis of hormonal fluctuations and other physiological processes which the patient can neither measure nor monitor.
I find I go through periods when the blood sugar is constantly trying to rise despite my best efforts to bring it under control, and others when it is constantly dropping, with often catastrophic results. So it’s not likely to be a technological problem with the pump, but instead a side effect of the body’s natural fluctuations and their uncooperative interaction with the ignorant mechanical efforts to address them.
