Insulin resistance

Most Insulin dependant T2's are insulin resistant. I've got a real case of it. The amount of insulin I take would scare some folks. Diet and exercise helps a lot but it still requires a lot.

How does everyone else handle this insulin resistance thing.

Gary S

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Try to inject in an area you haven't used yet, that will help. Exercise helps if you can get it, so does reducing your carbs. Anyone else have any ideas?

drink water, exercise, low carb. those are your only options my friend!

Thanks Karebear. I believe you have a point there. I have been working on doing those things for the last few months and they have been a great help. I have greatly reduced my insulin requirements.

Gary S

good to hear!!!

I am convinced that my insulin resistance varies from day to day. I can eat the same meal, at the same time, with the same bolus, on two different days and get markedly different outcomes. I suppose that should come as no surprise -- everything else involving diabetes is highly variable, why should this be any exception . . .

Anyone else have this phenomenon?

Unfortunately there are so many variables involved. So many things affect our diabetes. Things such as not feeling well, other meds we take, our last meal, the weather, timing and on and on.

The only way to have any sense of predictability is to be predictable. To have such a regimented routine that you can set your watch by your own actions. To have such a stable diet that there is never a question about what your next meal will be.

Me I like a little bit of variety in my life so I'm going to keep chasing that moving target.

Gary S

It's true. You can eat the same thing at the same time with the same bolus and have different results. For that matter you can check your BG, eat nothing, and test again in an hour and have a higher BG. That's just the way it is when your pancreas and your liver are not working correctly.

My BG is so out of control that I'm afraid to go to work with a bg lower than 10. (180 U.S.) Metformin helps me quite a bit but also gives me radical lows. Of course, I'm not very strict with carbs. I just don't eat high Glycemic very often.

What type of insulin regime are you using. Are you doing long acting only or are you doing MDI(Mulitiple Daily Injections).

If your doing MDI with short acting at meals how are you determining your injections. I have been practing carb counting which is helping even out my highs and lows. I don't always get it right but nobody does.

Is the reason you stay above 10 because you feel low if you dip below that? If thats the case you can try lowering you targets over a long period. If your body is used to running above 10 then you will feel low if you dip much below that even though the number is still high. By lowering your targets slowly your threshold for lows will go down to where you feel low only when you are truly low.


I agree. I use Humalog for rapid response injections. I'm starting to inject more times per day. I figure out what my BG will rise to and then try to inject for that pre-emptively.

I have just started Humalog and need to use 30-40 units per meal if I have any carbs - that is 30 clicks on the pen, is that right? - so many people talk about 4-5 units and I think wow I must be really bad. My pen lasts under a week - If I eat zero carbs then i dont need as much. Someone said I may be insulin resistance (I thought that was what diabetes was??)

... and what is a type 1.5?

Lastly, I never get those lovely lows like 93, 120, etc. Im always running in the high 200's and sometimes 300;s

Frustrated - Thanks

Insulin resistance is a problem mostly found in T2 although it can be a problem for T1's also. Diabetes is high blood sugar levels caused by insufficient insulin levels. In T2 its frequently caused by your body not using its own insulin effectively. There might be an abundance of insulin (at least in the beginning) but due to insulin resistance there still isn't enough insulin to get the job done.

In T2's with insulin resistance high doses, such as the ones you describe, are common to overcome the resistance. There are lots of things one can do to reduce insulin resistance. If one is over weight then loosing a few pounds can help. Exercise is a great way to reduce resistance. And following a low carb diet can be a good way to reduce those high insulin doses. Those are the big three for T2 and a combination of those three things is what is generally needed to get T2 under control. In T2's such as myself the body's ability produce insulin is destroyed or reduced over time by overworking the pancreas thus the need for insulin. I suspect that's true for you also. If that's the case treatment becomes more like T1 treatment.

In T1 insulin resistance is not as much of a problem and the opposite is true for a lot of T1's in that they can be quite insulin sensitive and need very little dose wise to control their sugar levels. They always need insulin since their diabetes was caused by an autoimmune reaction where their body has attacked and destroyed all or nearly all of their insulin producing cells.

Type 1.5 or LADA and adult onset diabetes as its also called is a form of Type 1 diabetes that started later in life. It is T1 diabetes the only difference is when it began.

You say that you never see low numbers and always run in the high 200 to low 300 range. I want you to know that you can with the right treatment plan and a lot of work. The hard work is worth it because lowering blood sugar levels greatly reduces the complications you are likely to experience. If complications have already started then lowering BS can reduce the severity. And on top of that you will just feel better.

Your are in a good place to learn. I was frustrated also when I joined TuDiabetes but I became a daily visitor. There are so many people that can teach us so much here. Things like low carb eating and counting carbs so that insulin dosing makes sense and gets the job done. I hope that we can help make thing less frustrating for you.


This is sort of redundant, since Gary covered the territory pretty thoroughly. I just want to repeat a few things he said, simply to pile on and add emphasis.

If you are very insulin resistant -- which is what it sounds like -- then as Gary said, all three of these will make a difference:

1. Losing weight
2. Exercise
3. Low carb diet

And they are closely interrelated. Doing #3, for instance, will have a huge effect on #1. When I switched to a low carb diet, I dropped almost 20 pounds without doing ANYTHING else. Didn't change my exercise pattern, meds, or anything. The weight just fell off when I stopped consuming carbs.

One other thing that's very worthwhile, if you haven't done it already, is to read this book:

Richard K. Bernstein, Dr. Bernstein's Diabetes Solution, 4th ed. (New York: Little, Brown and Company, 2011)

Bernstein is a true pioneer in the management of diabetes. Just as an example, he invented the basal/bolus approach that is now pretty much standard practice. But importantly, he is himself a Type 1 diabetic so he has more skin in the game than most doctors and writers. His book is the bible for me and many others. Regardless of how much of his advice you do or don't choose to follow, his book will give you a more thorough, grounded understanding of practical day-to-day management than even many doctors possess.

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Drinking water is good. Just curious: Specifically, how is water and diabetes related? If I were slightly dehydrated, or prone to drinking less water, what could happen? (I think that I happen to have a small bladder, so I tend to go to the bathroom frequently. This is not related to having a high BG).

After being diagnosed with 350 blood sugar at 55 years old 22 years ago, I just keep eating as little as I can, and exercising as much as I can (mostly just brisk walking after meals). My 40-pound weight loss down to normal weight in the first 6 months was nice, but had nothing to do with my BG levels. Used diet and exercise only for the first 11 years with A1cs in the 6s, and then supplemented my d&e routine with metformin and glipizide the second 11 years with A1cs in the 7s. It’s not perfect, but it works pretty well.

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