Insulin Resistance?

What is your injection technique? I pinch, much easier to gather the bodyfat and enables me to use a longer needle. You may find a modified injection technique and/or a different size pen needle helps. What size needle do you have?

Yes I pinch but it’s hard for me to even do that because I do not have much fat. I am using a very short thin needle…wonder if a longer one might make a difference?

Are you using the 4 mm needle? That may just be too short. You also don’t want to pinch hard, just bunch up those thar “love handles.” And you may find that releasing the pinch while you count to 5 helps. Part of the concern is that the injected insulin is “under pressure.” If you let it equalize in pressure, you have less pushing it back out.

Well if I do not have much fat can I just inject without pinching up? Or should I pinch up and then release while I count?? Thank you SO much for bringing this to my attention I didn’t even think about it!! I’m going to call the pharmacy and request longer needles to see if it makes a difference.

the very best thing you can do to make your short-acting insulin work (more) correctly is to get your fasting BG under control, and that means using a basal insulin like lantus (which acts on top of your mealtime insulin). if your fasting BG is too high for two consecutive days, titrate up your dose a bit; if it’s too low, titrate your dose down. i use 1:15, in reality it’s probably closer to 1:18 for me but i’m happy to run a tiny bit on the low side most of the time (my target is 75-115, but i’m 100% functional even in the mid-high 60s).

i find the pens work fine; i use a 5mm 31G needle and haven’t had trouble with it.

Infections can have a HUGE impact on bg. The Flu, which has struck me twice since being D, keeps me 200+ even with doubling the basal rate. Respiratory infections are particularly brutal on the D. They decrease insulin sensitivity significantly – so it doesn’t surprise me too much that exercising helped bc it would bring your sensitivity back up. Just don’t overdo it or you’ll never get rid of it! Keep an eye on it. Don’t consider any changes you make now permanent – they never are, lol! And back off if you start drifting downward. When these things resolve bg can come down just as fast as it went up.

Things will probably change a lot for you in the coming months and years. At this point, it’s too difficult to tell what is the honeymoon waning and what is the infection messing up your sensitivity.

Thanks for the reply Tom! Thats def good to know1

Don’t worry about the carb/insulin ratio. That takes a while to get right and varies during the day for some people.



The more important thing to determine whether you’re insulin resistant is your total daily dose (TDD) and your weight. There is a table in the Pumping Insulin book (maybe also in Using Insulin if you still have the book). But as others have said, there is a fair amount of variance from one person to another. I don’t think you need to worry about resistance unless you are taking huge amounts of insulin. One variable that makes a big difference is the average amount of exercise you are getting at the time.



I don’t have my book with me, but if you’re curious how you compare to the average, then post your numbers I’ll check unless someone else beats me to it.

Aww thansk! See thats the problem I am only taking insulin right now to cover meals no basal yet and it seems like everyone is sayin that since I am not on a basal thats why I need less carbs per unit…right??

Not really. Basal keeps BG more level between meals & overnight. There are things other than food that raise BG–simply being alive for one. Basal is too slow acting to have much effect on pp readings.

Please don’t worry about carbs per unit. You need what you need.

I have good sensitivity and my ratios depend on the type of day but range from 1:10 (AM) to 1:15 (late afternoon). I doubt you have much resistance. SOmetimes, if your BS was still rising, your correction might not lower you much, but just prevent you from going higher. And yes, illness can impact BS quite a bit. I think one unit lowers my BS around 50 point, but that is not always totally consistent. Sometimes it hardly budges me and other times it seems to make by drop by 80 points or more. Sorry to say this, but using insulin is very unpredictable. That is why checking often, very often , is key.

Thanks for the reply Hope thats good to know…I was told by my endo each unit drops you about 50 points so it’s good to know that sometimes it doesnt and sometimes it drops you even more.

i think this is slightly misleading. of course your basal insulin will not work in lieu of mealtime insulin, but it does help “smooth out” the blood sugar curve over the course of the day. it’s not as if it stops working when you take other insulin or eat a meal, and PP numbers will definitely come down slower and more erratically without background basal insulin. i think this is a silly discussion in any case, because you need background insulin and no one is suggesting otherwise.

Anyone else experience swelling after starting insulin?? My abdomen is sooo swollen!

Hi -

If your abdomen is swollen, I would call the doctor. You might have an infection which is why you are having trouble with your numbers. An insulin shot should do no more than give you an occassional black and blue mark if you hit a capillary.

Maurie

What do you mean, what kind of infection?? I googled it and this is what I found:
Insulin causing edema especially in underweight or juvenile. In rare cases a patient will develop edema after starting to take insulin. Puffy feet, swollen legs and bloating in the abdomen can occur. This is due to insulin’s ability to retain sodium and water. Hair loss is a symptom too.

Well, the formula’s in Using Insulin assume a diet where you get 45-65% of calories from carbs, so the TDD calculations will be off. And you say that your fasting blood sugar is fine, but you also said it was 100-135 mg/dl. A non-diabetic fasting is 83mg/dl. You fasting blood sugar is close enough that you should be able to go without a basal for now, but at some point you should add it. When you still produce insulin it is very hard to estimate your actual insulin to carb ratio. All you should aim for is eating meals that are healthy, shoot for a consistent number of carbs and try to work with your bolus to return you to a normal fasting (7-120 mg/dl) 3-4 hours after the meal. If you are consistently high with a ratio of 15, then adjust your ratio, but try to adjust in modest increments and have several meals to see how well it works out.

You want to inject in fat is what I am told. If you inject into muscle the insulin doesn’t work properly. Pinching the fat ensures that it isn’t going into muscle tissue.

And if you don’t have a lot of fat, shorter needles should be best. Just try leaving the needle in for 5-10 seconds before pulling it out.

Injecting into muscle is extremely painful & the insulin will start working very quickly. Shooting into the fat layer ensures insulin is absorbed & released.

Actually, I would even make stronger statements. Injecting your bolus insulin into muscle can result in highly variable absorption. Injecting your bolus into muscle can result in very bad results (particularly with Lantus). A basal insulin may totally fail to absorb properly, releasing all the insulin at once if injected into muscle or veins. Care should be taken (particularly with Lantus) to inject into your bodyfat layer.