i have had type 1 diabetes for over 30 years, recently it appears that i have become insulin resistant. i have changed insulin in my pump from humalog to novolog and still appear to be using much more insulin. has anyone else experienced this and if so how much more insulin is now taken as compared with your previous amount. it seems i am using almost twice as much and have found that this causes weight gain. any advice?
I have been a type 1 for about 40 years, when I go see my CDE's they say I am insulin resistant as well, I started on a pump 2 months ago and use around 60-70 units of rapid a day, I am about 30lbs heavier then I should be, have lost about 10 lbs since starting the pump. I am interested in this discussion as well, what can we do to decrease insulin resistance. I am not sure if this is a lot of insulin or not, I realize it depends on exercise and carb intake, this should be a good discussion!!
I've had Type 1 for just over 20 years. Over the past six months I've had to start taking a lot more insulin. Like you, about double what I was taking before. I've tried switching back to Humalog (I use Apidra) but it has no impact, so I think it's insulin resistance.
I am, however, overweight (although my weight hasn't changed in years), and so I'm hoping my insulin needs will decrease as I lose weight. My weight has been holding steady, I haven't found taking more insulin caused me to gain weight.
The drug Metformin can be used for Type 1 diabetics too. It improves the sensitivity to insulin and will moderate the glucagon production of the liver down. If I remember it correctly you can ask Marps about this combination.
My TDD was 30u for about 15 years and then it increased to around 50u over a couple of years but it has been very stable for the last 5 years. Insulin pumpers.org says the average TDD for a T1D pump user is around 42u.
We just need to use however many units it takes...it's not a sin...;-)...
As I get older it has become easy for me to gain weight, but as long as I get some exercise and only eat junk food half dozen times a year my weight stays stable.
Weight loss and activity are about the only two ways to lower resistance. My TDD will drop during the summer because I'm always more active....
I hit 50 years in 2011 and have encountered insulin resistence. I am on a pump and use less than 20 u perday--basal and bolus.
One of the things I have noticed lately is I have more trouble finding a good spot for my pump catheder. As I have used my stomach for all this time with shots, and pump, it is getting harder and harder to find fresh real estate!
As someone mentioned, you can try Metformin, Symlin, or other medications to help with insulin resistance.
Symlin helps with insulin resistance? I did not know that. Though if you have any type of gastro problems they won't let you take it. I knew Metformin works for it. The only time though I have had insulin resistance was the last part of my pregnancy. Getting ready to go through it again.
That's what my doc told me, that it would help with my insulin resistance, but he might have been thinking of Metformin. Wouldn't be the first time a doc got something confused.
OK - I see that this is a OLD thread…but - the phenomenon of insulin resistance is NEW to me. I have been a type 1 for 42 years. This is the FIRST time in all those years that neither Novolog or Fiasp seems to be helping much. I am thin and so it’s not a weight issue. I’m bewildered! Is my body just saying “I’m tired of insulin, ha ha, try something new for once?” Is this a thing that happens after x years, and I was just happily ignorant until now?
Has your total daily dose of insulin increased by a significant amount? Like 2x your former total daily dose?
Not to be nosy but are going through menopause?
How are your insulin injection and/or infusion sites? Do you have any scar tissue at your preferred sites?
Be aware than insulin resistance is not always indicated by an overweight or obese condition. I watched and read about the large increase in T2D in India and China, both populations without much obesity.
I’ve found fasting to be a potent antidote to insulin resistance. I first noticed that when I had to fast for a blood draw or a medical procedure, my blood sugar was well behaved, in range and without much variability.
What is your prebolus routine? Do you allow a fixed amount of time to elapse between dosing your meal insulin and your first bite? If you use a CGM, do you watch it following a meal insulin dose and wait for the downward bend before starting to eat?
Exercise for me, especially walking for 30 minutes starting about 30 minutes after eating increases my insulin sensitivity. If I do this as a daily habit, I oft n find that I need to decrease my insulin to carb ratios.
While I realize that insulin dosing can seem complicated, it really only breaks down to two factors: dose size and timing. You can only change how much and when.
What are your food habits? Are bread, potatoes, noodle, pasta and other processed carbs a significant part of your diet?
I believe that too much insulin causes insulin resistance. If you reduce the amount of carbs you eat, you will reduce the amount of insulin you take, and your insulin resistance should diminish.
Having stated that, I realize that there are people who consume large amounts of carbohydrates, not processed carbs, and ultra low amounts of fat and become insulin sensitive. What low fat, high carb proponents agree with the low carb, high fat eating style is the elimination of highly processed carbs.
You can defeat insulin resistance, it’ll just take more of what diabetes already demands of you: careful observation, thoughtfulness, persistence, and a good attitude. Good luck!
Medication for type 2 resistance works for us too. I’ve been on Metformin for years, started back when I needed help controlling dawn phenomenon other than getting up at stupid-o-clock to take insulin, and after switch to a pump kept on it because it seems to help keep down my TDD. More recently I started taking Jardiance, which has been amazing. First time I’ve had A1C’s in the 5’s since I was dx’d in 1983.
Thanks for your thoughtful response.
Ok, to answer some of your questions:
My TDD of short acting insulin has doubled in the last month - from 4-5 units a day, to 8-10 units a day, counting all of the correction doses. I’m also taking 8 units of Tresiba daily. I’m using pens, so I’m not sure how to check for scar tissue - there’s nothing obvious, anyway. And, done with menopause several years ago.
I usually pre-bolus about 5 minutes before a meal; if I take my dose earlier, I will crash while eating. (Although this quick onset is no longer happening, hence my post today about resistance.) And, yes, if my CGM says I’m high, I will wait until I eat until I’m lower.
As far as exercise, I have a very high energy Black Lab. She requires two long walks daily. I take her for at least one of these walks.
I have found that a high carb diet just lands me on the roller coaster, so even though I like carbs, they are generally not worth the b.s. swings. So, I have gravitated to a very low carb diet over the years, about 25-30 grams a day. My one exception is small amounts of chocolate, because without daily chocolate, why bother with any of this?
: - ) Maybe I am missing some key clue in all of this, but so far I am still baffled. It’s only 2 pm and I’ve already had 6 units and done an hour of vacuuming and my b.s. is still 250. Way too high for my comfort.
Sarah, I recently had this problem and I use the same insulins that you do. I also use pens. I finally realized that my Fiasp was just not working well at all, so I quit taking it for several weeks and my Novolog started working well again. I stayed off Fiasp for about 3 weeks and when I added it back in my levels were fantastic again. Looking for answers was frustrating. I love Fiasp but realize that I will probably need breaks from it.
I have been a type 1 for 61 yrs and my Insulin resistance number is lower than it has ever been.
Eating a low fat plant based diet greatly reduces insulin resistance.
Thanks for the information. So, does anyone have any idea why Fiasp works better when it’s used intermittently? Seems kind of crazy.
Just so I understand, when you say your insulin resistance number is lower than it has ever been, you mean you are needing less insulin/it’s working better than ever?
I could probably use to lower the fat in my diet! Even though I weigh 110 pounds. All that cheese is likely causing trouble. Since the cashews and avocado are unsaturated fats, they are probably ok. Looks like peanut butter is ok as well:
Thanks for helping me think about this! 61 years of managing this! That’s very impressive.
I know that other people have had trouble with Fiasp no longer working for them, so I knew it was a possibility when I kept needing more and more insulin. I will keep using it until I start having more problems with it.
I ate 30 carbs a day for 11 yrs. Now I eat close to 275 healthy carbs daily without using much more insulin than I was when low carbing. I have been eating this way for about 3 1/2 yrs. Instead of eating meat, dairy, eggs, and nut butters, I eat fruits, vegetables, legumes, oats, quinoa, potatoes, rice etc. I use absolutely no oils.
Having heart stents which I got about a decade ago, I follow what I think is a healthier diet for the heart. I have read an enormous amount of literature and reports from doctors and professionals on both sides of the diet controversy over the years
and I truly don’t know who is right. This just feels like a healthier way of eating to me, and I enjoy being a vegan. I was a vegetarian before I followed the Bernstein diet. I have never been drawn to eating meat.
My last alc was 5.2. I try to stay within 60-170.
With Fiasp I rarely break 150. Less than 2 hrs after a dinner which included potatoes, green beans, a low fat fake chicken patty and two garbanzo bean chocolate chip cookies, my glucose level is 98.
I’m really interested in your diet and insulin requirements. I have been keto, and low carbing for years, only to be much more insulin resistant in the past couple of years and I’m quite frustrated by this. My A1C’s have gone up - not down. Basals up, not down etc… What is your insulin to carb ratio? I’d love to become more sensitive and end this resistance I’ve been going through.
Claire, I eat about 275 carbs daily and take about 23 or 24 units of daily insulin. I am 5’1” and weigh 106. I also try to exercise at least 1/2 an hr a day. If I don’t exercise I require a little more insulin. I eat about 9 times the carbs I did when eating 30 carbs a day and I only take 3 or 4 more units of insulin. The low fat eating greatly reduces insulin dependence.
I haven’t figured out carbs in a long time, because I eat close to the same thing everyday.
Breakfast is a 1/4 cup cooked oat grouts, 1/2 banana, 1/2 cup of blueberries,1/2 a medjool date and a couple,of walnuts with chai and flax seed along with cinnamon.
Lunch and dinner vary, but I can usually guess how much insulin I will need.
I took the personalized course that the guys at Mastering Diabetes teach. They are both type 1’s and Cyrus has a doctorate from UCBerkeley in Nutrition and a degree from Stanford. They are getting quite a reputation for a very healthy way of eating while keeping insulin resistance low.
They have a book which is coming out this month. They taught me which carbs to add and how quickly. I had been very low carbing for 11 yrs, but was gaining weight and just needed a change.
Thanks so much for your response! I’ll take a look at the Mastering Diabetes guys- really appreciate it!