I was diagnosed with type 2 diabetes about 5 years ago and up until a few months ago was able to control my blood sugars with diet and medication (but I am not very good about exercising regularly). This winter my blood sugar numbers suddenly increased and I started seeing numbers in the 200’s and 300’s regularly with a few 400’s here and there. My A1C in January was 9.5, which I think captured at least one month where my blood sugars were controlled. I started eating almost no carbs and still my blood sugars were over 200. My doctor started me on insulin about three weeks ago, which I have increased every other day or so. I am currently taking 50 units of Lantus each day and between 100 to 150 units of Novolog every day and am still seeing an average blood sugar of slightly over 200. The diabetes nurse seemed surprised that I am taking so much insulin and still having high numbers. She tested me for a urinary tract infection and did not find one. I am 36 years old and very overweight (not sure how much this affects my treatment). I am wondering if the suddenness of my decline is at all normal. Also, do any of you take this much insulin even when you are eating between 50 and 75 carbs each day? Now the nurse has asked me to temporarily cut the carbs out completely; she calls this a ‘cleansing diet’. I am skeptical that doing this in the short term will help my blood sugars in the long term. I have been reading about LADA and have asked to be tested for antibodies to see if I could have this. I am wondering if this may explain why my A1C’s increased so quickly and also why I need large amounts of insulin? My 6 year old has type 1 diabetes (was diagnosed at 3) and there are also many type 2 diabetics in my family. I know that I covered a lot of topics here, but does anybody have any insight into whether any of this seems “normal”?
Everybody is different. And until you get your blood sugar under control, you will need more insulin. High blood sugar levels alone cause significant insulin resistance. Some people require 2-3 times their normal insulin correction levels in order to recover form a high blood sugar level. Just work with your doctor to use the insulin to get things under control. Eventually, you will discover the “normal” amount of insulin that fits your body.
“Normal” if you are not insulin resistant is about 0.5 unit/kg per day. You have had sky high BG and it may take a while to bring them down. 200 is still to high. No carbs good if that is not sufficient then you must eat a few less calories that will make BG much better immediately at least it does for me.
“Normal” is whatever you need in the insulin department. I know that my needs change depending upon the weather. When it gets really cold, I need to increase my insulin by almost 100%. Your health, your stress level, and your genetics all work together to determine how much insulin you require. Many T2s look at having to go on insulin as a failure, or that they are really bad if they need insulin. Not true, not true, not true. Being overweight will also affect the amount of insulin you need, the heavier you are, the more insulin you will require.
Diabetes treatment is a very individualistic kind of thing. What works for you may not work for me and vice versa. A very popular saying around here is “your mileage may vary” or the shorter “YMMV”. It’s not really useful to compare yourself to others from a treatment standpoint. Lots of people can’t eat bananas without a huge spike, I don’t have any problem with them. T2s are the insulin resistance poster children. It can require a great deal of insulin to bring someone with insulin resistance into normal range. There are folks out there who use U-500 insulin. Checking your antibodies is a good confirmation.
Best of luck to you. It can be so frustrating but it will come into line eventually. Don’t be too hard on yourself while this dosing experiment is going on. It happens to all of us – in that respect you are a normal as can be.
There is no “normal” as you see!
You can also try walking daily- it will make you much more insulin sensitive. This may help you get your insulin requriements down.
And yes, it IS more of an art than a science.
I would push for additional testing to rule out LADA. As you know, there is a genetic piece to Type 1, and you may share that with your child. It may not be LADA at all, and you just happen to need a lot of insulin right now. There’s really no right or wrong answer to how much – you need what you need to control your blood sugar and stay healthy. Good luck to you!