what about a 220 lb man? I think the ultimate point he’s trying to make is that doses vary widely, and ultimately it’s only Too much insulin if it’s causing hypoglycemia… And ultimately it’s too little insulin if not preventing hyperglycemia. I agree with him that it’s a silly notion that if someone takes more than a certain amount that they are doing it wrong, or it’s just because they are huge, or just because they’re not actually T1, etc. human physiology is pretty complicated… Some people are going to need a lot more insulin than others.
sam I am exactly 220 lbs at the moment (6’5") and my basal is just under 14U a day. a long ways away from 100. I am purely T1 and have been since prior to '78. I used to take a bit more basal than that when not as active and when eating stupid things instead of healthy foods but the difference has ALWAYS been under 5U/day variation in all the years on a pump. I can’t remember my pre-pump numbers. And I have weighed as much as 340 lbs and STILL my basal never climbed over 20U a day. I suppose if I were truly clueless, or on a self-destructive bent, I could figure out how to apply a 50 or 100U per day basal. Actually, no, I don’t think I could manage to do that, UNLESS I went to one of my doctors and said, “filll me with prednisone, please!”. THAT would increase my basals dramatically, but I don’t think past about 60U a day.
I know that PREGNANT WOMEN can take huge amounts of insulin. I have NOT been referring to that subset of T1’s for the purposes of this discussion, as that is not what Brian was referencing.
Sounds like you’re at the low end of the spectrum for insulin requirements as am I— but I think we wouldn’t have to look too hard to find small ladies half your size who take more insulin… Which is what I, and I think Brian are saying— that it varies widely from one person to another.
my wife is 1/2 my size and takes less than 1/2 of what I take. 
Her I:C ratio and her drop ratios are 1/2 of mine, just about exactly
I haven’t been arguing the point simply due to my personal experience. I know what the general rules of insulin usage are, and t that presupposes that none of the caveats that I mentioned in previous posts are involved.
FYI: Many pumpers enjoy a roughly 20% reduction in insulin usage when switching from MDI to a pump, thanks to the more efficient use of only a fast-acting insulin. Basal formulations usage and/or MDI tend to GENERALLY cause an increase in needed insulin, as opposed to pumping.
What, exactly, is “purely T1”? None of us are pure anything. We all have different circumstances and different bodies that make us (and our insulin requirements and diabetes control) unique.
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I, for one, wish the concepts of T1 being different from T2 never came into prevalence. I dismiss the differences, think we’d all be collectively better off to do the same, as I described above.
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There are Type 1s who develope antibodies to insulin who can require huge doses of insulin just to survive. U500 is the recommended treatment. With time some improve.
But insulin resistance is genetic in origin and many thin young people carry the genes for it, only becoming overweight as they age. There is nothing that says a person with these genes can’t experience an autoimmune attack that takes out their beta cells, too. They will need more about insulin because of that IR.
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Well, I’m sympathetic to why you might say that but I’m not a big fan of categorical overstatement. Etiology matters. If my problem controlling my BG is not caused by my islet cells having been destroyed by an auto-immune reaction due to some kind of viral infection trigger, then if they figure out a way to encapsulate islet cells so they can be transplanted and not destroyed by an overreacting immune system, it’s not going to do me any good. Whereas if that auto-immune reaction and so forth IS the problem, then that cure does matter to me. And that’s just at the grossest level of course. There are all kinds of things that are different in terms of what went haywire very suddenly in my body back in my twenties versus a condition that seems to creep up very gradually on people who (not exclusively but most frequently) are quite a bit older and much more likely to have had relatives with the same thing. And those differences have consequences in terms of treatment regimes, not to mention having very different kinds of psychological impacts and complications.
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But it’s not you, or I, or Brian, or jenny, or the little young child, or the obese old man or any other person with diabetes who benefits from highlighting those distinctions, it’s the insurance company who gets to deny the claim for a certain type of treatment to one of us vs another who benefits from it…
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I’m sympathetic to that aspect of it, yes. When it comes to activism, it’s important to stress our commonalities. In that context I don’t think you’ll find a lot of disagreement here on TUD. But there are other contexts. I think this particular discussion has strayed pretty far from where it started out, which makes it increasingly hard to communicate effectively. The eternal problem with online forums: shifting frame of reference.
nonsense. I make NO insulin. I have been a Type 1 insulin diabetic for decades. My insulin usage is classic T1, my endo knows I’m a T1, I know I’m a T1 and if I miss insulin for a few hours, my bg’s will go skyward. How you can claim that there isn’t any “pure” anything is simply untrue.
Having said that, I know that other folks have a variation on a theme, so to speak; meaning their diabetes is nothing like a T1. My wife is a prime example. Her fastings without insulin are normal. She eats carbs, she goes way up. An hour or two later, she is back to normal. She wouldn’t die in a week without insulin. I’d be comatose in a few days without it. Don’t tell me I’m not a “pure” T1
yes, I am sam. I saw a new endo who Rx’d this. Got home, read about it and went…what the heck, is he trying to kill me? I tossed both samples he gave me and decided to go back to my original endo and try pump again. I sent my original endo an email about this, just asking out of ‘curiosity’, she said, no way, this would not be a good basal for me, too strong, that’s not what I need.
100 units of basal for a type 1 is incredibly uncommon. In fact, I know of none. average basal for type 1 is around 15 - 20 units per day. I take about 6 - 7 units and can’t believe this endo Rx’d this for me. Thank goodness I didn’t take any.
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a lot of it has to do with how much cpeptide is left and how vicious the autoimmune attack was on ones body. but in general, there is a vast difference between the amount of insulin needed for type 2’s vs. type 1’s. i know no type 1 who uses 100 units of anything. there is a vast difference, as every endocrinologist has ever told me between my type 1 diabetes and that of a type 2. As I’ve been told, “they don’t even compare, they’re nothing alike.” That’s from doctors who specialize in this disease and have study it for years.
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THANK YOU for a voice of reason, Sarah! I get really frustrated with misinformation on the scale that has been perpetrated on this thread.