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Discussion Starter · #1 ·
I have had type 1 diabetes for 15 years. I was diagnosed when I was 9 years old. All seemed to go well for the longest time; about 13 1/2 years. I cannot really even remember ever worrying about having diabetes. I counted carbs religiously and had my ratios down pat. I remember when I switched to Humolog from R and the doc told me to make sure that I ate within 10 minutes after giving myself humolog lest I become hypoglycemic. I followed orders and so long as I did the correct amount of humolog I would not get hyperglycemia (i.e. my blood sugar would maybe get up to 150 an hour or so after eating and then come down to the correct range within 2 hours after eating).

About a year ago I found myself getting up into the 200's after eating even if I would give myself the correct amount of insulin. I know my ratios were correct (despite getting up into the 200's) because my blood sugars would eventually come down within range within a 3-4 hours after eating. For a while I would "stack" (or over correct my 200's blood sugar only to get hypoglycemia an hour or two later). I began to think that the insulin was just not working or something, so I tried switching to a "faster insulin" thinking that may fix the problem; first I switched to novolog but when the problem continued I even tried Apidra, which is supposedly the fastest. But the problem persists.

I have learned to quasi-remedy the problem by exercising after eating (thus increasing my blood flow to speed insulin absorption), eating a lot of fiber (slowing down digestion), and I even sometimes do my apidra doses up to an hour before I eating. By the time I get around to eating the insulin has begun absorbing so the insulin starts doing its job right when I start eating. All of these strategies work to a degree, but it has become unduly burdensome managing by blood sugars after eating because it JUST DOESN'T FEEL LIKE MY INSULIN IS WORKING like it used to.

I have therefore begun thinking that I may be insulin resistant like a type 2 diabetic. The way I understand "insulin resistance" is that one's cell's more or less build a callas. Consequently, one's insulin cannot successfully unlock the cell to transfer the glucose (that it is carrying into the cell) in order to use it for energy. As a remedy, type 2's many times take pills to get rid of the calluses around their cells. I feel like the symptoms I have been experiencing (i.e. high blood sugars after eating despite doing the correct amount of insulin) is the result of inefficient transferring of glucose (by the insulin I inject) into my cell's, which perhaps have developed some type of callas; a.k.a insulin resistance. ???????????

I have been recommended by a doc to take chromium which supposedly aids insulin function not by helping insulin production or by increasing the quality of the insulin created (which in a type 1's case would be pointless to take then), but rather in order to help my insulin better unlock my cells to dump the glucose in. If this is the case then would this be another way of saying that I may be insulin resistant? If so, then could it be conceivably better to take a more powerful "cell unlocker" that type 2's take?


Thank you for taking the time to read this. Any comments are much appreciated.
 

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Hello, Sloan . . . I'm just going to offer greetings and then make room for Richard, who has much more knowledge & wisdom about type 1.

Just know that we're all here to help & support each other & are glad to have you join our forum. Welcome aboard!
 

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I have a friend who has been Type I for years. The amount of insulin she needs has gone up and up despite all her efforts. She finally went to a new doctor who said that she had in fact become insulin resistant. He put her on Metformin and drastically reduced her insulin. She looks and feels a lot better now.
 

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Hello Sloan, I have the same problem as fat is in insulins way. I was thinking of having some Metaformin to stimulate insulin's work but the Endo's think differently. :( But then it's a drug that I don't have to take. ;)
Have you tryied to exercise first then inject and eat? I think that way would make the body ready for food & insulin to mesh better. Just a thought. ;)
 

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Hello Sloan, your problems sound familiar. Are you overweight? i have been Type 1 for 64 years now. In the 1990's I started gaining weight while taking modern day insulins (Humulin and then Humalog). I gained enough weight that I became insulin resistant. I started taking a Type 2 med (Avandia) and my resistance improved. My insulin resistance improved and I lost most of that extra weight. Now I am pumping insulin and I have very good control and good health.

I suggest that you have your doctor have you tested for insulin resistance. Is your doctor an endocrinologist? I think it is better to work with an endo in a situation like this. Other doctors, sometimes, do not realize Type 1's can become insulin resistant. When it happens it is called "double diabetes". Weight gain is not the ony thing that can cause insulin resistance. Certain medications can cause it too.

If you are not insulin resistant then there is something else you might try. Some insulin dependant diabetics with your problem take some of their bolus insulin 30 minutes or so before eating and the rest at meal time. Be careful if you try that, your Apidra is very fast acting. Maybe 15 minutes before your first bite. If you are still high 2 hours after eating, try 30 minutes the next time. Trial and error will tell you the right procedure. You should not do this if you are going to be active between your early shot and your meal. Stay still while your insulin is getting a head start. You should also avoid doing this if you are low prior to the meal.

I have done this in the past and it worked for me. Do you have this problem with every meal? I used to have the problem only with breakfast so I took two units an hour before eating and the rest at meal time. I did not need early insulin with my other meals.

Richard
 

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Discussion Starter · #7 ·
I am not overwieght and have never been. I am about 5'9" 1601bs and have been so for a while. I do see an endocrinologist but I have yet to discuss this matter with her because I recently moved; so I just started seeing her.

I do not seem to have what appears to be delayed insulin absorbtion all the time. Many factors influence whether I will get high after a meal despite doing the correct dose of insulin (e.g. the type of food I eat, the amount of activity I have done during the day, and the time of day). I, like Richard, need more insulin in the morning. My bolus rate is twice as much the first few hours I wake up compared to what it is in the late afternoon. It goes without saying that all of these factors make it incredibaly difficult (if not impossible) to have even a semi-predictable blood sugar.

As I stated in my first post, I have adopted certain strategies to combat my problem (e.g. exercising right after I eat (and sometimes before), eating fiber with my meals, and doing my insulin 30 min or so before I eat), but the extra time and effort it takes to manage my diabetes when doing this is almost unbearable. I am 24 yrs old and am in my first year of law school. I have a very fast pace, hectic, and disordered lifestyle. With this problem that has developed (i.e. what seems like insulin resistance) it is hard for me to eat breakfast or lunch because I have class soon after and it is unbelievably hard to worry about this problem during class. I can't tell you how many times I sat through class trying to get my blood sugar down when I did not understand why the hell it was high in the first place (because I know I did the right amount of insulin). On the other hand, I cannot just go without eating nor do I have the time to simply exercise after every single meal. I guess I am most discouraged because I never had this problem before, and for it to crop up now is depressing.

How can I take an "insulin resistance test"? And are they very accurate/reliable, because I hear they were not?
 

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Basel

What's your Basel doses are like? If you are fighting the high BG's and constantly seeing highs all the time. It's worth having a look. ;)
 

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Let us know what your endo has to say about all this I am curious. I know that increased weight can decrease your absorption rate. Do you rotate your shot locations? if you consistantly give yourself shots in about the same area your body starts creating some fat in that area that hinders the absorption... Try a different location maybe see if that helps.
 

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I cannot remember how my doctor determined I was insulin resistant, that was 1998. I assume it was a blood test but I'm not sure. His diagnosis was correct though and the Type 2 med has been perfect for me. I know other double diabetics (Type 1's with insulin resistance) who use Metformin and it works for them.
 

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Discussion Starter · #11 ·
Thank you guys/gals for your responses.

Anthill: my basal rate is 1.4 from 10am to 1pm; 1.15 from 1pm to 4pm; .8 from 4pm to 12am; .7 from 12am to 10am. This may seem too nuanced but I have worked incrediably hard to get it right. If I go a day without eating my numbers remain beautifully stable. I am not high all the time. In fact, since I switched to the pump my numbers have been very good (my A1C's are better than ever). The problem is that instead of being able to just count carbs, take insulin and eat, I now have to worry about how long it is going to take for my insulin to start working after I inject it, which varies all the time; and thus my numbers become impossible to manage it seems. This insulin-type resistance makes it very difficult and depressing to manage my diabetes because it is simply too burdensome (and many times impossible) to have fiber, do insulin at the right time before I eat and/or exercise before/after every single meal I eat.

isisgate: I am on the pump now so I do not take injections. However, I took injections for 13 years. I was pretty good at rotating, but as many shots as I did I couldn't help but build up calluses sometimes. And you are absolutely right that injecting insulin into a buit up callas will postpone insulin absorption. Although this is something I always looked out for when doing injections, it does not seem to be a problem anymore now that I am on the pump.

Richard: so am I correct to say that a) you are type 1 diabetic, b) in the past you experienced insulin resistance like I think I am experiencing now, c) you started taking type 2 diabetes oral meds to combat insulin resistance (and currently still do?), and d) it works very well for you by speeding up your insulin absorption???
 

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Discussion Starter · #12 ·
I emailed my “pump lady” (i.e. the lady that advises me on how to manage my diabetes with a pump) and she mentioned a medicine called Amylin. Has anyone heard about it? This is the run down on it that I gathered from my brief research:
Healthy beta/islet cells produce insulin and Amylin. Type 1 diabetics do not have working beta cells and thus do not produce insulin or Amylin. Amylin regulates the livers production of glucose and counters the insulin resistance that results from cortisol (i.e. the hormone produced when one is stressed). Amylin also slows the rate at which food is released from your stomach. When people eat their liver sometimes produces glucose.
To make a long story short, type 1 diabetics likely do not produce Amylin (due to malfunctioning, or just nonfunctioning, beta cells). Consequently, they lack a hormone that a) slows the releasing of food from stomach, b) regulates the livers production of glucose, and c) counter balances cortisol. Any or all of these could explain my apparent insulin resistance, or so it seems.
Amylin is supposedly taken in the form of a shot. Has anyone heard anything about it? Richard?
 

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Richard: so am I correct to say that a) you are type 1 diabetic, b) in the past you experienced insulin resistance like I think I am experiencing now, c) you started taking type 2 diabetes oral meds to combat insulin resistance (and currently still do?), and d) it works very well for you by speeding up your insulin absorption???

YES to all questions! My A1c's have been below 6.0 for several years and I have no complications, so things are going well for me.
 

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Hello everybody,
Some time ago I talked with Richard about this problem about DM I and ins.resistance that was quite new to me. In the latest 10 days I have had symptoms with unexplainable high BS-values + feeling very tired and unwell + severe difficulty reducing the high BS-value. My body/physiology did not react as usual. Now I will try to ollow this thread with the doctors. I do expect some resistance here also because I do not think that this way of thinking is common in norwegian medicin. I hope I am wrong. Thank you for the inspiration. I think this could be it.
Peter, Norway

Pump user - Meditronic Minimed Paradigm 715
Medicin: Humalog about 60-70 IU -per day
 

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Finally!

Hello Sloan,

I understand your situation because I am living through the same one. This problem started two years after I was diagnosed with type one, and at the same time that I was diagnosed with hypothyroid. I started noticing that my blood sugar was very high after breakfast but the the insulin would kick in around 11:30 and go back to normal. Like you, if I gave more insulin, I would experience hypoglycemia before lunch. It is a very, very, very sad and complicated problem for me and often leaves me depressed and feeling guilty about my high blood sugars. Like you, it is most terrible in the morning.

I am trying to find a solution which will give me a more normal diabetes without having to go through all the shenanigans of waiting one hour, exercising before and after ect. So far the only thing that has really helped is eating aotmeal (big flakes) with four fried apricots boiled with it for breakfast and waiting about 30 min to eat it. But despite this plot I often feel tired, yawney and have trouble concentrating in classes.

I have thought that my hypothyroid condition could have altered the way that I absord insulin. My dimwit endo does not believe I have insulin resistance and so refuses to change anything. I am trying to get on desicated thyroid to see if this helps.

Through this post I have learned that type ones can take type two oral medication and that it helps! This is news to me. It just makes me sad that my endo does not help me and that it is hard to get to try new things.

Presently I am not in school because I am exhausted a lot. My heart goes out to you who is in law school you must be feeling so stressed about all this. Keep me posted if you can find anything that helps. Remember the porridge (big flakes) it is really wonderfull,

Love Alice:llama:
 

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Alice? This is an old thread and Sloan has not even logged in to our forum for that last nine months, so getting a response is unlikely.

Thanks for your interest in our forum. There are buttons to bring up new posts or today's posts if you wish to see more recent messages.

If you go to the introductions board and start a new thread, you'll get more response for your own situation.
 
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