Insulin Resistance of a different kind
I find that I have insulin resistance that is of a mental/emotional nature, too.
That is, sometimes I just can't inject enough insulin to cover my food.
This usually happens when I over-eat and the calculation on my carbs/insulin kind of floors me. I still binge from time to time, and when I calculate and discover that I need to inject 80 or 90 IU to cover the binge I just...can't do it. I'll inject 45 or 50 instead, scattered around in three or four injection sites (twelve here, fifteen there, etc.)
I'll inject half of what I should and tell myself, "I'll test later and correct."
As I'm a T2 and still make some insulin despite being on MDI of Lantus and Novolog, I can "get away" with a bit of this. That is, if I've been walking daily, eating fairly well and regularly doing my basal/bolus, then if I have a rare binge and fail to cover it all, my sugars will go up to 280 -- not 480 -- as my body kicks some in to help cover and my insulin resistance doesn't fight me as hard.
However, if I go back to my bad old ways and do this nonsense more frequently, the base-line will creep up and up over a period of days and it will take me a week of perfect vigilance to get leveled-off back at a good place again.
I wish I could just STOP this nonsense, but if I put on my scientific observer hat I think it's fascinating that I'm sitting here with the Novolog pen in my hand and the cold, hard facts of my carb consumption right in front of me and I can't inject what I should. I just...balk. I've no idea why. It's like a mental block or temporary insanity that goes with the mentality of binging. It's almost as if injecting what I should makes the binge more "real"...or something like that.
Human beings can be weird, and I'm no exception...sigh...
Do you ever resist injecting the right amount of insulin for mysterious emotional reasons?
That is, sometimes I just can't inject enough insulin to cover my food.
This usually happens when I over-eat and the calculation on my carbs/insulin kind of floors me. I still binge from time to time, and when I calculate and discover that I need to inject 80 or 90 IU to cover the binge I just...can't do it. I'll inject 45 or 50 instead, scattered around in three or four injection sites (twelve here, fifteen there, etc.)
I'll inject half of what I should and tell myself, "I'll test later and correct."
As I'm a T2 and still make some insulin despite being on MDI of Lantus and Novolog, I can "get away" with a bit of this. That is, if I've been walking daily, eating fairly well and regularly doing my basal/bolus, then if I have a rare binge and fail to cover it all, my sugars will go up to 280 -- not 480 -- as my body kicks some in to help cover and my insulin resistance doesn't fight me as hard.
However, if I go back to my bad old ways and do this nonsense more frequently, the base-line will creep up and up over a period of days and it will take me a week of perfect vigilance to get leveled-off back at a good place again.
I wish I could just STOP this nonsense, but if I put on my scientific observer hat I think it's fascinating that I'm sitting here with the Novolog pen in my hand and the cold, hard facts of my carb consumption right in front of me and I can't inject what I should. I just...balk. I've no idea why. It's like a mental block or temporary insanity that goes with the mentality of binging. It's almost as if injecting what I should makes the binge more "real"...or something like that.
Human beings can be weird, and I'm no exception...sigh...
Do you ever resist injecting the right amount of insulin for mysterious emotional reasons?
Replies to This Discussion
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Permalink Reply by acidrock23 on -
A big bolus can be a defeat in the battle against a pantsometer but if you are eating big food, the bolus should match.
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Permalink Reply by lotsofshots on -
acid, I agree with that but the problem is that eating emotionally almost never consists of calculation so it is more like a shot in the dark than a match. There is the problem of a stomach full of sugar and fat and not a clue to how fast or slow that it is going to digest. One takes a chance of going on the roller coaster thing and eating a couple hours later because of overcompensation. The whole up and down affect just makes for feelings of lethargy, helplessness and defeat and then comes the guilt. I like the comparison you made before about insulin being like a hard drug, a potent hormone that affects all the processes in our bodies, organs and brains and it can be quite intimidating to "be a pancreas" 24/7. Shooting to kill, can result in a vicious circle, for me anyway.
JeanV, I would be very careful about using words like emotional and mysterious because words are powerful and why use ones that tend to lead to a sense of powerlessness that makes you feel even more like you are not in control?
Binge eating is not good for us and we all know that on an intellectual level. It is just not a good thing for anyone to do. Choose words that will serve you well and write them down and put them where you can see them. You are fighting a battle, one that I truly think that you want to win. I know that you want to lose weight, be healthy, exercise and eat right and that you are a smart lady too. Find a way to plan how you are not going to get in the habit of binging again. There are tools and techniques to stop behaviors that are harmful to you and lots of practice makes them extra useful especially when stressful life situations come up and you have to be the most prepared. You are not alone, many are struggling with the same issues. . .
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Permalink Reply by acidrock23 on
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I can see that but, to me, if you are eating b/c of whatever reason (potato chip addict myself....so I'm not totally unfamiliar with the "mysteries" of which you speak...) you can either eat and calculate the bolus and end up "in the ball park" *or* you can eat and not calculate or take 1/2 as much insulin as you should and have two things to be annoyed/ upset/ depressed/ etc. about. If you can keep your BG in line while binging, it seems like you'd be more able to focus on why one is binging in the first place, instead of being distracted by cleaning up the diabetes debris everywhere?
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Permalink Reply by LaGuitariste on -
You make an excellent point. I find it easier to recover from a binge if I'm not bouncing around on the ceiling, hitting my head on 280's and 340's. Ow!!!
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Permalink Reply by Jen on
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I think it's like I posted above, eating sushi (or whatever) is "bad." We spend so much time trying to be "good," but no one can keep that up forever, 24/7 (or at least I can't!). And especially lately when I've been trying so hard, it just feels like defeat falling off the wagon again, even though I know tomorrow I'll start over again.
So it's like I eat this stuff and then feel guilty for eating it. So, yeah, I think the bolus just contributes to that guilty feeling.
There have been dark times in the past (even the not-so-distant past) where I've just gotten so sick of the whole diabetes thing that I've just gone, "Forget it!" and not covered a meal at all. Several times I even missed two or more boluses in a row. But sending my blood sugar to 600+ like that does nothing but harm and makes me feel like utter crap, and logically I knew that, but I still did it.
I think diabetes in general is a very, VERY emotional/psychological disease. Maybe I get too emotional about it. Some people are all logical and engineer-like. I really admire them. I am trying to be more like that, but after 20 years I still have lots of emotional reactions towards diabetes. Not sure how to overcome that. I tend to be kind of emotional/philosophical in general, so I think it's just part of my personality. It's kind of weird, though, because I was diagnosed as a kid and it wasn't really until my 20s that the whole emotional, "How can I keep this up forever?!?!" stuff hit.
I really like what people on this site say about taking it one day, or one meal, or one test at a time. I've been trying this lately and it helps. I don't get so overwhelmed with trying to be perfect forever ... just for this one decision, and I'll think about the next one when it comes up in a few hours.
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Permalink Reply by LaGuitariste on
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Absolutely: one thing at a time. One test, one bolus, one calculated meal, one pill. I can't think of those things stretching out in front of me "forever" or I go a bit mad. On my best days I'm all "get it done and move on". Very business-like and no more emotional about it than I am about brushing my teeth. Who feels like a failure when they have to brush their teeth before bed? You just do it and move on. You don't fret about having to do it for the rest of your life, right?
But D is fraught with emotional undercurrents for sure, all this "was I bad, or was I good" stuff.
T2 especially is prime "beat yourself up" territory, especially in a culture that is swamped with debates about "good" vs. "bad" foods and "ugly" vs. "pretty" BMI's and "those darn obese people are destroying everything from air travel to the medical system" diatribes.
Unless I operate from an almost clinically detached place within myself, I feel like a failure no matter what I do, because it's never perfect and it's never "enough". I can go there (putting on my proverbial white coat and getting out my clipboard and my fine-point pen) but I'm more of a roll around in the back of the VW van playing "Me and Bobby McGee" on my beat up old guitar while we drive out to the creek to swim and have a bar-b-que kind of girl.
God, I miss just being able to sit cross-legged on the sand with wet hair and a sunburned nose, eating watermelon with my buddies and never, ever thinking, "I wonder how many carbs are in this?"
Those were the days...
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Here's me taking out the big guns for sushi ... big combo bolus plus increased basal rate for eight hours. Let's hope it works!
I'm trying to learn to avoid this stuff 99% of the time, but bolus for it in a way that doesn't leave me high for hours when I do want it.
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Permalink Reply by LaGuitariste on
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You go, Jen!!! Aim for the center and keep shooting till it's down! LOL
I'm going to go test and bolus a bit more in your honor. ;O)
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Heh, yeah, didn't quite work out ... I was 220 after an hour and a half (bolus!) and 238 after two hours (another bolus!), so I'll have to be even MORE aggressive next time (whenever that is)!!!
Crazy, considering I don't think of sushi as that unhealthy, aside from the white rice part ...
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Permalink Reply by LaGuitariste on
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White rice slays me. It's like drinking double glucose or something, not sure why either.
I guess it's just super-easy to digest.
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Permalink Reply by Lila on -
I totally get what you say about big boluses being shameful.
It's double shame. Because first you feel like a failure because your body can't do something so simple and basic that almost everyone else's body can do automatically. (E.g. a friend of mine commented when hearing of my dx, 'How can you not be able to metabolize a croissant? That's crazy!)
And then doubly shameful because you then need extra extra help at the scene of the crime, so to speak.
I am currently on an insane insulin regimen due to being pregnant. It's particularly bad in the morning, when I need a couple of units just for oxygen. Then another couple of units for a cup of decaff tea with a splash of milk and no sugar. This morning, 1/8 of a bagel with a bite of egg and a strip of bacon required 12 units of insulin. (That's on top of what I need for the oxygen and the tea hahaha.)
Do I feel like a failure for needing this much insulin? Yes, all the time. But I so hate highs that I go the opposite way and set my phasers on high.
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Permalink Reply by peruvianpasohi on -
Have you discussed getting U500 insulin with your dr? You would only have to inject 20% of the volume. BUT YOU WOULD HAVE TO BE HYPER VIGILANT, to not mix up the different insulins.
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