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 LaGuitariste on -
I honestly had no idea that such a thing existed on this earth.
Huh.
I'll ask him about it. With my big boluses on "normal" days, you'd think he'd have mentioned it.
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Permalink Reply by MossDog on -
Usually you can't just go to any pharmacy to get it (not sure if GH would cover or not) and like peruvian said it can be dangerous if mixed up. It also has a slow onset and a quite wicked tail (obviously everyone is different....) so by and large I do not see a whole lot of it used. I do think when this size of a bolus is needed though............
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Permalink Reply by Natalie ._c- on -
Well, dear, you just described me to a T. (Or is that an N?) When I'm depressed, I have to FORCE myself to test and bolus, and I DO binge. Did it twice in the last 2 weeks -- with angel food cake, and chocolate layer cake, and butter cookies, and ice cream. I have a CGM, but I DON'T have to look at it, and I AM capable of going up into the 400's without any trouble at all. I did eventually force myself to bolus my BGs down, but I also have the problem of there being the lasting effect of driving my BGs higher than I want.
I also have the problem with not injecting enough insulin. I just had a cup of tea with some Kavli crackers and cream cheese, and it came up to 26g, but I only bolused for 15. I think it's sort of wishful thinking -- hoping that maybe my moribund pancreas will kick in with a little, although I know that it won't. I also let myself run at 150 all night long, hoping that just maybe, my pancreas would work if given enough time, but it didn't. Maybe I need to have a funeral for my pancreas, because it's really not showing ANY signs of life.
I had a long talk with my psychologist about it, and realized that I binge and struggle with treatment because I'm feeling BAD about myself, and I'm throwing a tantrum, screaming for help. Which is hard, if not impossible to find. One resolution I've made, but not had any success in following yet, is to absolutely NOT read the media. If the word "diabetes" comes up and it's not in a scientific journal, and does not specifically say Type 1, then I need to close my eyes and turn the page. Even in your case, where you ARE a Type 2, most of what the media says does NOT apply, and you are better off not getting near it. You are an individual, not a statistic, and you just don't need the crap.
I also make bargains with myself when I really can't resist a binge. I'm going to quote our fearless leader, AR: "Go ahead and binge, but BOLUS for it!!!!" It's probably going to take time to figure out why you binge, but your immediate well-being is much more important. If I binge, and bolus for it, and keep correcting, and therefore keep my BGs in a relatively good place, I've won half the victory. The other half is concentrating on eating better for the next few days to try to get my "groove" back in the right place. Current groove is 120 - 140, whereas I'd REALLY like it to be 70-90, but will settle for 100 - 120.
Nobody ever said diabetes would be easy, no matter what the particulars of your own case -- but I really appreciate your talking about it, especially since I have some of the same problems. Just gotta remember to keep on slogging.
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Permalink Reply by LaGuitariste on
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Yeah, it's tough. Of course, I have no trouble telling you, "Oh, gosh, go ahead and bolus for it, Nat." But do I heed my own good advice?
Sometimes...
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Permalink Reply by Natalie ._c- on
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The reason I allow myself to go ahead and bolus for it is because the alternative in my case is NOT to bolus for it, but binge anyway, and I almost killed myself doing that last year. I DO agree with the person who suggested shining the light on WHY we binge, but first things first, which, in my case is keeping myself alive (and I HOPE the same goal in yours.)
I don't usually bolus ENOUGH for the binge, mostly because I don't know how many friggin' carbs there are in the food, nor how much I'm going to eat. But again, the agreement with myself is that I keep checking hourly, and keep correcting until I get my BG down. I had a problem last year in that my boluses and corrections were way too small, and I never did come down satisfactorily -- go up a lot, come down a little, go up more, come down a little, etc. And this was with all food, not just binge food. So the agreement now is that I take as much as I need, EVEN if I throw myself low. (Thanks, AR!!) I have good hypo awareness, and I can catch them before they go dangerously low. I don't like them (actually, am terrified of them), but that's the price I have agreed to pay for bingeing.
Of course, I am only talking about my own experience, may or may not be relevant to you, but I think the process of making a plan for handling binges is better than just bingeing mindlessly, and then feeling sick and guilty afterward. I don't need to punish myself even more when I already feel like the worst, most unloveable woman in the universe. Taking care of my diabetes is self-love, EVEN though it is sometimes almost impossible to do it. Still gonna keep tryin' . . .
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Permalink Reply by Gerri on -
500 U insulin is a great suggestion.
Aaah, indeed, why do we do the things we know we shouldn't? Denial, rebellion & then inevitable shame & self-punisment followed by more rebellion & denial & indulgence. An inter-related complex web. I'll pretend I didn't really eat that much by under bolusing. I'll punish myself by taking my lumps with high BG. Ooo, I'm so "bad"--further proof I can't do this. Easy to get too caught up in the overwhelming daily minutia, over think, over analyze & toss it all out. Another avoidance strategy.
Understand the fear of lows. It's real. It feels horrible. We all hate lows. Easier to correct a low than a high, though. Nothing I detest more than the high/low roller coaster scene & I'll do anything to prevent both.
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Permalink Reply by LaGuitariste on
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Part of it is, I think, that I ran so high for so long that I'm more scared of seeing 79 on my meter than I am of 179.
I have now printed across my log book sheets:
Remember: Anything between 71 and 99 is normal.
I have an irrational fear of double-digit readings, but I'm working on it.
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Permalink Reply by Gerri on
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Jean, I'm the opposite:) I get white hot mad at highs. Know I'll be spending the rest of the day or night testing & attempting to bring numbers down. Feels like it takes forever to get back into range. I get impatient & frustrated when the high is already physically making me feel irritable.
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Permalink Reply by LaGuitariste on
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Oh, I hear you loud and clear. I did that a couple of times in my teens and learned my lesson.
If only it were as easy for me to avoid over-eating as it is drinking. I could go the rest of my life without drinking a sip of alcohol and I'd never even think to miss it.
Over-eating mountains of food? That's another story.
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Permalink Reply by lotsofshots on -
Gerrie, that is what worries me, the binging is the main problem and the one that will effect our health and well being in the long run and make us feel like crap every time we do it. There is only a few minutes pleasure before sick feelings, guilt and the impact of what we have done hits home. A big bolus is not going to really address the real issue of why we are doing something harmful to ourselves in the first place. No food we eat when binging can do anything but worsen the psychological problems, and the future of our health. Nobody binges on carrots, salad or tuna and such. Usually this is an ongoing thing. It is not like most of us are in good enough shape to run off the extra calories later and maintain our weight or leave a sufficient time period between binges to assure ourselves that we have a healthy diet most of the time. That is what needs to be addressed and all of us are having a hard time letting go of the idea that first we treat the binge and later we will figure out the rest and reach our goals. I think it is better to shine a bright light on the binging behavior itself and do whatever we can to help each other to admit that nothing is going to get better for us until we can get it out open and look at what we are really doing to ourselves. Why really are we perpetuating a state of hormonal misery that can only harm us in the future and make us feel awful every time we do it and take us further from the goals that we really say we want to achieve?
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Permalink Reply by LaGuitariste on
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I agree with every word you wrote. Thank you for your sincere honesty.
I just need to...stop it.
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