Replies to This Discussion

Permalink Reply by Anthony Holko on December 7, 2012 at 7:38pm

Using a pump should help since you can tailor your basal needs but going on U500 I would stall until all other options are exhausted. Give victoza a try.

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Permalink Reply by brokenpole on December 8, 2012 at 3:21am

Leslie, I'm sorry if someone else repeated this information. I am on my way to dialysis and didn't want to forget to respond to you.

I used to take U500 insulin (5x stronger than U100) to the tune of several hundred units per day. Now some of that was my fault. I was not eating right. At that point I had given up and figured why should I fight it.

As my BG readings came in control I started using less and less. But still I was taking mega doses of insulin.

I went to see an endo here in MS that started me on Byetta. That started the transformation. I am now on 5u Humlaog before each meal and 40u of Lantus daily. A far cry from where I was 4 years ago.

Talk to your medical team about something other than Levemir.

Also, are you seeing an diabetes specialist or a regular family practice? If you are not seeing an endo...might I suggest that you look for one and see them.

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Permalink Reply by Brian (bsc) on December 8, 2012 at 5:14am

Wow, using 60 units of rapid for a meal does seem high. And as others have said, high blood sugars and high insulin levels "cause" insulin resistance. Many people find that once their blood sugar levels normalize, their insulin demands decrease.

It also seems out of whack with your basal insulin (Levemir). I am a T2 on insulin and I also consider myself insulin resistant. So I eat a low carb diet, not a fairly low carb diet, a really low carb diet. Years ago I found Dr. Bernstein's "Diabetes Solution" book and it really helped me understand how much carbs played a role in my blood sugar problems. For me, I usually eat less than 50g/day in carbs and I bolus under 10 units for meals, usually just a few units. Compared to my basal, which is 55 units/day, my meal boluses are very small. I actually think that a serious low carb diet can be really helpful for those of us who are very insulin resistant, which by definition means we cannot tolerate carbs.

Many educators will suggest that for the recommended diet of 45-65% of calories from carbs, you will have your Total Daily Dose (TDD) evenly split (basal/bolus) at 50/50. Mine is more like 75/25 or even 80/20. Just some thoughts.

Please have faith, you can get your blood sugar under control and you can improve the insulin resistance. A pump will really help, allowing you to more safely correct your blood sugars down to normal levels

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Permalink Reply by Aimee on December 9, 2012 at 10:44am

Hi Leslie,
I too am extremely insulin resistant. I take 100 units of Lantus a day, although my doctor asked me to split into a morning and evening injection (50/50). Also, Metformin helps keep my blood sugars down. If I forget to take a dose, my blood sugars are definitely much harder to manage. If you are not still taking Metformin you may want to talk to your dr. about going back on it. I am more insulin resistant in the mornings, so I take more insulin in the mornings than the rest of the day. I find that once my blood sugars get above 200 it gets harder to get them back down. I am hoping that once you are able to get your numbers a little lower you will find that it will be easier to keep them that way and you will feel better. It is no fun having high blood sugars! You are definitely not alone. Keep fighting; you are worth it!
Aimee

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Permalink Reply by jims on December 11, 2012 at 1:30pm

Stemwinder has it right and makes extremely inportant point about diet and exercise.

he doesnt tell this part but it has to do with glucose saturation.

As the temporary glucose storage sites on the skeletal muscles get fully loaded, the muscle cells keep down grading the insulin receptor sites of the cells to the point the insulin just keeps ciculating around blood system like water doing nothing.

Exercise - sufficient - 1 to 2 miles walking get that loaded glucose of skeletal muscle sites burned off making more room.

Room to store glucose means blood glucose kept down.

The infinite wisom of medical science has been conned over the infinite glucose storage capacity of human skeletal muscles - just add insulin and/or actos and that will keep the glucose out of blood system - good luck there. Comments in this blog suggest something else.

Decent diet 1200 calories helps prevent over loading of storage. Metformin in sufficient doses and i prefer stringing around clock rather than one or two large doses will keep liver arrested.

in past, i could watch 26 units of humalog 75/25 do nothing till walked 2 miles and the see blood glucose drop down to a 100.

best wishes and good luck.

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Permalink Reply by april on December 13, 2012 at 6:37pm

You may not be resistant, but worsening. From what I have been reading since I have the same problems you do. I went from being prediabetic, to 1 500 metformin, to 2 500 metformin to 1500 metformin. Then to 5 different other meds. I didnt realize the side effects especially stomach issues. This was not controlling my sugar levels but the metformin was actually making me sick. Now off the metformin, finally the doctor listened, I feel 70% better than before. I started on 8 units of Levimer now on 12 units and he wants me to start a instant pill you take 5 minutes before you eat 3 times a day to stop any spikes. Besides being nervous to take it, I dont wanna be sick again. I have other issues tho. IBS, gerd, high blood pressure, and high cholesterol. I am very sensitive to any pills and the diabetes pills just don't work on me. Over-time diabetes only worsens, its proven..whether you lose or gain weight. I haven't eaten pasta in 4 months, and now trying to learn to stay away from bagels, they are making me spike and get me sick. It's a fact, medicine is just a band-aid and you have to make the life style changes to get better. It stinks right?? I am tired of fighting with my doctor's, they don't get it and like my endos secretary said pills are a big business. I am ready to try a vegan diet because its just not worth the hassle of dealing with uncredited doctors who really don't care. In the back of their mine, they are just thinking that we are unhealthy people who don't care. When in fact, we are the ones that care the most of making better of our mistakes, or its something we just can't help. My entire ancestory comes from a long line of diabetics as well. My highest numbers have been about 235. years ago it was only 120. There is always hope, and you can fight this with all of us. Never give up...and determine with your meter what foods are causing these spikes..that's what I have been doing. Veggies always seem to help

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Permalink Reply by Jeannie Wagner on December 14, 2012 at 12:26pm

Are you still taking Metformin to deal with the Insulin Resistance? I am also very insulin resistant. I lost all the weight I can without being underweight. The best things for my IR is daily exercise 1-2 hours. I find walking 3-4 miles is best. As said above go as low carb as you can tolerate. Giving up all wheat products really helped my IR. I still have to watch carbs, arou d 10-15 carbs per meal.

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Permalink Reply by jims on January 3, 2013 at 9:37am

That matches my experience. My read is that the exercise and for me was 2 miles min walking and 1200 calorie diet - drop the grains/flours way back helps get the body working better. My read is that it is glucose saturation of the temporary glucose storage sites of the skeletal muscles and fat cells that pushes up the IR. Burn some of that stored glucose off and reduce calorie input - nee grains and voila; there is room to store more glucose - maintain regulation.

Medical Science has yet to acknowledge that the glucose storage in the skeletal muscles is finite and can saturate. The muscle sites as they fill up downgrade their insulin sensors and thusly it takes more and more insulin to force in the glucose and if one is in to jacking the stuff in - use actos.

I meant to add that metformin used in sufficient doses is critical to corral excess liver glucose release adding to the saturation.

Best wishes and good luck!

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Permalink Reply by Autumn Haley on January 3, 2013 at 9:11am

I'm agreeing with several of the others' posts here. I also have severe insulin resistance and am very frustrated with the HUGE amounts of insulin I've had to take. I was taking the same amounts of Levemir as you however, I was just gaining weight. I was also taking Novolog before every meal. My last A1C was 8.4, my highest ever!!! I freaked out. My new dr. put me on a new insulin instead of Levemir. Its more concentrated (I forgot the name of it, sorry) and so I only take 20 or 25 units in the AM/PM instead of 60 or 100. It is amazing! I wake up under 100 almost everyday instead of waking up at 200-250. Since I changed I don't think I have ever been over 200 all day long.
Another change she made that I think is helping a LOT is with my Glimeperide...I went from taking 2 in the AM to taking one in the AM and one in the PM. She also put me on Victoza. These changes have helped me stay low. I have also started Exercising, which I absolutely hate but because I'm boxing instead of walking the treadmill I "kind of" like it better and can tolerate it more.
These small changes have made a world of difference for me but I recognize we are all different. I hope some of this helps someone :)
Blessings, Autumn

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Permalink Reply by Belila on January 3, 2013 at 10:54am

Hi haley, can you tell me what is teh name of that concentrated insulin as I am doing bad with levemir

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Permalink Reply by Brian (bsc) on January 3, 2013 at 1:16pm

Regular U-500 is the name of the concentrated insulin. It is five times more powerful allowing smaller injections. The downside is that U-500 is really slow, more like a basal insulin and it is also quite expensive, > $500/vial.

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