For people with Type 1 who develop insulin resistance, does the insulin resistance develop slowly, or can it develop quickly over weeks/months?

Over the past six months or so I've been needing to take WAY more insulin than I used to with no obvious cause (no major change in weight, bloodwork fine, not feeling sick, etc.). I thought maybe I'd developed "double diabetes" but it developed over a period of about a month, which seems really fast to me.

I am taking the same TDD of insulin eating 55-65g of carbs per day as I was eating 250-300g per day over the summer! The other day I slacked off and ate about 225g in one day and ended up taking double the amount of insulin I would have needed before, and still had high blood sugars (had a TDD of 87u, while in the summer it would have been about 43u for that many carbs).

My endocrinologist doesn't seem to think this is a big deal, and maybe it's not and I'm finding it disturbing for no reason. I'd like to know if others have had similar experiences and maybe it is as simple as "double diabetes" (rather than some unknown medical cause, which is what I keep worrying about!). The only other thing I can think of is that for some reason Apidra has just stopped working for me.

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hi Jen `

Interesting topic. My endo hasn't discussed insulin resistance with me, but I am on a low dose of metformin (500 mg twice daily) to be sure that any insulin resistance is minimumized. I sometimes wonder if Apidra stops working for me, and about the time I am ready to change infusion sites, my blood sugar goes low! I try to eat reasonably, but sometimes treat myself to ice cream or just pig out, even when I shouldn't. If I go high, my numbers some down in a reasonable time. It seems as if I have waaaaay more control with the pump than with MDI.

I always thought insulin resistance was more common in type 2 diabetics. I am a LADA diabetic, and the metformin is a continuance of type 2 meds, although the endo lowered the dose considerably.

I know I haven't answered any of your concerns here, but I will be interested in following this thread. Thank you so much for bring it up. You rock!

Brian Wittman

I've had Type 1 since childhood and I've heard that it's not that uncommon for people who have had Type 1 for decades to develop some insulin resistance. I'm wondering if something like metformin might help me, but at the same time I really don't like taking medications and my insulin dose is not horribly high (just a lot higher than it was!).

My CDE tells me that metformin is a pretty benign drug. She tells me that they put a lot of type ones on it, just to help with insulin resistance. Other than the possibility of a slight lactose intolerance, it is very safe. It doesn't affect me at all.

Metformin is pretty safe, but if you have any indication of kidney issues your doctor should be careful. There is a higher risk of lactic acidosis.

The only time I've ever had this happen is when I have had an underlying infection or illness. I think sometimes our bodies fight infections/illnesses without us even knowing it (i.e., there aren't any outward symptoms of being sick). That said, when I have had this happened, it has been relatively short-lived, not lasting longer than several weeks.

It definitely sounds like you've developed insulin resistance. However, I also know that my insulin needs go up by about 8-10 units/day during the winter months (and decrease as soon as the weather warms up). During the summer, I am definitely able to be a bit more lenient with my diet, as I become extremely insulin sensitive. Has your change corresponded to the weather or to being more sedentary?

That is interesting, and I too would be very concerned if my insulin needs increased by that much over such a short period of time.

I'd say this started in October/November so it did correspond with the weather. Maybe it will all go away in Spring. That would make me very happy but would be a huge shift in insulin requirements!

Hi Jen

I was diagnosed at 34 treated for a very short time as a T2 but the oral meds had no effect and my health continued to fail was put on isophane, NPH, then Lantus/novolog, then a pump. My TDD was stable for many years and my weight has dropped. When I was using Lantus/novolog my TDD was about 25-30 units for years and then slowly over a few years it doubled some days even a little more. I seem to have weeks where my insulin is not as effective but it can also go the other direction for several weeks. It's seems like my TDD is stable, it's hard to cut back on insulin.

My endo says not to worry just use however much you need...just don't start eating the door off the fridge. The biggest change to my life style has been activity and I would suspect if I could go back to the activity level I was 15 years ago then my TDD would be about half of what it is now.

Uh, no chance you're pregnant, is there?

Nope, no chance at all, but good suggestion!

I too have suddenly like almost over night needed more insulin too. And Ive seem to have developed DP as well. I went to be last night around 160 at midnight...cause I was running so low at dinner time. Corrected...and was 268 at 6 AM. I guess I really need to start dragging my butt out of bed at the god awful hour of 3 AM to see what's going on. I seem to be doing fine literally though according to my CGM until about 5 AM. Its strange I agree and I find it disturbing too.

It's been about a month now since I started taking 500 medformin before breakfast ( around 10-11) and 500 medformin around lunch time(3or 4 pm) I know you might be thinking that I eat late and dinner around 7or 8 but it's so weird that these times just work so much better for me if I eat breakfast upon rising (6am ) I end up going low within the next 2 hours or high cause I sometimes will purposely underside cause on those days that I have to be at class around 9:30 I just cannot deal with a low . If I get a low on the way to class it's so hectic I can't drive , I have to eat what I don't want and than I overtreat cause I'm so nervous while driving that I sip coke cola while I'm driving after I've already treated that low . So I just let the bloodsugar upon rising stay the same cause all I let myself have is coffee with cream and like this morning I woke up at 160 and 4 hours later I was 133 . Anyway about the medformin it has changed my life I mean this pill works so well for me . I've been on the pump for 12 years and always had very smooth control and then all of a sudden ( like the last year ) it's been horrible. I would eat like 30carb for dinner which usually would only take 2 units and I was taking like 8 units . So I think you would really benefit plus it helps with suppressing the appetite . Whenever I don't take it I get so hungry late at night and when I do take it I still might feel hungry ( cause I'm on diet) but the hunger is bearable like I don't feel ravinous where I can't curb the hunger

No your concern is fully justified. I don't find double diabetes fun. Sometimes I inject 12 units of insulin and it has the same effect as if I squirted it on the floor.

IR will also insure that you gain weight which is not fun.

Our Richard was a pure type 1 but did develop IR later in life.

Metformin if your body can stand it is about the only drug we have left that is considered safe for nearly everyone (not me).

Exercise also helps.

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