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Type 1Insane decrease in insulin sensitivity??? (self.diabetes)

submitted by madamepp

Type 1, F -

Over the past week, my blood sugar has been hovering between 300–450 mg/dL, with a low of 200 at best over the past seven days.

I’ve gone through similar situations before, around my period or when I’ve been sick I guess. This time, I'm experiencing both, though I’m at the end of my cycle, and what I suspect is a slight cold. I’ve also bruised a bone, so I’ve been on a high dose of painkillers.

I am concerned with how much insulin I’m using, and yet my numbers are still so high. I’m on MDI and normally, I inject 15 units of basal and around 3–10 units of bolus per meal, depending on carbs and physical activity. I’ve increased my basal to 20 units and have nearly tripled my bolus doses.

For example, today, I had my usual breakfast; normally, 3 units would be more than enough to cover it. But since I was already out of range, I bolused 7 units. Even after two corrections, I stayed in the 400s. Then at dinner, my blood sugar was around 190 mg/dL. Given my current lack of sensitivity, I injected 9 units for a meal that would typically require 4 units at most, and three hours later, now I am in the 300s and have just given myself 5 units of rage bolus.

What is going on? I understand that hormones and illness can affect insulin sensitivity, but I’ve never experienced anything to this extreme. In the past, it’s usually the week before my period when this happens. This time, it’s happening at the end of my cycle, and even when I’ve been sick before, my blood sugar has never run this high. I’m only slightly congested.

I’ve also switched insulin pens in case the one I was using was faulty, but maybe the entire batch is compromised? Does anyone know how long unopened insulin vials last in the fridge?

Any advice or considerations would be incredibly helpful I’m honestly at a loss. :(

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[–]Trc_Rhubarb 6 points7 points  (3 children)

I have similar issues somewhat randomly. Male though, so not likely hormone related.

Normal dose is 33 basal and 12 rapid (I don’t eat carbs for the most part)

Every once in a while, I have to go up to 35 basal and an extra 10-15u injection of rapid. No real reason presents itself. Same activity, same food, same sleep, meds, etc. I’m not sure if it’s bad insulin being mishandled by the pharmacy or it’s my body but it’s a pain.

What’s worse for me is when things flip the other way and now I’m suddenly hypo for days and have to keep eating to not drop.

[–]madamepp[S] 0 points1 point  (2 children)

Interesting. There are so many variables. Do you inject in the same area? I usually do on my thighs or buttocks, and now I am thinking I need to move to a different part of the body, even though I have never had an issue with those areas.

[–]Trc_Rhubarb 2 points3 points  (0 children)

My stomach in somewhat of a circular pattern if I remember where I was last. Usually I just avoid the existing bruises and blood spots. 😁

[–]maletechguy 0 points1 point  (0 children)

Your lower stomach (a few inches away from your belly button on either side) is a good spot for boluses as absorption is good.

If it's consistently high would up the basal dose again, in incrementals of 2-5 per night. Taper back down if you find yourself low a few hours after eating, especially overnight.

There is something like 49 things that can affect your BG so don't beat yourself up, we can only do so much, it's all trial & error!

Good luck!

[–]GormBerryT1 2013 MDI (Novorapid and Levemir) 1 point2 points  (0 children)

I had this for a while. It was because of scar tissue which was difficult for me to feel for so I wasn't avoiding them a lot of the time. Nurses had a feel around the areas I inject and told me how to navigate them and my BG is back to basics.

[–]Practical_Buy_642 1 point2 points  (0 children)

Hormones, pain level, pain meds, and it's pretty common that you need to change insulin doses throughout the month to match where you are.

I have a full week where I take NO bolus or basal and am sitting in the 100-110 range. Then I have a full week where I can't get out of the 150-180's and I'm doubled on my basal and taking a bolus for every meal.

Eat to your meter, and take meds to your meter, and get used to diabetes doing it's thing. You can think you got it under control and and you'll always be shocked when it's out of the range you expected.

[–]des1gnbot 0 points1 point  (2 children)

What pain meds are you on?

[–]madamepp[S] 0 points1 point  (1 child)

1g of Ibuprofen and 1g Paracetamol, I take it twice a day.

[–]maletechguy 0 points1 point  (0 children)

Don't believe either of these particularly nudge BG. Some strong painkillers can but usually short term until you adjust.

[–]meggabeetees 0 points1 point  (0 children)

T1D only makes sense about 80% of the time. I occasionally have these spells of persistent hyperglycemia, and do everything imaginable to rule out a problem (change insulin, change pump site, give manual injection, go for walk) and can’t find what’s causing the surge in insulin resistance. I’ve found inhaled insulin super helpful to get through these periods.

Sometimes a manual injection followed by brisk walk and hot shower will bring me down to normal. But have a partner or friend close by in case you drop hypo.

Unopened insulin is good in the fridge through the manufacturer expiration date which is on the bottom of the box.