32 Responses

  1. bellemead
    bellemead March 29, 2010 at 6:26 am | | Reply

    Hanna – thanks for your post — I feel your pain. I also neeed a 300 unit reservoir for less than 3 days. But my A1c has been under 6.3 for over a year and if that what it takes, then that’s what you have to do.

  2. bill
    bill March 29, 2010 at 7:10 am | | Reply

    See, this is why I read your blog — for real-world attitudes. Yesterday, I took about three times the amount of N that I normally do — but yesterday, that was what I needed! Sometimes I have to remind myself that its not a problem to occasionally have to do that kind of thing. That the goal is a decent level, and not (so much) how you got there.

  3. Bethany
    Bethany March 29, 2010 at 7:43 am | | Reply

    I looooooove this post! I also have a high insulin-carb ratio and a high daily dose on my pump. Its definitely harder to find quality equipment but it is SOOOOOOOO important to us. thanks for fightin’ for us insulin suckers, dorkabetic!!

  4. Cara
    Cara March 29, 2010 at 7:45 am | | Reply

    I have some insulin resistance and I take what some might call a “Lot” of insulin. But I keep myself fairly healthy and my medical team seems to have no problems with what I do. I agree that diabetes effects each person differently. And, hopefully, in the OC, we don’t judge. We just support. :)
    p.s. I’m glad to know I’m not the only one who takes a “Lot” of insulin.

  5. Leigh Ann Ehmann
    Leigh Ann Ehmann March 29, 2010 at 8:29 am | | Reply

    I totally agree with you, I am 16 years into my own Type I Diabetes and I am surprised whenever people, Diabetic or not, have the audacity to compare any one’s health care to another. I once had a fitness trainer who thought he could “get me off insulin” b/c he got a type II MAN off insulin! I fired him!

  6. Bennet
    Bennet March 29, 2010 at 8:54 am | | Reply

    I can understand the emotional need to fit in, to be the same, to be part of the in crowd, to be cool, to be part of the tribe.

    It seems to me that just having T1 sould be enough. Needeing to compare TDD seems nuts. Everyone has a different body mass, metabolizim, activity patterns, stress level, diet and a boat load of other stuff. All this impacts insulin needs. Makes ya kind appreciate how much ye olde pancreaus did befor it bailed out.

    Great bit.

    Thank – YDMV.

  7. Fred
    Fred March 29, 2010 at 9:05 am | | Reply

    I had type 1 diabetes for 29 years and use more than 110 units (basal + bolus) per day. I go through periods where I just cant get my levels down and have to take a bolus of 40 units or more to accomplish it. Cannulas start to leak when giving big boluses and it just make it worse. I always asked the question to pump manufacturers “What about us”, they make these pumps for kids and newly diagnosed. There is a British pump manufacturer that is so proud because their pump have unique ID so you can’t reuse cartridges. I refill my pump almost every day and it will cost me 30 cartridges/month. I’m not overweight and think that everyone will at some stage in their life get insulin resistance the longer they have this disease and we should all stand together and tell manufacturers that we won’t buy their product if we can’t refill for FREE.

  8. kungger
    kungger March 29, 2010 at 9:18 am | | Reply

    I also have a high insulin-carb ratio and a high daily dose on my pump. I agree that diabetes effects each person differently.

  9. xim1970
    xim1970 March 29, 2010 at 9:36 am | | Reply

    Very much agreed! We all do what we have to to live with this damn disease. Thanks for the post!

  10. Hannah
    Hannah March 29, 2010 at 9:57 am | | Reply

    I love the feedback! I am beginning to wonder if those prototype insulin pump backpacks are the answer. Why yes, I would like a barrel of Novolog, please, Ms. Pharmacist. :P

  11. Stacey D.
    Stacey D. March 29, 2010 at 10:09 am | | Reply

    I too take more insulin per day than lots of other PWD that I know. Sometimes I feel like I’m doing something bad but other times I have to remind myself if that’s how much I need to keep my bg in “target” than why does it matter? My diabetes management team has never once mentioned that I take too much. I think it’s something we do have to remind ourselves … although we all have the D in common, our bodies are vastly different and respond to elements of the D differently. And none of us should be judged for it. Good post Hannah :)

  12. Jonah
    Jonah March 29, 2010 at 10:50 am | | Reply

    I’ve read a couple of papers that suggest that U-500 insulin allows for better absorption for people who are sometimes taking doses of upwards of 50 units, and is recommended for those with a 200 or more units per day intake. Reading the articles, I suspect it’s under prescribed. People can and do use U-500 with pumps even though it’s not FDA approved.

  13. AngelaC
    AngelaC March 29, 2010 at 11:39 am | | Reply

    Hannah — Fantastic post! While my issue is opposite of yours (I take a very small dose of Lantus and have a relatively low I:C ratio), my problem is the same as yours: People who think they have the right to judge me and my insulin! When I’ve discussed my insulin dose in public forums, I have had people write back to me to tell me that since my insulin dose is so low, I either must be a child or I can’t possibly need it and why don’t I go on metformin or some other oral drug!? It’s enough to make you start doubting yourself, regardless of what you and your doctor have decided. I think about Bennet’s signature, which always reminds readers that Your Diabetes Mileage May Vary, and wish others would take that advice — for all of our sakes! Thank you, again, for making the point so eloquently and clearly.

  14. Penny
    Penny March 29, 2010 at 11:47 am | | Reply

    Great post Hannah! As a parent of a young ‘un who uses a lot of insulin, I even feel the backlash at times from other parents. I see it on their faces “She uses WHAT a day????” then the look of pity, as if my daughter with Type 1 must have ‘the sugars’ real bad (as opposed to their kiddos with Type 1) to use so much insulin and such carb ratios.

    I agree with Bennet wholeheartedly on this one. Isn’t it enough just to have this lousy disease? Do we really need to ‘classify’ within the tribe into who might have it ‘worse’ and who has it ‘better’? Seems like a waste of time to me. We are all members of a club we never wanted to join. Enough said.

    Great post Hannah and great blog!

  15. Michael Ratrie
    Michael Ratrie March 29, 2010 at 11:49 am | | Reply


    FWIW – the Accu-Chek Spirit cartridges hold 315 units. Unfortunately, the max bolus is 25.

    Nice post,

  16. George
    George March 29, 2010 at 12:09 pm | | Reply

    Once again I feel less alone. Thank you SO MUCH for this post Hannah. I can MAYBE get two days out of my reservoirs. I too use the 722.

  17. k2
    k2 March 29, 2010 at 3:37 pm | | Reply

    AGREED – Great post Hannah!
    Kelly K

  18. Big Mac With Cheese
    Big Mac With Cheese March 29, 2010 at 6:03 pm | | Reply

    You hit it. I have two type 1 nephews that have MUCH lower insulin requirements than my insulin resistant type 2 butt does. Plus that now that I am on chemo having to deal with steroids. My insulin dosing is going though the roof! 160+ units a day!

  19. tmana
    tmana March 29, 2010 at 10:22 pm | | Reply

    As an “outsider” listening in to the conversation, what I sometimes hear as the undertone to the “you really need that much insulin?!?!” remark is an indictment of body mass and carb consumption, both ASSumptions based on the perception that body weight over BMI 22 implies insulin resistance (“so if you were really concerned about your health, you’d lose some weight!”) and that the more carbs one consumes, the more insulin-resistant one becomes (“if you’re using more than x units per day, you need to go back to the Atkins induction phase and stay there”.)

    Obviously this is another division of the Diabetes Police who mean well, but who don’t know your body.

  20. T1 in Boston
    T1 in Boston March 29, 2010 at 11:10 pm | | Reply

    I learned a lot from this post (and the responses) – AND got introduced to a great d-blogger (you go, Hannah!). If I ever have a (good) reason to ask someone their TDD, I will be very mindful!

  21. » Basal/Bolus Mix-and-Match - DiabetesMine: the all things diabetes blog

    [...] Diabetes Support or Suspicion? (aka Don’t Question My Insulin Dosing as Long as I’m Heal… [...]

  22. David
    David March 30, 2010 at 9:58 am | | Reply

    the upcoming Solo pump probably not a better option for you but its insulin reservoir swaps in and out of the pump easily and you can add insulin at any time (vs Omni). The fill process is just one action. The capacity is only 200mL but filling is easy because the insulin goes straight from the vial into the reservoir vs withdrawing insulin into a fill syringe first and then injecting into the reservoir.

  23. Kathleen Weaver
    Kathleen Weaver March 30, 2010 at 10:38 am | | Reply

    Your mileage may very, but I do as many as 100 units of insulin a day, and I have found my skin breaks down if I try to put more than 200 units in the hole.

    So yes, I change my site every other day (or even a day), for that very reason.

  24. Erica
    Erica March 30, 2010 at 2:16 pm | | Reply

    Well said. It often seems like people brag about how low their insulin requirements are and it so soooooooo so annoying.
    Even more annoying than bragging about low A1C.
    This was an extremely inspiring, and much needed post!!!!
    ((((((HUGS)))))) to you

  25. anonlurkermom
    anonlurkermom March 30, 2010 at 5:40 pm | | Reply

    my daughter uses over 100 units humalog per day. I have to stop myself from saying that is a lot. It’s just what she needs. Just another number that is just a number.

  26. Lyrehca
    Lyrehca March 30, 2010 at 8:46 pm | | Reply

    “Well, here’s the real scoop: what you might call a lot of insulin might just be what I call the amount of insulin that keeps me healthy.”


    Excellent post, Hannah!

  27. G
    G April 5, 2010 at 12:16 pm | | Reply

    Great Post Hannah! Do you think those who feel the need to comment on higher daily doses are just nosy, or do they have some real concern that we need to take so much? I mean, if my pancreas worked, who the heck knows how much insulin it would need to kick out to keep me healthy, right??? Side note, I’ve had type I for nearly 18 years (joy) and have in recent years been facing more and more insulin resistance, and therefore weight gain, and not-so-great control. My new endo has recently put my on extended release Glumetza (unheard of supposedly for Type I’s–as in “that med is only for Type II’s”) in addition to my insulin, and it has totally been helping! Just wanted to share, in case any others were interested in looking into it. I’m beginning to hear a bit more here and there that more Endo’s are starting to warm up to the idea that YES IN FACT you can be both Type I and insulin resistant :) Thanks again for the great post….

  28. Scott K. Johnson
    Scott K. Johnson April 6, 2010 at 10:33 pm | | Reply

    I love this post Hannah (and how fun to see you here!). You are so right about us all being different, and doing things differently.

    How about when another D asks “what’s YOUR A1C?” How about none of your damn business!? :-)

  29. The Work is Never Finished. « Lemonade Life

    [...] was 1 unit for every 25 mg/dl I wanted to drop. It was a lot of insulin, and although Hannah recently wrote that it shouldn’t matter how much insulin you’re taking, so long as your diabetes is [...]

  30. floreksa
    floreksa July 20, 2010 at 2:28 pm | | Reply

    I just started w/ the Revel on Sunday and BINGO today I hit the 25 unit “MAX DOSE EXCEED”. Gee thank MM, but I need more than that… I miss my Cozmo.

  31. The Work is Never Finished. | Lemonade Life

    [...] was 1 unit for every 25 mg/dl I wanted to drop. It was a lot of insulin, and although Hannah recently wrote that it shouldn’t matter how much insulin you’re taking, so long as your diabetes is [...]

  32. Wolf
    Wolf April 5, 2011 at 10:35 am | | Reply

    Aw, xxoxx. I’m just about to start using a Revel pump next week, and (being insulin resistant type 1+2) while practicing with the pump I kept hitting the max bolus warning, and went web searching for ways to get around the 25U max, like maybe with a secret mfg menu workaround or something.

    Your information suggests I’m xxoxxed and there’s no way to even hack around it. :( Bummed before I even get started with it.

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