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3 Responses

  1. Anne
    Anne March 31, 2012 at 7:51 pm | | Reply

    maybe another option for Beth could be metformin? I don’t have any experience with it but I know of several type 1 friends who have used it to help with insulin resistance.

  2. Karmel
    Karmel April 1, 2012 at 10:42 am | | Reply

    Hey Will and Beth,

    I am not a doctor, but I worry about the attitude that, “But I don’t think the cause matters, it’s just an underlying fact. I think we should focus on treatment.”

    Insulin resistance in non-obese subjects is not well characterized (see, for example, http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0019878 ), but it could be a symptom of a larger problem, and I think at the bare minimum, Beth, you should get your cholesterol levels, lipid levels, etc. checked, as taking tons of insulin could be less effective overall than some insulin and something else that addresses lipid irregularities.

    Also, there is some inherent danger in focusing on the symptom of insulin resistance alone; not looking for an underlying cause would lead us to ignore the potential for other serious problems, like cardiovascular disease, that might accompany this single symptom.

    Good luck!

  3. Fred
    Fred April 5, 2012 at 5:30 pm | | Reply

    I was diagnosed with T1 diabetes 31 years ago at age 16(1981). As a young boy I thought insulin kept me healthy and never realized that I need to control my blood sugars better to prevent all the nasty complications . I was very skinny and started having pains in my knees at age 34. I saw many doctors, explaining that I had diabetes for 23 years and none of them even blinked an eye. After many MRI’s they found nothing. I started reading on the internet and realized that It was neuropathy(damage to the nerves) and getting worse.
    Not really understanding how things work I aggressively increase my insulin, going into many low blood sugar comas. I started to gain weight and my neuropathy went away never to return after going on an insulin pump and getting my A1C down. I started with much less insulin and as the years ticked by I became more and more insulin resistant and had to increased my insulin and were using 100 to 120 units of Novolog a day(basal + bolus) to keep my A1C’s between 5.8 and 6.1.
    A year ago I decided to go on a NO carb diet, wow, what a change, my blood sugars immediately stopped the roller coaster effect, my insulin usage dropped to 28 units a day and my BS readings stayed the same for hours without moving. My A1C’s went down to 4.9. While adjusting my pump in the beginning I had one low and haven’t had one since. I started to lose weight almost immediately. I am eating a very small amounts of carbs at the moment to keep my body from making ketones and to control my weight. The nice thing about this low carb diet is that when your blood sugars go a little low you can stop or lower your basal on your pump and it will slowly go up without needing to find food or glucose to force feed yourself.

    Beth is very skinny, telling me that her blood sugars are not under control. All diabetics with uncontrolled blood sugars have one thing in common, all of them are very skinny. Beth has to get her Blood sugars under control first. Giving her more insulin is just making things worse.

    Many diabetics listens to their doctor and expect their doctor to control their blood sugars for them…..SO WRONG!!!! He can give you advice but It’s your body and you have to control it yourself.

    Everyone is afraid of change but Beth needs to get off the Lantus and use her Humalog (short acting insulin) as a basal and bolus in her insulin pump. Go on a NO carb diet for a month. Believe me, she will feel better, will not crave carbs, her blood sugars will drop and her insulin resistance will decrease dramatically within 4 weeks. She will start gaining weight because her body will be able to use the sugar in her blood better and she will be able to control it with the amount of carbs she eats. Over weight diabetics will lose weight because it will be less carbs and no more eating unnecessary to get blood sugars up.

    While on the no carb diet she should divide her weight by 4 and set her basal on her pump to 1/3 at night and 2/3 during the day: example 103 pounds / 4 = 25.75 units/ day. Divided by 3 = 8.58 at night and 17.17 during the day. If you wake up with a high blood sugar in the morning set your pump for + 10%, + 20% until your readings are correct in the morning and adjust as you become more insulin sensitive.

    At about 3 in the morning our livers starts giving off an hormone called glucagon and raises our blood sugars to get us ready to wake up full of energy(well, that’s what they say) so, keep the amount of basal low from 12 Am to 3 Am and then go double until 8Am in the morning, not to exceed the total of 1/3 by 8Am(adjust accordingly).

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