Insulin Resistance in a Type 1 Diabetic

rated by 0 users
This post has 14 Replies | 4 Followers

Top 75 Contributor
Female
Posts 12
KristenRadloff Posted: Tue, Sep 6 2011 10:49 PM

I have been diabetic T1 for 17 years. I am 23 now. About 6 months ago, I became severely insulin resistant. My typical hourly basal of 1.2 quickly rose to 9.0 and that didn't even budge my sugars from the upper 300's. However, later in the day, it was as if all the insulin started working and I would crash with lows in the 20's. I have 2-3 episodes a day where I am completely resistant to my insulin, but the rest of the day I'm fine. Whatever insulin I give during my "episodes" comes back to haunt me hours later. I have seen 7 different doctors in Raleigh, NC and they have ran several tests. None of them know what is wrong. I did test positive for Insulin Anti-bodies. And from what I understand, the anti-bodies will latch on to my insulin, try to destroy but then release it all hours later. This sounds like what is happening. Problem is, no one knows how to treat it. I am miserable. Prior to this, I had A1c's in the 6 range. Finally, yesterday, my doctors recommend that I make an appointment at the Joslin Center in Boston. I am planning a trip for October. 

Has anyone ever experienced this? Does anyone know of any treatments??

 

Update: After doing a lot of research and reading many posts on this issue, I have found another girl who ALSO started having these issues. The only thing we had in common was starting zyrtec within the last year. I wonder if the zyrtec could have done something to our immune system? Causing it to create more anti-bodies??

Top 25 Contributor
Posts 120
amrad replied on Wed, Sep 7 2011 6:55 PM

I wonder if going on a different insulin regime would help (maybe the cells are attacking the Humalog insulin, maybe use a long acting insulin, and a regular), could be your body is reacting badly to the insulin. I assume you are using a pump. Another possibility is a different diet.

Have you tried not using Zyrtec to see if things go back to normal. Have you asked your Dr or Pharmacist to submit a inquiry to the manufacturer on this possible side effect, when we had a pharmacist at work about 10yrs ago she would submit them.

 

Top 500 Contributor
Posts 2

Wow, that is interesting. My allergies have been bad this year and I take Zyrtek D and allergy shots. Worst blood sugars ever,this year....BUT I do have very brittle diabetes. I have had diabetes 26 years now. I am always following doctors orders. now I can't control it at all and I use a pump.

 I am wondering if there is an inpatient diabetes program where they can watch my foods,excercise and alter my dose as needed. TIRED OF FEELING BAD_in texas but will travel for good care.

PS-the often used areas or sites of insulin injections (pump use) can cause scar tissue to build up at those sites. Are you alternating your sites?

 

Top 10 Contributor
Posts 173
zrebiec replied on Mon, Sep 12 2011 8:06 AM

Lisa,

As I mentioned in my response to your other post - you can no longer get an inpatient admission for diabetes education and blood glucose control. Our Joslin Clinic inpatient program was replaced in 1995 by our 4 day intensive outpatient management program - DO IT - you can find more information on our Joslin website or call Joan Beaton, the program coordinator, at 617-309-2628.

John Zrebiec, MSW, CDE

Joslin Moderator

 

Top 75 Contributor
Female
Posts 12
KristenRadloff replied on Tue, Sep 20 2011 8:29 AM

I have tried every insulin out there: Apidra, Levimir, Lantus, Humalog, Novalog, Humilin N, and Humilin R. All of them had the same effect on me. I have tried going off the Zyrtec and it has not made any difference. I was using a pump when these episodes started but my doctor pulled me off, because she wanted to make sure it wasn't a pump default. I have been to see 7 different doctors in the last 3 months, no one can help me. I have tried reaching out to the Joslin Institute, but I haven't gotten a response from them either. I am willing to fly up to Boston, but I have to know that I will be admitted into the hospital. I can't just fly up for one visit. 

Have you been tested for insulin anti-bodies?? I am wondering if my body started producing them after I had the allergy testing, as an immune system reaction. 

I go through episodes throughout the day where my insulin will completely stop working. The lantus (I took 3 hours ago) will just quit, and no matter what amount of humalog I give, my numbers won't budge. Then, hours later, it's as if all the insulin comes crashing back down on me.

My doctors here, told me that there was nothing more they could do for me.

I wish someone who works at Joslin would respond to this email and give me some advice on what kind of appointment I should schedule.  

Top 25 Contributor
Posts 120
amrad replied on Tue, Sep 20 2011 6:29 PM

Just saw this article,

http://meridianvalleylab.com/insulin-resistance4-steps-to-curing-the-common-condition-your-doctor-may-be-overlooking/

Maybe your Doctor should set-up an appt/admission with the Joslin.

US News and World report rates John Hopkins in Baltimore as #3 for Endo. Joslin made #16.

http://health.usnews.com/best-hospitals/rankings/diabetes-and-endocrinology?page=1

 

Top 500 Contributor
Posts 2
plusones replied on Tue, Sep 20 2011 11:51 PM

A Type 1 doesn't produce their own insulin anymore. So the Type 2 issue of being resistant to the body's insulin is moot, since the body doesn't produce insulin. However, a Type 1 can become insulin resistant, in other words, resistant to the injected insulin. But that is not going to cause any disease, it just means the insulin-resistant Type 1 has to inject more insulin per unit of carb than someone who is insulin-sensitive. On the other hand, someone with Type 2 could get Type 1 on top of Type 2. This is how it would happen: the person is insulin-resistant and their body doesn't respond to the insulin they make, so blood sugar goes higher. But they are still making some insulin of their own. However, if they were to then suffer a Type 1 autoimmune attack, the beta cells in their pancreas would be killed off and they would become insulin-deficient. If they were not on insulin previously, they would have to be completely dependent on exogenous insulin to survive. So to use the eyes analogy, they would go from partially blind to totally blind.

 

plus ones

Top 25 Contributor
Posts 120
amrad replied on Wed, Sep 21 2011 6:25 PM

There is a formula to break insulin resistance, remembering reading about it when I was dx in 1981. It had to be done in the hospital, I believe you kept on increasing the insulin dose until it started to work.

I wonder if animal based insulin would work for you, unfortunately you need to get it from the UK or Canada, as they stopped making it in the US.

https://www.getcanadiandrugs.com/ProductSearch.aspx?s=hypurin%20insulin&DrugID=71065

 Has your doctor tried you on U-500 insulin? In my old Joslin book from 1978 they mention someone who needed U-5000 insulin to break their resistance. Only Lilly makes it in Humulin R for these cases. http://pi.lilly.com/us/humulin-r-u500-pi.pdf

Top 25 Contributor
Posts 120
amrad replied on Sun, Sep 25 2011 10:06 PM

an article on the U-500 insulin from the ADA

http://care.diabetesjournals.org/content/28/5/1240.long

 

Top 10 Contributor
Posts 173
zrebiec replied on Mon, Sep 26 2011 7:35 AM

Kristen,

The Joslin Clinic is an outpatient facility. We have not had an inpatient unit since 1995. It's very rare these days that insurance will allow a hospital admission for uncontrolled diabetes. You might want to consider our replacement for the week long inpatient program that is a 4 day intensive program called DO IT (Diabetes Outpatient Intensive Treatment).The coordinator, Joan Beation, can be reached at 617-309-2628.

John Zrebiec, MSW, CDE

Moderator

 

 

 

 

Top 500 Contributor
Male
Posts 3
lb1109 replied on Sun, Oct 30 2011 5:27 AM

Here are some articles about diabetes, and I hope to help you

http://www.diabetes-kidney.org/type-1-diabetes/

Top 75 Contributor
Female
Posts 12

UPDATE*** 

I am still searching for answers. I am getting more and more frustrated with each day and each new doctor. I have tested positive for insulin auto-antibodies, and the doctors think that has something to do with my problems, since we have tried Metformin and Symilin with no change. When I give my Humalog in the morning, it will not work, and 5 hours later I will crash in the 20's and 30's. I have been having seizures because there is no way to control when it will work. At night, I will give my Humalog with dinner and it works within 15-20 minutes. It unpredictable and I'm not sure how to control it anymore. I am seeing an immunologist who believes it is insulin neutralizing antibodies. He says the antibodies latch on to the insulin and neutralize it until they run out of energy. They cannot destroy the insulin, so let let it go, and that is what causes my extreme lows and seizures. 

Not sure whats going to happen from here. My doctors are talking about some type of immunotherepy, but I have yet to meet another diabetic or hear of one that has experienced this. I also have yet to meet an endocrinologist who is familiar with this. I'd be willing to travel if one exists. 

Top 25 Contributor
Posts 120
amrad replied on Fri, Nov 11 2011 9:17 PM

hopefully the immunotherapy will help. from what you said it appears the best time for the humalog to work is at night. If it were me that is when I would eat.

This would scare the living daylights out of me, do they have you on a CGM device, so you can at least know when you will have a low?

Not Ranked
Posts 1

Bit curious, you ever find an answer/workaround for this?  I've had similar issues in the past that I never managed to figure out the trigger/cause for- instead just knowing things were being nuts thus backing off food till things stabilized (or heavily overbolusing up front and playing the "keep the levels up" game when it occurred).

Annoying as hell to say the least, especially in that it wasn't easily predictable if it would be rearing its head that day. 

Top 75 Contributor
Female
Posts 12

Hi! Yes, email me at Kristen.Radloff@gmail.com 

I am actually currently at The Mayo Clinic in Rochester, Minnesota. 

 

Page 1 of 1 (15 items) | RSS