Discussions By Condition: Diabetes

Extreme Resistance U500

Posted In: Diabetes 3 Replies
  • Posted By: julie312
  • February 22, 2008
  • 04:04 AM

In 1999, I was diagnosed with diabetes 2 yrs following my recovery from breast cancer. I am cured on the cancer, and am ready to fight the good fight with diabetes.

After unsuccessful standard protocols of pills to treat my high sugar.
In 2006, I finally found a doctor who was willing to prescribe insulin.

Immediately, unit doses rose to 80 units Lantus/day and 80 units Novolog/meal.
We tried large needles but that did not help.

By 2007, I was out of control again with a 8.3 A1C.
So, I found a doctor through MiniMed and insurance plan willing to support an insulin pump.

Using the pump, daily doses dropped immediately to 150 units/day.
THEN...doses have to be increased to the point, my doctor switched me to U500.

I have put on 80 pounds in the last 2 yrs since I started in insulin.

I am very concerned the continued increase of U500 dose will be harmful.

So, here is the question:
Is diabetes a progressive disease?
Do I have 1.5 diabetes?
Will a pancreas transplant help someone with 1.5 diabetes?
Is Bariactric surgery/lap band surgery the only solution?
Are there any auto-immune solutions to this extreme insulin resistant disease?

All my hopes and fears are in your hands!

Julie Thompson, FLORIDA

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3 Replies:

  • When you started taking insulin, did you stop taking the pills? If so, you could try using both together. With type 2 diabetes, your body develops resistance to insulin, including the insulin your pancreas produces, making it less effective. The pills that T2 diabetics take lower insulin resistance, allowing the insulin your body produces to go further. The insulin you get with a pump replaces or supplements what your body produces, and it will have more of an effect if you have less insulin resistance.The important thing, though, is to test often and keep your blood sugar within a normal range (80-110 or so). Use as much insulin as you need to make sure it stays in that range. That is the ONLY thing that matters. Having the pump helps; make sure you have your basal rate, carb ratio and correction factor set correctly. The less often your blood sugar goes high, the lower your A1C will be, the less your risk of complications, and the less insulin you'll need.Losing weight will make it easier, but keep in mind that messing with your blood sugar messes with your appetite. Get rid of any food that messes up your blood sugar. Many diabetics have had great success with low-carb diets, so you might give that a try. Focus on your A1C, not your weight.
    Anonymous 42789 Replies Flag this Response
  • In 1999, I was diagnosed with diabetes 2 yrs following my recovery from breast cancer. I am cured on the cancer, and am ready to fight the good fight with diabetes. After unsuccessful standard protocols of pills to treat my high sugar. In 2006, I finally found a doctor who was willing to prescribe insulin. Immediately, unit doses rose to 80 units Lantus/day and 80 units Novolog/meal.We tried large needles but that did not help. By 2007, I was out of control again with a 8.3 A1C. So, I found a doctor through MiniMed and insurance plan willing to support an insulin pump. Using the pump, daily doses dropped immediately to 150 units/day.THEN...doses have to be increased to the point, my doctor switched me to U500. I have put on 80 pounds in the last 2 yrs since I started in insulin. I am very concerned the continued increase of U500 dose will be harmful. So, here is the question: Is diabetes a progressive disease? Do I have 1.5 diabetes? Will a pancreas transplant help someone with 1.5 diabetes?Is Bariactric surgery/lap band surgery the only solution?Are there any auto-immune solutions to this extreme insulin resistant disease? All my hopes and fears are in your hands! Julie Thompson, FLORIDA Hallo Julie312You tell us you have diagnosed DM-II. DM-II is a progressive disease and you can newer be free from that. Your terminology about Diabetes 1.5 is unknown in the medical science. You must explain what that is. Home made words are very difficult to be understood.You have nothing explained about your diet. You use exogenous Insulin amount, but it is very important to watch your intake of Carbohydrates. To have a normal BMR- basal metabolic rate, you must intake about 150 gram Carbohydrate per day. This amount of Carbohydrate needs Your lever (Hepar).To find out how Insulin resistant you are, you shod ask your physician to make a C-peptide test.If Your Pancreas does not produce insulin more, then you are switched to DM-I and it is normal Your Insulin intake per day. You can minimise Your Insulin amount by minimising your intake of Carbohydrates. Take a look on the www.glycemicindex.com and learn about nutrition’s Glycemic Index and Glycemic Load.Intake of nutrition’s with a low GI is the only useful method to minimise Your Insulin intake.You can find on your own what your normal BMR is. You shod multiply your normal weight with 24 to find out Your BMR in Kilo Calorie. Moreover you shod add to the BMR about 15% of the BMR for Your postprandial thermo genesis. Postprandial thermo genesis is produced by metabolic inerconversions after a meal and by increased futile cycling in metabolic pathways. Then if you intake less then (BMR + 15% of the BMR) Kilo calorie per day, you will lose weight and Your Insulin amount will be reduced.Have a nice day and remember: “Memento Vivere”, you shod control DM and not DM You!Don
    Don Hemmingsen 30 Replies
    • October 8, 2008
    • 01:59 PM
    • 0
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  • In 1999, I was diagnosed with diabetes 2 yrs following my recovery from breast cancer. I am cured on the cancer, and am ready to fight the good fight with diabetes.After unsuccessful standard protocols of pills to treat my high sugar. In 2006, I finally found a doctor who was willing to prescribe insulin.Immediately, unit doses rose to 80 units Lantus/day and 80 units Novolog/meal.We tried large needles but that did not help.By 2007, I was out of control again with a 8.3 A1C. So, I found a doctor through MiniMed and insurance plan willing to support an insulin pump.Using the pump, daily doses dropped immediately to 150 units/day.THEN...doses have to be increased to the point, my doctor switched me to U500.I have put on 80 pounds in the last 2 yrs since I started in insulin.I am very concerned the continued increase of U500 dose will be harmful.So, here is the question: Is diabetes a progressive disease? Do I have 1.5 diabetes? Will a pancreas transplant help someone with 1.5 diabetes?Is Bariactric surgery/lap band surgery the only solution?Are there any auto-immune solutions to this extreme insulin resistant disease?All my hopes and fears are in your hands!Julie Thompson, FLORIDAAn awful lot of LADAs (type 1.5) are misdiagnosed as type 2, and it sounds to me as if you could certainly be LADA (Latent Autoimmune Diabetes in Adults), which is a much slower progressing form of type 1 diabetes, and occurs later in life, on the whole, than type 1. A GAD antibody test will confirm this. Most misdiagnosed LADAs are put on medication which they may or may not respond to, but eventually they will all require insulin. A LADA honeymoon can last years, which can make it particularly hard to diagnose without an autoantibody test.Here's a possible explanation for your colossal insulin dosing: you are rebounding from massive insulin overdoses. A rebound occurs when the body senses low blood sugar and tells the alpha cells of the pancreas to release glucagon, which stimulates the liver to release glucose into the bloodstream. This "liver dump" creates high blood sugar which can last for hours. The blood sugar level at which the rebound response occurs is usually in the 40's, but varies widely among individuals. I am at one end of the spectrum, and have no rebound response whatsoever, so an overdose of insulin is dead obvious. On the other end of the spectum are those who rebound with blood sugars in the 70's (possibly even higher).It's nearly impossible to kill an "easy rebounder" with insulin, because they just keep rebounding. Sometimes it happens at BS levels that don't feel low, so no one has an inkling that the person is overdosing. Once the blood sugar has begun to come down after a rebound (remember, we are overdosing, so it will come down), a low may be clearly felt, but there is, of course, no clear association with any particular insulin injection, so the person is thought to be "very brittle", especially since he or she will then go very high.You can watch the progression of your basal insulin by doing a basal test. In the morning, don't eat anything, and don't inject any rapid acting insulin, but take your basal insulin as usual, if that's when you take it. Test your blood sugar every hour. If you are overdosing, the rising blood sugar will eventually stop as the pancreas stops stimulating the liver to release glucose, and will then start to drop. Ideally, you should not have more than a 30 point BS fluctuation if the basal insulin is correctly dosed. If you are dropping down into normal or low range from a previously high one, then you can be sure you are overdosing on your basal insulin, maybe even massively overdosing. And with that comes weight gain, insulin resistance from high blood insulin volumes, and the frustration of having the blood sugar levels go higher and higher as the insulin doses increase.This is actually not unusual at all, and, I'm sorry to say, not unusual for a doctor to miss. In my experience, PCP's know nothingabout insulin management, so see an endocrinologist if possible. Once your basal dose is established correctly, you can find the correct insulin-carb ratios, but until the basal is set correctly you won't be able to adjust anything else correctly. Lotsa luck! :)
    DartGirl 6 Replies
    • November 19, 2008
    • 08:36 PM
    • 0
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