From Gainesville, Florida, USA:
I am 23 years old and was diagnosed with type 1 diabetes nine months ago. At diagnosis, my blood glucose was in the high 300s mg/dl [16.7 mmol/L]. My doctor diagnosed me as a type 1 because my father became type 1 around the same age I did. (The doctor believes I inherited it.) I am currently taking around 9 units of 70/30 insulin a day, 5 units in the morning and 4 units before my evening meal.
I often have low blood sugar, usually at least once a day. I find that I am having to eat quite a lot of sugar to keep my blood glucose from dropping too low. My doctor is now unsure what type of diabetes I have. I have tried coming off the insulin completely, but my glucose readings were too high. I have tried all types of insulin and always have low blood sugar. I have to eat about 40 grams of sugar to compensate for 1 unit of Humalog. The honeymoon period ended about two months after I was diagnosed so I can't attribute my insulin sensitivity to that. Is this type of insulin sensitivity normal for people with type 1 diabetes? Is there a "normal" amount of insulin I should be taking? Is oral medication a possibility? I don't mind taking shots, but it's the glucose testing I hate. I'm having to check my blood glucose about 14 times a day because it's so erratic.
I'm about 5 feet 7 inches tall and weigh 148 pounds. Other people with diabetes that I meet, of the same weight as me, seem to need a lot more insulin than I do. I desperately want to get my blood sugar under control. Do you have any recommendations?
It sounds like you may need to switch to mixing different combinations of Humalog and NPH rather than using a fixed combination of the two. This way you can better fine-tune your insulin. (You can change one without changing the other, or change one more than the other.) If you are overweight and your antibody tests for type1 diabetes are negative, you may have Typeá2 diabetes and do better on an oral medication. If you are that sensitive to small amounts of insulin, you more likely have Typeá1, but are still producing a lot of insulin and are therefore sensitive to small changes in dosage.
[Editor's comment: I completely agree that your current regimen isn't working. Given your age, and knowing that people your age need a lot of flexibility, I would strongly suggest that you explore the options of multiple daily injections, or, better yet, an insulin pump. The pump would allow you to given even minute amounts of insulin and prevent the vast swings you seem to be having. You would be able to adjust insulin requirements based on your own, individual sensitivity to it. Please see Is pumping for You?
As far as checking blood sugars goes, there are several new devices on the market which allow for relatively easy and painless testing. One, which a lot of people like, is called, FreeStyle. Check out other products reviewed on this site as well. In addition, you might ask about using Continuous Glucose Monitoring to assess where your problem areas are and what changes need to made to your current treatment plan. SS]
Original posting 12 Sep 2000
Posted to Daily Care
Last Updated: Tuesday April 06, 2010 15:09:14
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