I have a diabetic question. I also have underactive thyroid

[Soundwell1]

I've had type 1 diabetes since age 20 and now age 68 I'm being tested for insulin resistance. I did have pcos when I was a teenager. I'm also obviously using twice the insulin than I normally use for very little carbs. What's happening.

[Judithdalston]

Can you tell us bit more about your hypothyroidism- what are your blood results and what hormone replacement are you on. I’ve insulin dependent diabetes ( routine bile duct procedure went wrong and I ended up with sepsis/ acute pancreatitis etc that destroyed ability to produce insulin), and have hypothyroid/Hashimoto’s, plus fibromyalgia. I am currently having problems with my blood sugar levels at the moment, and over say last 6 months...everything seemed to be ‘off’ with my health about 15 months with lots of pain, weakness and kept falling asleep.... started adding T3 as I could never get my FT3 up above about 33% in range. Anyway discovered that I believe it has been the high T3 that has altered my blood sugar levels. 3 weeks ago went on very low carb diet, then ‘testing’ which carbs raise my blood sugars. Seem to have changed or certainly more responsive ( negatively) to certain carbs...no idea why, except for T3 use. How does your endo think insulin resistance relates to type 1, or my, diabetes? You are the same generation as me , brought up to believe a meal consisted of carbs whether sandwich for lunch, or meat and pots, or pasta etc for main meal...and later how low fat was good! Be interesting to see what other answers you get...tried healthunlocked Diabetes sister site?

[MMaud]

Hello there, Sounwell1 - I'm sorry you find yourself feeling a bit perplexed.

In trying to understand what's happening with you, please forgive my questioning.

How long has your insulin requirement been rising, and does it appear to have stabilised now?

In terms of general recent event, many folks find significant changes in the wether impacts on their insulin use. Some use less, but equally so, some use more, so there's plenty of tweaking going on it seems in the worlds of thse living with diabetes.

If you had PCOS are a young woman, the chances are you were insulin resistant then, and may actual have continued to be so, even though unnoticed or it raised no concern.

These days, I observe more and more people living with T1 starting to use Metformin. Metformin is a drug more commonly used by those with T2, but in reality it works by helping your body use your insulin (whether natural in T2, or injected, as in T1 or insulin dependent T2s) a bit better.

How are you being tested for insulin resistance? What tests or examinations are you undergoing?

[Soundwell1 in reply to MMaud]

Hello, I have only had blood test done four days ago so have not yet had the result.

I'm in the uk. I think it was called homo and had to be put on ice.

Thank you for your interest.

[MMaud in reply to Soundwell1]

Samples for some blood tests can be very temperature sensitive; especially anything involving hormones, so that explains that part - probably.

I'm sure your Doc will have gone through all the questioning about whether you have added any weight of late, reduced your exercise or have been under stress, sleeping well andso on. I'm also assuming you have tried new insulin vials/pens, and rotated your injection or pump set locations?

Because you inject insulin, testing for insulin resistance in T1s is trickier than fr anyone not using insulin.

Hopefully you won't have to wait long for your blood results.

[Soundwell1 in reply to MMaud]

Thank you for your support.

[humanbean]

This website is very helpful on the subject of diabetes of all kinds :

diabetes.co.uk/

They also have a forum with some very knowledgeable people on it - they may have some answers for you :

diabetes.co.uk/forum/

I hope you find a useful source of information. I'm slightly surprised (in the way a total novice is surprised - I know practically zero about diabetes) that someone with type 1 diabetes could ever have developed insulin resistance. It suggests to me that you were taking too much insulin to treat your diabetes because I can't see how else you could become resistant to it. But then that is baffling (to me) because I would have thought excessive insulin use in a type 1 would have produced frequent hypos. (Or am I giving away my almost total ignorance?)

[G2G2 in reply to humanbean]

Insulin resistance is possible with T1 & is often overlooked by doctors (no surprise). Too much insulin results in hypos, you're right. It's not the amount of insulin that's responsible for insulin resistance.

[Soundwell1 in reply to humanbean]

I used to use the doses 4, 4 , 6, during day for each meal and that would allow me a snack or two but still had hypos. It was quite brittle so the doc said. Obviously I had a basal insulin of 6 units too.

Now, for less food I have 4 units 4 units.. then 8units+6units. Then basal of 6 units which I also have in the morning too at 6 units. Sometimes bs goes up to 16 on testing.

[MMaud in reply to Soundwell1]

Sounwell1, it's not at all unusual for rratiosn of insulin to food to vary, whether throughout the year, or over time.

It is becoming clearer in recent times that some people living with T1 continue to produce some insulin, and some of them do that for many moons. Some also find their pancreas splutters along - sometimes producing more or less (inadequate amounts) insulin as they go.

Annoyingly, insulin resistance tends to increase with age, in both those with and those without diabetes. That also goes some way to explaining why T2 diabetes often develops in the mid to later years, rather than childhood or younger years.

Sadly, it is also becoming clear that there are an increasing number of children developing T2 diabetes, but that's a digression.

One final thing is, it could well be helpful to you to go from fixed bolus doses with each meal, to flexing how much bolus insulin you take, dependent on the specific food you have eaten. many people find the DAFNE course to be very informative and worthwhile.

I really do hope you get this sorted out very soon.