November 23, 2010
Daily Care, Insulin
Question from Paris, France, USA:
What are the possible reasons for a very sudden increased insulin requirement (doubled overnight)? Having ruled out a pump problem, insulin problem, site problem, the only other two times I had an issue like this… the results are asleep upstairs. Can anything cause such a dramatic increase other than pregnancy, which is unlikely and unplanned but always possible, I guess?
I’ve had type 1 for nearly seven years and my usual dose is approximately 45 to 50 units a day and has been stable for some years so I would think end of honeymoon is unlikely. If I am pregnant, I know insulin changes occurred two days after conception (similar to my previous experience). There is no point testing for another couple of weeks. Is there anything else it could be?
Answer:
Obviously, you need to be checked for pregnancy, if this is at all possible. Yes, it can increase insulin requirements. However, have you missed a period? How do you know you have ruled out an insulin problem? I usually have my patients just get a new vial of both basal and bolus insulin. Sometimes the insulin is bad before it gets to you. Sometimes it is left out in the cold or heat or in the sunlight and the insulin is broken down. Make sure you do not have any lipodystrophy. This refers to hard areas where you inject the insulin. This results in a block in the absorption of the insulin. Obviously, if you have a urinary tract infection or other illness, this could increase your insulin requirements.
JTL
