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[IP] problems w/ highs

I am a 34-year old female, and was diagnosed about 2
years ago with type 1 diabetes (GAD+ and ICA+).  I use
an insulin pump (about 20 units/day total), exercise
about 2+ hours/day, and have been very well controlled
(HA1C~5.9) these past 2 years.  Suddenly, for the past
1.5 months, I have had a lot of trouble controlling my
blood glucose (it has tended to run high), despite
increasing my basal and bolus rates to approximately
40 units/day total.  

My most recent lab results (about a month back) show
normal thyroid function as well as normal everything
else my endocrinologist could think to check.  The
only changes I can think of are that I stopped taking
oral contraceptive pills about 2 months back, and also
briefly switched from humalog to novolog (I tried it
for only about 4 days) didn't notice any difference
and switched back to humalog. The only other thing I
can think of is that I enrolled in a research study to
examine the effects of Sam-e vs. Celebrex for knee
pain (which I do experience, but manage to ignore).
It's a cross over, double blind trial (meaning one of
the sets of pills is a placebo so I don't know if I'm
on Sam-e or Celebrex now and what I'll be on during
the next phase.

I hate taking all this insulin and feel really lousy
(like I'm constantly having a low, but my blood sugars
are always above 120 and the insulin I take seems very
ineffective (even with exercise)).  I also have to
bolus a lot with meals (about 1 unit for every 5 grams
of carbs) where I used to bolus 1 unit for every 30
grams of carbs)and the insulin action or absorption
seems slower than it used to be. 

I have of course consulted with my endocrinologist and
he's at a loss.  I am very concerned by these changes
and would like to ask whether anyone has any thoughts.
 For example is it possible that I'm producing
antibodies to humalog, or becoming insulin resistant
because of the change in my hormonal milieu (although
exercise does not seem to reduce my blood glucose
levels without extra insulin)?  Any other
thoughts/suggestions for investigations would be
greatly appreciated.


Meha Harthill.    

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