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[IP] RE: Insulin Resistance

 Have you considered trying Victoza or Bydureon? Those slow down the digestive
process, and result in a more steady BG rise after meals instead of a huge
spike. My BG usually only rises about 100 points after a meal when I am on
Victoza, 150 or so on Bydureon.

 You will need to titrate up the Victoza and start with a small dosage for a
week or two (.6 mg). If you take too much too quickly you'll have about 18 hours
of vomiting and awful nausea. However, I think it's a really great medicine.

 4 hours, IMO is actually on the low side of insulin reaction. Mine is rather
high at 6 hours.

 To me this doesn't sound like insulin resistance. We would need to know your
insulin to carb ratio and 24 hour basal to know if you are experiencing insulin
resistance. If that were the case I would suggest metformin.

-----Original Message-----
 From: email @ redacted <email @ redacted>
On Behalf Of Robert Braunstein
Sent: Friday, July 5, 2019 10:15 PM
To: email @ redacted
Subject: [IP] Insulin Resistance

Ive been a T1 diabetic for 37 Years and on a pump for 23 Years using Humalog.

 Starting at age 16 I started becoming very brittle with huge swings in my Blood
Sugars with no discernable pattern. Even after I was on the pump I still had the
swings but they were more controllable.

 Over the last few years it seems my body is taking a long time to react to my
Boluses. Approximately 10 months ago, I switched to the Dexcom G6 CGM because
the Minimed CGM did not give me good information to make immediate adjustments.
The trend I am seeing is that no matter what I eat for meals within 10 minutes
my Blood Sugar jumps very high.

 For example last Friday my Blood sugar prior to breakfast was 67. My typical
breakfast on weekdays is 2 pop tart pastries with a total of 70 carbs I bloused
10 minutes before eating. Within 5  10 minutes my Blood Sugar was up to 190 and
by 20 minutes in the 250s. Usually my Blood Sugar does not start decreasing
until approximately 4 hours after the Bolus. I have noticed also a
4 hour time after doing a correction for high sugar for my body to react.
 Since Humalog has about a 4 hour life the thought of insulin resistance came to
my mind.

 Since there is no endo near me I have been asking my primary care doctor
regarding Insulin Resistance if it could be a possibility and is there some sort
of test or way to determine if this is happening.

The answer I got is basically not sure if there is one for T1 Diabetes.

 Also I was referred to their Pharmacist who supposedly is an expert on Insulin,
pumps, & CGM she was not familiar with the Dexcom CGM, but only wit the Minimed
cgm. She is trying to blame it on Saturated fats because I eat Pop Tarts for
Breakfast. Most my meals have very little fat and Pop Tarts are my only vice.

 I am wondering if anyone else has experienced similar issues and what if any
thing was suggested. One thing I am considering is changing Insulin to Fiasp
because it has a faster active start. But I am concerned because I have been on
Humalog for a very long time.

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