Insulin Absorbtion with CFRD

annieop86 · Jul 3, 2008

Like so many others who I have read about on this site along with having cystic fibrosis I also have cystic fibrosis related diabetes. I was diagnosed when I was 13 and I just turned 22 last week. I have never been very good with keeping by blood sugars down, unfortunately I have a propensity for loving ice cream and junk food a little too much but within the past few months I have found my diabetes has gotten worse, almost like I am not absorbing the insulin like I used to. I am currently on 3 different types of insulin, 20 units of lantus before dinner, 10 unts of Novolog before every meal plus an additional unit per 20 points over 150 after my meals. And 20 units of NPH before my tube feeds four times a week at night. But I still find I am way to high.

A perfect example is this morning. I woke up and my blood sugar was 195. I took 13 units of insulin for breakfast, I had a glass of cranberry juice and two bowls of Rice Krispies (best cereal ever) at 9:00, it is 12:45 now I just took my blood sugar for lunch and it was 303. I am curious if it's a possibility that I am not absorbing my insulin as well as I did when I was younger.

It seems to make sense considering we have so many problems absorbing everything else. Has anyone else have any information on this? Experienced the same thing, etc. Any info would be helpful.

Hope all are doing well. xoxo

annieop86 · Jul 3, 2008

Like so many others who I have read about on this site along with having cystic fibrosis I also have cystic fibrosis related diabetes. I was diagnosed when I was 13 and I just turned 22 last week. I have never been very good with keeping by blood sugars down, unfortunately I have a propensity for loving ice cream and junk food a little too much but within the past few months I have found my diabetes has gotten worse, almost like I am not absorbing the insulin like I used to. I am currently on 3 different types of insulin, 20 units of lantus before dinner, 10 unts of Novolog before every meal plus an additional unit per 20 points over 150 after my meals. And 20 units of NPH before my tube feeds four times a week at night. But I still find I am way to high.

A perfect example is this morning. I woke up and my blood sugar was 195. I took 13 units of insulin for breakfast, I had a glass of cranberry juice and two bowls of Rice Krispies (best cereal ever) at 9:00, it is 12:45 now I just took my blood sugar for lunch and it was 303. I am curious if it's a possibility that I am not absorbing my insulin as well as I did when I was younger.

It seems to make sense considering we have so many problems absorbing everything else. Has anyone else have any information on this? Experienced the same thing, etc. Any info would be helpful.

Hope all are doing well. xoxo

annieop86 · Jul 3, 2008

Like so many others who I have read about on this site along with having cystic fibrosis I also have cystic fibrosis related diabetes. I was diagnosed when I was 13 and I just turned 22 last week. I have never been very good with keeping by blood sugars down, unfortunately I have a propensity for loving ice cream and junk food a little too much but within the past few months I have found my diabetes has gotten worse, almost like I am not absorbing the insulin like I used to. I am currently on 3 different types of insulin, 20 units of lantus before dinner, 10 unts of Novolog before every meal plus an additional unit per 20 points over 150 after my meals. And 20 units of NPH before my tube feeds four times a week at night. But I still find I am way to high.

A perfect example is this morning. I woke up and my blood sugar was 195. I took 13 units of insulin for breakfast, I had a glass of cranberry juice and two bowls of Rice Krispies (best cereal ever) at 9:00, it is 12:45 now I just took my blood sugar for lunch and it was 303. I am curious if it's a possibility that I am not absorbing my insulin as well as I did when I was younger.

It seems to make sense considering we have so many problems absorbing everything else. Has anyone else have any information on this? Experienced the same thing, etc. Any info would be helpful.

Hope all are doing well. xoxo

annieop86 · Jul 3, 2008

Like so many others who I have read about on this site along with having cystic fibrosis I also have cystic fibrosis related diabetes. I was diagnosed when I was 13 and I just turned 22 last week. I have never been very good with keeping by blood sugars down, unfortunately I have a propensity for loving ice cream and junk food a little too much but within the past few months I have found my diabetes has gotten worse, almost like I am not absorbing the insulin like I used to. I am currently on 3 different types of insulin, 20 units of lantus before dinner, 10 unts of Novolog before every meal plus an additional unit per 20 points over 150 after my meals. And 20 units of NPH before my tube feeds four times a week at night. But I still find I am way to high.

A perfect example is this morning. I woke up and my blood sugar was 195. I took 13 units of insulin for breakfast, I had a glass of cranberry juice and two bowls of Rice Krispies (best cereal ever) at 9:00, it is 12:45 now I just took my blood sugar for lunch and it was 303. I am curious if it's a possibility that I am not absorbing my insulin as well as I did when I was younger.

It seems to make sense considering we have so many problems absorbing everything else. Has anyone else have any information on this? Experienced the same thing, etc. Any info would be helpful.

Hope all are doing well. xoxo

annieop86 · Jul 3, 2008

Like so many others who I have read about on this site along with having cystic fibrosis I also have cystic fibrosis related diabetes. I was diagnosed when I was 13 and I just turned 22 last week. I have never been very good with keeping by blood sugars down, unfortunately I have a propensity for loving ice cream and junk food a little too much but within the past few months I have found my diabetes has gotten worse, almost like I am not absorbing the insulin like I used to. I am currently on 3 different types of insulin, 20 units of lantus before dinner, 10 unts of Novolog before every meal plus an additional unit per 20 points over 150 after my meals. And 20 units of NPH before my tube feeds four times a week at night. But I still find I am way to high.
 
 A perfect example is this morning. I woke up and my blood sugar was 195. I took 13 units of insulin for breakfast, I had a glass of cranberry juice and two bowls of Rice Krispies (best cereal ever) at 9:00, it is 12:45 now I just took my blood sugar for lunch and it was 303. I am curious if it's a possibility that I am not absorbing my insulin as well as I did when I was younger.
 
 It seems to make sense considering we have so many problems absorbing everything else. Has anyone else have any information on this? Experienced the same thing, etc. Any info would be helpful.
 
 Hope all are doing well. xoxo

lightNlife · Jul 3, 2008

It could depend on where you're injecting the insulin. The body absorbs it differently depending on the injection site. It could also be that you need a different concentration of insulin. Is your insulin U-40 or U-100?

If you inject in your abdomen, it absorbs the fastest. The arm is also pretty fast. If you need it to absorb more slowly, try injecting into a site on your leg or rear end.

Let me know if I can be of further help. Don't try to change too many things at once, or you won't know which worked and whcih didnt.

lightNlife · Jul 3, 2008

It could depend on where you're injecting the insulin. The body absorbs it differently depending on the injection site. It could also be that you need a different concentration of insulin. Is your insulin U-40 or U-100?

If you inject in your abdomen, it absorbs the fastest. The arm is also pretty fast. If you need it to absorb more slowly, try injecting into a site on your leg or rear end.

Let me know if I can be of further help. Don't try to change too many things at once, or you won't know which worked and whcih didnt.

lightNlife · Jul 3, 2008

It could depend on where you're injecting the insulin. The body absorbs it differently depending on the injection site. It could also be that you need a different concentration of insulin. Is your insulin U-40 or U-100?

If you inject in your abdomen, it absorbs the fastest. The arm is also pretty fast. If you need it to absorb more slowly, try injecting into a site on your leg or rear end.

Let me know if I can be of further help. Don't try to change too many things at once, or you won't know which worked and whcih didnt.

lightNlife · Jul 3, 2008

It could depend on where you're injecting the insulin. The body absorbs it differently depending on the injection site. It could also be that you need a different concentration of insulin. Is your insulin U-40 or U-100?

If you inject in your abdomen, it absorbs the fastest. The arm is also pretty fast. If you need it to absorb more slowly, try injecting into a site on your leg or rear end.

Let me know if I can be of further help. Don't try to change too many things at once, or you won't know which worked and whcih didnt.

lightNlife · Jul 3, 2008

It could depend on where you're injecting the insulin. The body absorbs it differently depending on the injection site. It could also be that you need a different concentration of insulin. Is your insulin U-40 or U-100?
 
 If you inject in your abdomen, it absorbs the fastest. The arm is also pretty fast. If you need it to absorb more slowly, try injecting into a site on your leg or rear end.
 
 Let me know if I can be of further help. Don't try to change too many things at once, or you won't know which worked and whcih didnt.

pjspiegle · Jul 3, 2008

I'm not sure this is answering your question or not, but this is what I know based on my son.
Nathan was taking over 100 units total of 3 different insulins and was still high a lot of the time. I do know that your numbers will vary depending on when you take the insulin in relation to when you eat, ie, should take 15 minutes to 30 minutes before eating for best results, this does vary a little from person to person.

Here is what else I know. Nathan got an insulin pump almost 3 months ago now, and it was the BEST decision ever. He has cut the amount of inusulin needed in half (50%+)! It does have something to do with the absorption and the continuous drip of insulin that has made a world of difference for him. Our doctor specializes specifically in CFRD and wishes he knew how to convience ALL CFRD insulin dependent patients to get a pump.

If you are having to take that much insulin, that many types, and are still having high numbers, I would highly recommend giving in and at least looking into an insulin pump.

We are soooooooo happy with the pump. We are now working on getting the 24/7 glucose monitor that goes with the pump so that we can fine tune his insulin needs even better. They have proven that blood sugars that are not keep within a very narrow range causes significant damage that begins taking away from that precious life expectancy. Even CF patients need to start thinking about keeping good control over the BG levels. I know, one more thing to have to deal with.

Hope this helps a little at least,

pjspiegle · Jul 3, 2008

I'm not sure this is answering your question or not, but this is what I know based on my son.
Nathan was taking over 100 units total of 3 different insulins and was still high a lot of the time. I do know that your numbers will vary depending on when you take the insulin in relation to when you eat, ie, should take 15 minutes to 30 minutes before eating for best results, this does vary a little from person to person.

Here is what else I know. Nathan got an insulin pump almost 3 months ago now, and it was the BEST decision ever. He has cut the amount of inusulin needed in half (50%+)! It does have something to do with the absorption and the continuous drip of insulin that has made a world of difference for him. Our doctor specializes specifically in CFRD and wishes he knew how to convience ALL CFRD insulin dependent patients to get a pump.

If you are having to take that much insulin, that many types, and are still having high numbers, I would highly recommend giving in and at least looking into an insulin pump.

We are soooooooo happy with the pump. We are now working on getting the 24/7 glucose monitor that goes with the pump so that we can fine tune his insulin needs even better. They have proven that blood sugars that are not keep within a very narrow range causes significant damage that begins taking away from that precious life expectancy. Even CF patients need to start thinking about keeping good control over the BG levels. I know, one more thing to have to deal with.

Hope this helps a little at least,

pjspiegle · Jul 3, 2008

I'm not sure this is answering your question or not, but this is what I know based on my son.
Nathan was taking over 100 units total of 3 different insulins and was still high a lot of the time. I do know that your numbers will vary depending on when you take the insulin in relation to when you eat, ie, should take 15 minutes to 30 minutes before eating for best results, this does vary a little from person to person.

Here is what else I know. Nathan got an insulin pump almost 3 months ago now, and it was the BEST decision ever. He has cut the amount of inusulin needed in half (50%+)! It does have something to do with the absorption and the continuous drip of insulin that has made a world of difference for him. Our doctor specializes specifically in CFRD and wishes he knew how to convience ALL CFRD insulin dependent patients to get a pump.

If you are having to take that much insulin, that many types, and are still having high numbers, I would highly recommend giving in and at least looking into an insulin pump.

We are soooooooo happy with the pump. We are now working on getting the 24/7 glucose monitor that goes with the pump so that we can fine tune his insulin needs even better. They have proven that blood sugars that are not keep within a very narrow range causes significant damage that begins taking away from that precious life expectancy. Even CF patients need to start thinking about keeping good control over the BG levels. I know, one more thing to have to deal with.

Hope this helps a little at least,

pjspiegle · Jul 3, 2008

I'm not sure this is answering your question or not, but this is what I know based on my son.
Nathan was taking over 100 units total of 3 different insulins and was still high a lot of the time. I do know that your numbers will vary depending on when you take the insulin in relation to when you eat, ie, should take 15 minutes to 30 minutes before eating for best results, this does vary a little from person to person.

Here is what else I know. Nathan got an insulin pump almost 3 months ago now, and it was the BEST decision ever. He has cut the amount of inusulin needed in half (50%+)! It does have something to do with the absorption and the continuous drip of insulin that has made a world of difference for him. Our doctor specializes specifically in CFRD and wishes he knew how to convience ALL CFRD insulin dependent patients to get a pump.

If you are having to take that much insulin, that many types, and are still having high numbers, I would highly recommend giving in and at least looking into an insulin pump.

We are soooooooo happy with the pump. We are now working on getting the 24/7 glucose monitor that goes with the pump so that we can fine tune his insulin needs even better. They have proven that blood sugars that are not keep within a very narrow range causes significant damage that begins taking away from that precious life expectancy. Even CF patients need to start thinking about keeping good control over the BG levels. I know, one more thing to have to deal with.

Hope this helps a little at least,

pjspiegle · Jul 3, 2008

I'm not sure this is answering your question or not, but this is what I know based on my son.
 Nathan was taking over 100 units total of 3 different insulins and was still high a lot of the time. I do know that your numbers will vary depending on when you take the insulin in relation to when you eat, ie, should take 15 minutes to 30 minutes before eating for best results, this does vary a little from person to person.
 
 Here is what else I know. Nathan got an insulin pump almost 3 months ago now, and it was the BEST decision ever. He has cut the amount of inusulin needed in half (50%+)! It does have something to do with the absorption and the continuous drip of insulin that has made a world of difference for him. Our doctor specializes specifically in CFRD and wishes he knew how to convience ALL CFRD insulin dependent patients to get a pump.
 
 If you are having to take that much insulin, that many types, and are still having high numbers, I would highly recommend giving in and at least looking into an insulin pump.
 
 We are soooooooo happy with the pump. We are now working on getting the 24/7 glucose monitor that goes with the pump so that we can fine tune his insulin needs even better. They have proven that blood sugars that are not keep within a very narrow range causes significant damage that begins taking away from that precious life expectancy. Even CF patients need to start thinking about keeping good control over the BG levels. I know, one more thing to have to deal with.
 
 Hope this helps a little at least,

SaltyAndSweet · Jul 3, 2008

My biggest (read: HUGE) concern is why they have you on a fixed amount of insulin per meal, especially if you are a carb lover? (I am too hehe, Rice Krispies is my fav too!) Why do they not have you carb counting and adjusting your insulin as needed? (not blaming you, just confused as to your doc's intentions).

If you eat a meal that is low carb, or eat a meal that is high carb, your need for insulin could greatly vary. Like for me I could eat a dinner that requires 3-4 units of insulin or I could eat a dinner that needs 25 units (usually if I am on Prednisone which doubles my needs).

It makes sense why you are taking three different types of insulin. Lantus, to keep your baseline down over 24-hours. Novolog for your meal spikes and NPH, that acts in an in between speed for the over night feedings. That makes sense. I am not a huge advocate of the pump (just got one a month ago), but a pump would allow better control probably because of the night feedings. But that is the only reason I can see. I think decent control can happen with good carb counting (the hardest part) and with shots or pens. Great control can happen if you can get decent control by carb counting and then go on a pump (my opinion) because it is easier to dial in the numbers.

You could be having an issue with the absorption, of the insulin (I am not really sure), but also there are soooo many other factors that affect all of us with CFRD, such as steroids, stress, illness, exercise (or lack there of).... those are the big ones. Some people argue that caffeine affects BGs too, there are studies that say yes and some that say no. Do you have a change in medication, stress, illness, etc, since you were younger? That could explain it, but you would probably want to increase your insulin (of course with the doctor's ok).

Let us know how things go and if you have more questions. There is no reason for you to avoid ice cream, rice krispies and other carbs as long as you make up for the grams of carbs with the correct amount of insulin from what I am learning.

Oh... and a lot of junk food carbs act faster than normal "closer to the earth" carbs (like white bread, white rice, anything with high fructose corn syrup (which is also an inflammatory agent!), soft serve ice cream). My doc had me take my insulin about 10-15 minutes ahead of those carbs to match up the spikes, and acting time, better. But this is after we found the correct insulin to carb ratio.

Good luck!

SaltyAndSweet · Jul 3, 2008

My biggest (read: HUGE) concern is why they have you on a fixed amount of insulin per meal, especially if you are a carb lover? (I am too hehe, Rice Krispies is my fav too!) Why do they not have you carb counting and adjusting your insulin as needed? (not blaming you, just confused as to your doc's intentions).

If you eat a meal that is low carb, or eat a meal that is high carb, your need for insulin could greatly vary. Like for me I could eat a dinner that requires 3-4 units of insulin or I could eat a dinner that needs 25 units (usually if I am on Prednisone which doubles my needs).

It makes sense why you are taking three different types of insulin. Lantus, to keep your baseline down over 24-hours. Novolog for your meal spikes and NPH, that acts in an in between speed for the over night feedings. That makes sense. I am not a huge advocate of the pump (just got one a month ago), but a pump would allow better control probably because of the night feedings. But that is the only reason I can see. I think decent control can happen with good carb counting (the hardest part) and with shots or pens. Great control can happen if you can get decent control by carb counting and then go on a pump (my opinion) because it is easier to dial in the numbers.

You could be having an issue with the absorption, of the insulin (I am not really sure), but also there are soooo many other factors that affect all of us with CFRD, such as steroids, stress, illness, exercise (or lack there of).... those are the big ones. Some people argue that caffeine affects BGs too, there are studies that say yes and some that say no. Do you have a change in medication, stress, illness, etc, since you were younger? That could explain it, but you would probably want to increase your insulin (of course with the doctor's ok).

Let us know how things go and if you have more questions. There is no reason for you to avoid ice cream, rice krispies and other carbs as long as you make up for the grams of carbs with the correct amount of insulin from what I am learning.

Oh... and a lot of junk food carbs act faster than normal "closer to the earth" carbs (like white bread, white rice, anything with high fructose corn syrup (which is also an inflammatory agent!), soft serve ice cream). My doc had me take my insulin about 10-15 minutes ahead of those carbs to match up the spikes, and acting time, better. But this is after we found the correct insulin to carb ratio.

Good luck!

SaltyAndSweet · Jul 3, 2008

My biggest (read: HUGE) concern is why they have you on a fixed amount of insulin per meal, especially if you are a carb lover? (I am too hehe, Rice Krispies is my fav too!) Why do they not have you carb counting and adjusting your insulin as needed? (not blaming you, just confused as to your doc's intentions).

If you eat a meal that is low carb, or eat a meal that is high carb, your need for insulin could greatly vary. Like for me I could eat a dinner that requires 3-4 units of insulin or I could eat a dinner that needs 25 units (usually if I am on Prednisone which doubles my needs).

It makes sense why you are taking three different types of insulin. Lantus, to keep your baseline down over 24-hours. Novolog for your meal spikes and NPH, that acts in an in between speed for the over night feedings. That makes sense. I am not a huge advocate of the pump (just got one a month ago), but a pump would allow better control probably because of the night feedings. But that is the only reason I can see. I think decent control can happen with good carb counting (the hardest part) and with shots or pens. Great control can happen if you can get decent control by carb counting and then go on a pump (my opinion) because it is easier to dial in the numbers.

You could be having an issue with the absorption, of the insulin (I am not really sure), but also there are soooo many other factors that affect all of us with CFRD, such as steroids, stress, illness, exercise (or lack there of).... those are the big ones. Some people argue that caffeine affects BGs too, there are studies that say yes and some that say no. Do you have a change in medication, stress, illness, etc, since you were younger? That could explain it, but you would probably want to increase your insulin (of course with the doctor's ok).

Let us know how things go and if you have more questions. There is no reason for you to avoid ice cream, rice krispies and other carbs as long as you make up for the grams of carbs with the correct amount of insulin from what I am learning.

Oh... and a lot of junk food carbs act faster than normal "closer to the earth" carbs (like white bread, white rice, anything with high fructose corn syrup (which is also an inflammatory agent!), soft serve ice cream). My doc had me take my insulin about 10-15 minutes ahead of those carbs to match up the spikes, and acting time, better. But this is after we found the correct insulin to carb ratio.

Good luck!

SaltyAndSweet · Jul 3, 2008

My biggest (read: HUGE) concern is why they have you on a fixed amount of insulin per meal, especially if you are a carb lover? (I am too hehe, Rice Krispies is my fav too!) Why do they not have you carb counting and adjusting your insulin as needed? (not blaming you, just confused as to your doc's intentions).

If you eat a meal that is low carb, or eat a meal that is high carb, your need for insulin could greatly vary. Like for me I could eat a dinner that requires 3-4 units of insulin or I could eat a dinner that needs 25 units (usually if I am on Prednisone which doubles my needs).

It makes sense why you are taking three different types of insulin. Lantus, to keep your baseline down over 24-hours. Novolog for your meal spikes and NPH, that acts in an in between speed for the over night feedings. That makes sense. I am not a huge advocate of the pump (just got one a month ago), but a pump would allow better control probably because of the night feedings. But that is the only reason I can see. I think decent control can happen with good carb counting (the hardest part) and with shots or pens. Great control can happen if you can get decent control by carb counting and then go on a pump (my opinion) because it is easier to dial in the numbers.

You could be having an issue with the absorption, of the insulin (I am not really sure), but also there are soooo many other factors that affect all of us with CFRD, such as steroids, stress, illness, exercise (or lack there of).... those are the big ones. Some people argue that caffeine affects BGs too, there are studies that say yes and some that say no. Do you have a change in medication, stress, illness, etc, since you were younger? That could explain it, but you would probably want to increase your insulin (of course with the doctor's ok).

Let us know how things go and if you have more questions. There is no reason for you to avoid ice cream, rice krispies and other carbs as long as you make up for the grams of carbs with the correct amount of insulin from what I am learning.

Oh... and a lot of junk food carbs act faster than normal "closer to the earth" carbs (like white bread, white rice, anything with high fructose corn syrup (which is also an inflammatory agent!), soft serve ice cream). My doc had me take my insulin about 10-15 minutes ahead of those carbs to match up the spikes, and acting time, better. But this is after we found the correct insulin to carb ratio.

Good luck!

SaltyAndSweet · Jul 3, 2008

My biggest (read: HUGE) concern is why they have you on a fixed amount of insulin per meal, especially if you are a carb lover? (I am too hehe, Rice Krispies is my fav too!) Why do they not have you carb counting and adjusting your insulin as needed? (not blaming you, just confused as to your doc's intentions).
 
 If you eat a meal that is low carb, or eat a meal that is high carb, your need for insulin could greatly vary. Like for me I could eat a dinner that requires 3-4 units of insulin or I could eat a dinner that needs 25 units (usually if I am on Prednisone which doubles my needs).
 
 It makes sense why you are taking three different types of insulin. Lantus, to keep your baseline down over 24-hours. Novolog for your meal spikes and NPH, that acts in an in between speed for the over night feedings. That makes sense. I am not a huge advocate of the pump (just got one a month ago), but a pump would allow better control probably because of the night feedings. But that is the only reason I can see. I think decent control can happen with good carb counting (the hardest part) and with shots or pens. Great control can happen if you can get decent control by carb counting and then go on a pump (my opinion) because it is easier to dial in the numbers.
 
 You could be having an issue with the absorption, of the insulin (I am not really sure), but also there are soooo many other factors that affect all of us with CFRD, such as steroids, stress, illness, exercise (or lack there of).... those are the big ones. Some people argue that caffeine affects BGs too, there are studies that say yes and some that say no. Do you have a change in medication, stress, illness, etc, since you were younger? That could explain it, but you would probably want to increase your insulin (of course with the doctor's ok).
 
 Let us know how things go and if you have more questions. There is no reason for you to avoid ice cream, rice krispies and other carbs as long as you make up for the grams of carbs with the correct amount of insulin from what I am learning.
 
 Oh... and a lot of junk food carbs act faster than normal "closer to the earth" carbs (like white bread, white rice, anything with high fructose corn syrup (which is also an inflammatory agent!), soft serve ice cream). My doc had me take my insulin about 10-15 minutes ahead of those carbs to match up the spikes, and acting time, better. But this is after we found the correct insulin to carb ratio.
 
 Good luck!

Insulin Absorbtion with CFRD

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