Problems With Insulin?

[ehickman]

o lately I have had non-stop occlusions on my T:Slim insulin pump. And i mean non-stop; for note i use contact detach infusion sets(they are steel and can not kink or anything) and Novolog u-100. So after hours and hours of tech support and days and weeks of feeling like death, constant highs, highs without occlusions, and then occlusions when I attempt to do a correction at 2 am bc I haven’t gotten insulin all night, I have some thoughts and would LOVE some input.

So in March I started having a LOT of GI problems, bloating, upset stomach, inability to eat certain foods without being sick, etc. So I talked to my endo (the office I am currently in is less than helpful, but that is a rant for later.) they decided that I need to see a specialist bc they believe I have full blown Celiac, which is not uncommon for type 1’s to develop over the years, and i’m on year 26 now… Anyway, so about the time all of that started with GI, all of the occlusions, bad sites, highs, highs for no reason etc. started as well. Now, I have been on Novolog for 16-ish years, give or take, but I started having to take shots pretty constantly, and finally got long acting insulin called in(with no instruction or anything, like I said my endo office is god awful), but once I started Novolog injections on a daily basis I noticed every time I do one, I will have a huge red hive like welt come up afterwards and it will last for hours(6-8 typically); the long acting insulin never does this.

My question/concern/“theory”: Novolog has brewers yeast as a stabilizer, has anyone ever had such an issue or known of any association between celiac (or the like) and Novolog? Or has anyone ever had a similar experience? Is it possible to become allergic to insulin because of an ingredient like brewers yeast? I go back to my terrible endo next monday, and plan on talking to her then, but I would love for anyone to give some input… I also think this could be causing the occlusions as my body seems to be attacking the infusion set and insulin.

Also, my endo was supposed to refer me to a GI specialist as my insurance requires a referral, but they still have not and it has been 6 months. I have a new pt apt with a PCP on the 21st and plan to get referrals to a GI specialist and a new endo.

XOXO

Emily

[joe]

HI Emily @ehickman, it was only when they changed the format of T1N that I saw no one responded to your question. sorry you didn’t get feedback…

here’s my totally unqualified opinion: If I accept that type 1 diabetes is an unintended attack of useful cells (or even benign cells) by my autoimmune system, then I have to see similarities between type 1 and celiac, lupus, multiple sclerosis, rheumatoid arthritis, hypothyroid, and even “hay fever”. All of which are my body’s autoimmune system attacking nuisance substances or critical substances/cells. In essence, and in my opinion, type 1 diabetes is an allergy of a kind.

Novolog and Humalog are made with either e coli or Saccharomyces cerevisiae (yes it is brewers yeast). These cells are not stabilizers, but the actual protein manufacturers. It works because the seed cell in the brewers yeast is genetically modified in a lab to include elements of the insulin protein in the cell nucleus. Then when the cell is introduced to sugar and water, it multiplies like mad and replicates the protein element. These cell nuclei are then smashed to bits, and refined using ultrafiltration and liquid chromatography (LC) to isolate only the insulin protein, which is only stabilized by buffer solutions and sterilized. There are other antibacterial additives as well due to the way insulin is dispensed, however, there are no elements of the original yeast or e. coli after manufacturing.

what I have learned from my colleagues, is that each insulin molecule is a “close facsimile” to human insulin. In fact, the way that the molecule is made and the way that sugars attach itself to the molecule may in fact cause a sensitive person to react to it much like an allergic reaction. The incidence of actual allergy to the insulin molecule is low, based on the data in clinical trials and safety assessments made during the licensing of the medicine by the FDA.

regarding your path forward, probably the GI is a good one but also consider a neurologist as some of the gi problems might be related to neuropathy of the gi tract. Neuropathy in t1d is also possible.

good luck and hope you are doing ok.