Not real sure what’s going on here, in these days of 3-d scanners, anything could be in my insulin pens… I got 5 of them: out of the 5, 1 stopped working after a few days, 1 of them worked too much, and I stopped taking the long-acting, and switched back to just regular (that pen had an effect on my head, subtle but I felt it like a thud when the insulin started), the next one worked pretty well, but was not peakless as far as I could tell. It disappeared the night before my cardiology appointment. Someone removed it from the table. The next one was the one I just finished – it apparently wasn’t peakless either. I finally switched to the last remaining pen yesterday, splitting my dose between 2 pens (6-11), drawing the last few units out of the old pen with a syringe). The plunger on this one doesn’t seem to depress evenly. It jams during injection. I’m dreading having to try to get more long-acting insulin, because of what happened last time.
To demonstrate that there is a problem, what I did was lower the long-acting insulin from 20 to 17 units. I then fasted all day, and rested (it being the Sabbath) in bed most of the day apart from services and Hebrew school. I started the day with a blood sugar of 147, during the day, it went up to 181, and then down to 90, an hour and 1/2 before the end of the fast. I was able to finish the fast, but it clearly demonstrates that something caused the activity of the insulin to peak. And no, this does not mean that my basal level of insulin needs to be less than 20 units, generally…
Looking at the different long-acting profiles:
Not sure what I’m on, but I’m guessing it isn’t Lantus, even though that is what is says on the pen. To uncouple the effect of the insulin vs. something that is going on in my body to change insulin sensitivity, the insulin could be tried on another insulin-deficient individual. Or, the simpler solution would be to mass-spec the insulin in the different pens.