Why in Type 1 Diabetes Insulin Not Working Efficiently?

Diabetes is a lifelong condition that impairs the maintenance of blood glucose levels. Then insulin becomes a lifeline for the patient. However, there are some instances when in the case of type 1 diabetes insulin not working properly. 

It will be a nightmare for any type 1 diabetic patient. However, I have rounded up all the situations where you may find the insulin is not working. It will help you to understand what’s going on and take the necessary measures.  

On the other hand, it might cause several episodes of hypoglycemia. Both situations are indicating that the insulin is not working properly.

Type 1 Diabetes Insulin Not Working
Photo by Nataliya Vaitkevich from Pexels

What is Insulin, and How Does it Work?

Insulin is an endocrine hormone produced by the beta cells present in the islets of Langerhans, which are patches of endocrine tissue situated irregularly in the pancreas. The main function of insulin is the regulation of blood glucose levels.

Insulin mainly works by facilitating the absorption of excessive sugar in the blood by the body’s peripheral tissues. It includes the liver cells known as hepatocytes, the fat cells known as adipocytes, and the muscle fibers. Sometimes the body does not need any glucose for utilization. Insulin helps the liver to absorb the extra glucose. 

The glucose goes through several chemical reactions in the liver. Then it is stored in the body in the form of glycogen. Glycogen is the storage form of glucose for humans. 

When the body suffers from low blood glucose levels, this glycogen is broken down to supply energy. Up to 5% of the liver’s body mass can be used as glycogen reserve. 

Reasons Why Type 1 Diabetes Insulin Not Working

Even though you are following your doctor’s orders and taking the exact dosage of insulin as prescribed, there might be several reasons to which your insulin might not be working. Rather than asking why is my insulin not working type 1, let’s look at the causes. 

Insulin resistance

Patients with type 1 diabetes are at risk of developing insulin resistance the same as anyone else. Insulin resistance may progress to form type 2 diabetes. Conditions as such are known as double diabetes. The major reason for developing such a condition is obesity. 

Though it is not as common, patients with type 1 diabetes mellitus can gain an excessive amount of weight which might lead to such devastating conditions. 

However, insulin resistance can be reduced by taking proper steps and measures. On the other hand, the type-1 diabetic condition needs to be carefully monitored as it is a lifelong condition.

The causes of such condition developing might be as follows:

  • Excessive weight gain or obesity
  • Presence of predisposing conditions like polycystic ovary syndrome, fatty liver, etc.,
  • Consumption of diet which is rich in carbohydrate
  • History of gestational diabetes mellitus
  • History of diabetes in the family
  • Sedentary lifestyle
  • Chain-smoking
  • Old age (above 50 years)
  • Hormonal conditions like Cushing syndrome, hypo/hyperaldosteronism
  • Taking steroid drugs, HIV drugs, antipsychotic drugs, etc. 

So, there might be multiple causes leading to the malfunctioning of insulin.

Photo by Artem Podrez from Pexels

Choosing the same site repetitively

One of the reasons for the insulin not working properly is choosing the same site again and again. You can take your insulin shot in several areas of the body. The areas include the abdomen, back of the upper arm, thighs, waist, or buttocks. 

But choosing the same site over and over is not a good idea. You must alternate between the sites regularly. If the same body part is selected for a prolonged period, then scar tissues may develop, and there might be a lumpy mass underneath the skin. For this reason, the mass may hamper the proper absorption of insulin.

Not taking the proper dose

I am not juggling with the concept of what happens if a type 1 diabetic doesn’t take insulin. But there may be an issue with the dosages. 

You might not be administering the proper insulin dose for which your blood sugar level does not reduce sufficiently. Some people are scared of needles or find taking shots very painful. 

As a result, they do not take the proper dose of insulin. Some people are scared of suffering from hypoglycemic symptoms. For which they may take reduced doses. This causes more harm than good. 

If you are nervous about taking shots by yourself, you can opt for using an insulin pen or a pump. Pumps have automated programming. This may alert you when your blood sugar level rises more than normal.

Improper drug combinations

You may be taking a combination of drugs for conditions other than diabetes, which hamper insulin action. For this reason, your blood sugar level is not regulated properly. 

You must consult your doctor and let them know about all of your medications. You might be suggested to adjust your dose or may be prescribed alternate drugs for your other condition.

Other reasons for persistent high blood sugar

Besides the reasons mentioned above, there can be several other reasons for which your blood sugar level is not within the normal level. Some of the reasons are:

  • Impaired physical condition or illness
  • Forgetting to take proper medication
  • Reduction in the frequency of exercise
  • You have reduced levels of insulin, but you are doing strenuous exercise
  • Increased intake of foods with high glycemic intake like carbohydrates, desserts, sweets, sugar, etc.

Type 1 Diabetes Mellitus and the Role of Insulin

In type 1 diabetes, the body produces an insufficient amount of insulin; thus, there is less absorption of glucose by the peripheral cells of the body. The amount of glucose absorbed is not sufficient enough to produce storage glycogen. 

This glycogen is the main source of energy for the body. Due to a lack of proper energy, the body tries to look for an alternate pathway to produce energy, producing keto acids as a replacement.

 But these keto acids can prove to be very harmful to the body. Excessive production of keto acids can cause a life-threatening condition called ketoacidosis

To avoid conditions like this, Type 1 diabetes patients need to take synthetic insulin shots which ensures proper insulin absorption and glycogen production. Until in type 1 diabetes insulin not working properly. You May have to think about other options then. 

Insulin Treatment for Type-1 Diabetes

When you have type 1 diabetes mellitus, it becomes necessary for you to administer insulin. Your body cannot produce enough to combat the flow of excessive glucose in the blood. 

Without this insulin, the body would start looking for alternate sources of energy, leading to lethal conditions. Type 1 diabetes mellitus is called insulin-dependent diabetes mellitus due to its dependency on insulin from an early stage of manifestation.

There are a whole lot of insulins to choose from for the treatment of type 1 diabetes mellitus. You can pick any of the following options. 

Rapid-acting insulin

This is usually taken before meals to combat the extra flow of glucose in the bloodstream after meals. This insulin is known as the bolus dosage, and it starts working within 15 mins of administration.

Short-acting insulin

Short-acting insulin also acts as a bolus dosage and is administered before meals. It is taken 30 minutes to an hour before taking a meal, and it takes almost 30 minutes to start its action. Its effects are more long-lasting as well.

Intermediate-acting insulin

This insulin is similar to the basal flow of insulin released by the beta cells. Basal flow is the amount of insulin constantly remaining in the body for normal functioning.

Since patients with type-1 diabetes do not have sufficient insulin, they must maintain their basal flow. So this type of insulin is necessary for type-1 diabetic patients. The effects of this insulin last for 10 to 16 hours.

Long-acting insulin

Long-acting insulin also has a very long-lasting effect. This also imitates the basal flow of the pancreas and provides a constant supply of insulin in the blood. Its effects last up to 24 hours.

Mixed insulin

Mixed or premixed insulins of several types of insulins. For example, Long-acting and rapid-acting insulins are mixed to ensure enough insulin in the body. It is used for sufficient basal flow as well as bolus flow.

Type 2 Diabetes Mellitus and the Role of Insulin

Patients suffering from type 2 diabetes mellitus mainly suffer from insulin resistance. The body might produce a sufficient amount of insulin, but the blood glucose level is not reduced due to insensitivity to the hormone.

Initially, there may be a rise in insulin production by the beta cells of islets of the Langerhans in the pancreas. But if the condition is prolonged, then the cells stop functioning, causing them to become atrophied. 

So the insulin production would reduce eventually. In such circumstances, the type 2 diabetic patient may need to take synthetic insulin shots. This will help maintain proper blood glucose levels.

However, like the scenario in type 1 diabetes insulin not working, you may have to face the same in the case of type 2 diabetes.   

Risks of High Blood Sugar

Suppose your blood sugar level is not maintained properly. In that case, you might be at risk of developing several serious conditions that might hamper the progression of your daily life or, worse, can prove to be lethal. 

  • High blood sugar for a long amount of time can deposit itself in different parts of the body.  It can accumulate in the eyes. Then it can give rise to several eye problems like cataracts.
  • Excessive deposit of glucose on the nervous tissue can cause peripheral neuropathy.
  • It may hamper your sexual health as it may hamper the ability to get erections due to deposition in the penile blood vessels and tissue.
  • High blood sugar may lead to low immunity. This makes you a susceptible host to bacterias and viruses who need sugar to survive. This may result in delayed healing of wounds and may even lead to gangrene.
  • You may be susceptible to more vaginal infections and urinary tract infections
  • You may develop proteinuria, which is the passing of proteins through the urine. It is caused due to excessive stress on the kidney trying to filter out the excessive blood sugar.

What to Do When in Type 1 Diabetes Insulin Not Working?

When you notice persistent high blood sugar levels, immediately inform your doctor about the situation to avoid adverse effects. You must test your urine for ketone bodies. Don’t delay the urine test. If the test comes positive, then you’re suffering from ketosis.

Drinking sufficient water may help to flush out some amount of the ketone bodies. But keep measuring your blood sugar level until your doctor advises you to take any steps.

Other Ways How to Lower Blood Sugar in Type 1 Diabetes

Insulin is the best solution for bringing down blood glucose—however, some old-school methods may help keep your blood sugar levels at bay.

Proper exercise

Proper exercise is one of the best steps you can take to keep your blood sugar under control. It would help you manage your diabetic condition and allow you to lose weight and maintain a healthy life.

It would also stimulate insulin to work properly. Daily 30 minutes or more exercise is enough to keep you active.

Choose your food wisely

A healthy diet is a go-to method for maintaining proper sugar levels. It also helps in weight reduction, which is necessary to combat insulin resistance. Consult a dietician along with a diabetes expert. They will help to figure out a meal plan that is best for your needs.

You can also opt for weight loss drugs if necessary but make sure to consult with a general physician first.

De-stress

Stressful conditions hamper the release of insulin from the pancreas. Prolonged periods of stress may lead to the accumulation of glucose in the blood. 

Proper relaxation along with a healthy diet is necessary. Breathing exercises, yoga, different forms of therapy, etc., can help you to de-stress. This is one of the best ways of how to bring blood sugar levels down without insulin. 

FAQ

Can type 1 diabetic patients become insulin resistant?

Yes, it is possible. It is becoming more common nowadays for type 1 diabetic patients to develop insulin resistance. One of the main reasons behind this is excessive weight gain.

Are all the type 1 diabetic patients skinny?

It has been observed that most type 1 diabetic patients are underweight. However, when they would start taking insulin, they revert to normal weight range.

What happens when a diabetic becomes insulin resistant?

Insulin resistance is when the peripheral cells of your body stop absorbing glucose. Due to insulin resistance, an excessive rise in blood sugar levels may lead to other adverse conditions.

Final Thoughts

A persistent rise in blood sugar levels may make you wonder why your insulin is not working. Our advice would be to frequently check your blood glucose levels and contact your health team immediately. 

Look out for adverse symptoms in type 1 diabetes insulin not working and make a trip to the hospital if necessary. 

I'm Sabriha Hasan, a 3rd year medical student from Armed Forces Medical College. I chose to study medicine to do something for the greater good and to use my skills and knowledge to provide relief to those who are suffering. Writing is second nature to me. I always try to provide readers with necessary information that would not only quench their thirst for knowledge but also help them in long run.

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