Advice needed. type1 and high levels

[Applenerd81]

Yes Ive done dafne and I carb count. How come your current insulin can suddenly stop working and the other one will work ?! Im definitely going to walk in clinic tomorrow. Hopefully will stay off ketones till then!

If the insulin is spoiled (heat exposure) or out of date it can stop working - this is pretty unlikely if you store your pens correctly at room temp or less and change cartridges at least every month.

If your blood glucose is high and producing ketones your sensitivity to insulin can decrease quiet dramatically until normal levels are reached - so more insulin is required. This is further compounded if your eating more carbs which drive up your blood glucose further before they can recover.

The sick day rules (someone will share of not already above) give guidance on dose adjusting. This centres around testing, dosing, testing and dosing as required - the key is regular monitoring and dosing until levels are back in range.

 

[CarbsRok]

If your ill your insulin requirements may go up considerably (basal can go up to 200%+).

Follow sick day rules, failing that contact your diabetes clinic directly and soon.

I think you are talking pump talk here OP is on MDI, so would only increase by a couple of units each increase.

 

[donnellysdogs]

Hi Ewelina

I would recommend that you see a consultant and not a GP.

If you are under GP care only then you need to politely ask for a referal to a consultant. If you are under a consultant then you need to speak to the hospital team. All type 1's are entitled for an endo advice rather than a GP.

There are still sick day rules for people on mdi, so whether you feel sick or not to me sick day rules apply as soon as I get two readings one after another above 10.0 without a known reason.

Basals do change and I would be doing a basal and correction test if I was in your situ. Ie. If you are high... You can still test to see if your correction ratio is correct so long as you do not eat or bolus again within 5 hours. By the end of 5 hours you should be at your ideal reading.. If not then your correction bolus ratio is wrong. If you go low within 5 hours your bolus was too much and you need to stop the test and eat, but make sure that you amend your bolus ratio for next time.

GP's generally practice medicine. They are not specialiasts.

 

[Daibell]

For interest can I ask what your BMI is just in case any excess weight is causing the insulin not to work. Also, you mention carb-counting but not whether you have reduced your carbs? Apologies if none of this is relevant.

 

[ewelina]

Thank you all for your responses. Its great to know I can always come here if I need any help.
My levels seems to be better now in the evening (about 10 which is not perfect but much better than it was before)
My BMI is about 25 so just on the border of being overweight My diet is on the lower side when it comes to carbs (about 100g) but in the last few days it was definitely low carb as I was scared of eating anything.
I cant really work out why Ive been so high in the last few days. I will go to diabetic clinic tomorrow and post here the update.

 

[ewelina]

Hi again. Went to diabetic clinic and saw diabetic nurse. Im kind of back to normal today with acceptable levels. The nurse told me it must have been either viral infection or some lumps in injection site. I guess I will never know
Thank you for the time you spent answering my questions

 

[jack412]

If the insulin is spoiled (heat exposure) or out of date it can stop working - this is pretty unlikely if you store your pens correctly at room temp or less and change cartridges at least every month.

If your blood glucose is high and producing ketones your sensitivity to insulin can decrease quiet dramatically until normal levels are reached - so more insulin is required. This is further compounded if your eating more carbs which drive up your blood glucose further before they can recover.

The sick day rules (someone will share of not already above) give guidance on dose adjusting. This centres around testing, dosing, testing and dosing as required - the key is regular monitoring and dosing until levels are back in range.

I would check with your nurse and/or drug company...AFAIK..insulin is normally stored in the fridge until use. the one in use has a 'room temp lifespan' of 30 days

 

[Applenerd81]

I would check with your nurse and/or drug company...AFAIK..insulin is normally stored in the fridge until use. the one in use has a 'room temp lifespan' of 30 days

Correct, insulin should be stored in fridge, my comment related to pen / cartridge which is currently in use. Thanks for pointing out, apologies for any confusion.