Insulin resistance/bloods not dropping like normal?

[azure]

Always be careful with your basal increases and corrections, but just to give you an idea my correction dose basically doubles when I have this problem, and, even then, my BS is higher than normal. Sometimes I have to do a second smaller correction to nudge it down. It's a question of patience and very careful monitoring throughout the day, I find.

As a note, when I first had this problem, I missed meals or had very low carb meals as I thought that might help, but in my case it didn't. In fact, if my BS was say, 10, I found eating my normal moderate carb meal with an appropriate bolus meant my BS after ws lower than having a no carb or low carb meal. I don't usually like to eat carbs when my BS is out of range, but when I have one of these high BS episodes I find this approach is best.

 

[Engineer88]

I'm on CGM so monitoring is easy alongside finger sticks of course. Low carb isnt unusual for me (actually it is the first lc meal in about 3 ish weeks now i come to think of it)

Stubborn high bs is ok I can deal with that, I'm just stumped by exercise and LC not fixing it, its my usual go to tools!

 

[azure]

Exercise doesn't work for me either when I get these highs. It usually brings my BS down quite quickly. I dont know whether it's correct, but my guess is that the dodgy site deprives my body of its normal feed of insulin for some hours or even days, and rectifying this takes longer as the effects continue much longer than normal. Thus exercise doesn't work as its fighting against this ongoing trend of high BS. When exercise does work is usually when things start to come down to normal levels.

 

[CarbsRok]

@Engineer88 how are you this morning?

 

[Engineer88]

Well yesterday evening as expected I dropped like a stone, ending up being 5/6 which was fine. CGM alarmed at 12pmish saying I was 18+

Now 14.5 and temp basal back on. tired but otherwise feeling fine. Going to call DSN in a min/ when I can get hold of her. Thanks @CarbsRok

Full set change including change of insulin vial tonight.

 

[CarbsRok]

@Engineer88 pleased you are in one piece even if bloods not behaving. As a matter of interest when you removed your cartridge from the pump was there any leakage from it I have noticed that there has been moisture/insulin from the cartridge seeping through the double rings at the bottom of the cartridge plunger, so am wondering if cartridges are faulty thus causing a problem. I informed Animas last night and they have asked for the return of one faulty cartridge which I have and the remaining 3 in the box.

 

[Engineer88]

No nothing like that that I noticed @CarbsRok

EDIT:

Changed everything last night and definitely no leakage. BG better today so far I think

 

[RuthW]

Branch Chain Amino Acids - something that weight lifters use to avoid DOMS. Since I started weight training, I started using them and the difference i have found to be immense. They really have made a massive difference and they seem to work with running, cycling and being a quick bowler in cricket as well.

Take 5g prior and 5g post training or match. I was amazed!

On the topic of post exercise inflammation, I have experienced this on extremely hard training sessions. The following day, I've struggled to get my BG levels anywhere near normal. It hasn't happened very often, but on the few occasions I have had it, it's a right pain. I was taking more than 2x my normal insulin and seeing little improvement.

Thanks. Though I wasn't too lazy. I googled it! (And I searched your blog, but you don't mention them there.) But your answer is more enlightening anyway. I think I'll buy some when I'm in the UK in July to visit my son. He's into weights as well so we can try them out together. And he'll know where to buy them, I'm sure!

 

[Engineer88]

Still having issues. Is there anyway to test the output of a pump? last ditch attempt is that it might not be delivering enough insulin (unlikely I feel)

Levels sticking in low/mid teens. Single figure results are rare though I have had a few.

Summary of what I've tried:
Temp basal
exercise
change set / cannula/ resivor
Change insulin vial (different batch)
busy at work but not hugely stressed I don't think
Not feeling unwell other than a mild headache which is just starting!

@Spiker @tim2000s @donnellysdogs @CarbsRok

Sorry I need to pick your brains guys,

 

[Robinredbreast]

Still having issues. Is there anyway to test the output of a pump? last ditch attempt is that it might not be delivering enough insulin (unlikely I feel)

Levels sticking in low/mid teens. Single figure results are rare though I have had a few.

Summary of what I've tried:
Temp basal
exercise
change set / cannula/ resivor
Change insulin vial (different batch)
busy at work but not hugely stressed I don't think
Not feeling unwell other than a mild headache which is just starting!

@Spiker @tim2000s @donnellysdogs @CarbsRok

Sorry I need to pick your brains guys,

So sorry to hear of your problems, you must feel like tearing your hair out. I hope you can get back into a normal stable range very soon.
Take care RRB

 

[Engineer88]

Thanks RRB, willing to take anyone's brain dump currently, I wasnt being too specific.

 

[Robinredbreast]

Thanks RRB, willing to take anyone's brain dump currently, I wasnt being too specific.

The only thing I know about pumps is reading about them on here, and some with a few issues as well.
Daft question probably, but have you googled the problem, apologises ( in advance if you have already) so frustrating for you

 

[tim2000s]

@Engineer88 This might sound daft, but can you test the bolus output of the pump into a pen needle protective cover (the ones that surround the entire needle and have the paper cover)? IIRC, The dose from the base of the cap to the bottom of the buttresses on the outside (on the novofine ones) is 20iu. If you were to cause a 20u bolus into one of these, you'd at least have a measure of whether it is providing the correct amount of insulin.

 

[CarbsRok]

@engineer can only suggest that you pump 20 units into your insulin pen cap. I think that's what people do to see if pen delivering ok.
Thinking back a few years now I seem to remember having a problem like that and what it worked out to be was the cannula, due to my body shape changing I required a different type/angle of set. So it might be worth your while looking in that direction. If you have ruled out hormones/pregnancy then try a different cannula type.
My basal does tend to change a lot though so overnight it can increase by 3 or 4 units then it will drop just as suddenly 4 or 5 weeks later.

 

[tim2000s]

20iu as per @CarbsRok and my earlier posts.

 

[azure]

Absolutely. I've found that most 'pump problems' aren't to do with the pump at all, but the sets and/or sites.

I got great help on here when I was having major high BS issues, and, having used Tenderlinks with no problem for years, I then swapped to Rapid Ds for my bum and that totally cured the problem. I coukdnt believe it. Thaose high sugars came on very quickly indeed so I'd never have guessed the solution could be a different set.

 

[donnellysdogs]

What sets are you using?

Flex ones are dreadful with me and I know a fair few ithers that have changed.

I was getting erratic levels on Insight flex.. Chronic but put up with them until the rspids came out.

Even now and this has been reported to Accuchek that I have to change daily. Itherwise at odd random times on these short sets on the 2nd day I get totally random highs occuring. As I only eat once a day and my first day is perfect. Currently this is being put down to me being slim and no fat.....but changing daily has resolved the problems.

I think whatever the sets you are ysing are unsuitable. May be too long or short, maybe because they are the wrong type for your body...

It is unlikely to be insulin resistance if you are getting good readings on 1st day etc...

You need to consider changing sets or length or length of them.

 

[Engineer88]

Thants what I was looking for - didnt even think it would be transferable! duh!! doing it now

 

[Engineer88]

I use inset II 90 6mm.

anyone know the BD microfine equivalent to the Novofine? I googled it but didnt find a picture. Its filled the needle tip.

Currently 8.5 and 60% basal has finished.

Typically my CGM has bugged out too so will test again in an hour.

 

[Engineer88]

What sets are you using?

Flex ones are dreadful with me and I know a fair few ithers that have changed.

I was getting erratic levels on Insight flex.. Chronic but put up with them until the rspids came out.

Even now and this has been reported to Accuchek that I have to change daily. Itherwise at odd random times on these short sets on the 2nd day I get totally random highs occuring. As I only eat once a day and my first day is perfect. Currently this is being put down to me being slim and no fat.....but changing daily has resolved the problems.

I think whatever the sets you are ysing are unsuitable. May be too long or short, maybe because they are the wrong type for your body...

It is unlikely to be insulin resistance if you are getting good readings on 1st day etc...

You need to consider changing sets or length or length of them.

Thanks Donnelly, I've been using 90's since ive started pumping and never had issues like this before. I havent gained piles or weight or muscle and I'm using areas I've used before again without issue. I dont think ive got any other lengths will look when I get home.