Kind of urgent levels staying high have no control

Amrit1712

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107
Type of diabetes
Type 1
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Insulin
Sorry about the long post... I'm wasn't sure what sub section to put this in so put it here. For the last 4-5 days, my levels have literally been out of control. They've only been below 9 a couple of times. Today they've been 6.7 breakfast , 9.8, 7.5 lunch, 13.1, 11.8 dinner and 12.8 just now. They are so high even though I've been taking correction doses and changed my ratios to take more insulin. I've tried replacing my cartridge of Novo but that didn't help. My control is normally fine but this is crazy for me and I feel helpless and tired.
 

himtoo

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why can't everyone get on........
Hi there
first thought is are you suffering with a cold or do you possibly have an infection ??
insulin needs increase with an infection.

here is a link to sick day rules which may help.

http://www.diabetes-support.org.uk/info/?page_id=141

also -- a call to your support team would be a good idea too in my opinion.
 
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AndyS

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Another possibility is you may have had a change to your basal requirements. If you are consistently having to apply the same or similar corrections or you are seeing that your numbers are always a similar amount above what you expected they should be following previous meal and dose then, if you are not ill, you are likely looking at needing to make changes to your basal insulin.

Hope you get it back under control soon.

/A
 

Amrit1712

Well-Known Member
Messages
107
Type of diabetes
Type 1
Treatment type
Insulin
Hi there
first thought is are you suffering with a cold or do you possibly have an infection ??
insulin needs increase with an infection.

here is a link to sick day rules which may help.

http://www.diabetes-support.org.uk/info/?page_id=141

also -- a call to your support team would be a good idea too in my opinion.

As far as I'm aware, I don't think I'm suffering from an infection so I'll probably get in touch with my support team. Thanks
 

Amrit1712

Well-Known Member
Messages
107
Type of diabetes
Type 1
Treatment type
Insulin
Another possibility is you may have had a change to your basal requirements. If you are consistently having to apply the same or similar corrections or you are seeing that your numbers are always a similar amount above what you expected they should be following previous meal and dose then, if you are not ill, you are likely looking at needing to make changes to your basal insulin.

Hope you get it back under control soon.

/A

Hi Andy, I have seen that my numbers are always similar amounts above what I think, normally around 11-13. I take 12 units of levemir before bed and thats the only time I take it. Went to bed at 12.8 yesterday and woke at 8.7. So increasing my basal to 13?
 

BeccyB

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How are your injection sites? Could you be injecting into lumps?
 

Amrit1712

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Messages
107
Type of diabetes
Type 1
Treatment type
Insulin
How are your injection sites? Could you be injecting into lumps?
I forgot about that! I don't feel any pain whilst injecting but it feels a bit weird under where I inject, feels a bit firmer
 

BeccyB

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465
Type of diabetes
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I remember being told that it doesn't hurt injecting into lumps. Sounds like moving to a fresh site would be worth trying
 

AndyS

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784
Type of diabetes
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Hi Andy, I have seen that my numbers are always similar amounts above what I think, normally around 11-13. I take 12 units of levemir before bed and thats the only time I take it. Went to bed at 12.8 yesterday and woke at 8.7. So increasing my basal to 13?
Did you apply any correction before bed or was it just the levemir?

With nothing else if you are seeing a drop overnight then it seems that your levemir is a little high if anything. I am surprised that you are only taking a single dose a day as typically it doesn't last a full 24 hours (according to http://iddt.org/about/gm-vs-animal-...imes-of-animal-gm-human-and-analogue-insulins they recon about 14 hours) so perhaps you need to look at splitting your dose. Ideally overnight you shouldn't see too much of a rise or fall, a 4mmol drop overnight looks to me like too much levemir at night, if I had that kind of drop I would be backing off my evening levemir by 2 units but I take 2 doses a day of that.

I would strongly suggest that you contact your DSN and discus with them about splitting your levemir dose since you are apparently dropping overnight and rising during the day, however I suspect you are covering for the lack of basal insulin in the afternoon with your rapid insulin doses instead. Have you completed DAFNE or some other similar course? If not then it might be worth doing a quick search and familiarising yourself with how to keep a diary in that format then go to your DSN with that. Being able to see the splits between your food dose and correction doses as well as the daytime and overnight basal activity should help work things out.
 

Amrit1712

Well-Known Member
Messages
107
Type of diabetes
Type 1
Treatment type
Insulin
Did you apply any correction before bed or was it just the levemir?

With nothing else if you are seeing a drop overnight then it seems that your levemir is a little high if anything. I am surprised that you are only taking a single dose a day as typically it doesn't last a full 24 hours (according to http://iddt.org/about/gm-vs-animal-...imes-of-animal-gm-human-and-analogue-insulins they recon about 14 hours) so perhaps you need to look at splitting your dose. Ideally overnight you shouldn't see too much of a rise or fall, a 4mmol drop overnight looks to me like too much levemir at night, if I had that kind of drop I would be backing off my evening levemir by 2 units but I take 2 doses a day of that.

I would strongly suggest that you contact your DSN and discus with them about splitting your levemir dose since you are apparently dropping overnight and rising during the day, however I suspect you are covering for the lack of basal insulin in the afternoon with your rapid insulin doses instead. Have you completed DAFNE or some other similar course? If not then it might be worth doing a quick search and familiarising yourself with how to keep a diary in that format then go to your DSN with that. Being able to see the splits between your food dose and correction doses as well as the daytime and overnight basal activity should help work things out.

I didn't apply any correction before bed and agree that I dropped a bit too much. I've been waking up slightly higher than when I go to sleep with normal levels so maybe going low overnight without realising. I've not completed any courses, was just taught about carb counting months ago. I'll get in touch with my DSN as well. Thanks for the help
 

AndyS

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Messages
784
Type of diabetes
Type 1
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Insulin
I didn't apply any correction before bed and agree that I dropped a bit too much. I've been waking up slightly higher than when I go to sleep with normal levels so maybe going low overnight without realising. I've not completed any courses, was just taught about carb counting months ago. I'll get in touch with my DSN as well. Thanks for the help
While waiting on a DAFNE course take a look at : http://bdec-e-learning.com/

It will get you started with a lot of the same principals though admittedly it doesn't go into basal correction. That tends to be a little more involved to do right.
 

BeccyB

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465
Type of diabetes
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I agree with AndyS - it's definitely worth getting on a DAFNE course if you can
 

Amrit1712

Well-Known Member
Messages
107
Type of diabetes
Type 1
Treatment type
Insulin
I agree with you both too, I'll ask my dsn and I have a meeting soon anyway. I think I've been alright up until now as my meter calculates my dose for me from the carbs I enter and correction. I just have to enter my ratios