Pump but can't get blood sugar down

[sweaty betty]

Hi there - I've been on a pump for about 18 months and love it!
I've always been able to keep my insulin requirements down a bit by following a low carb diet, but the past 6 months have had trouble sticking to this (lots of life issues etc) so my control hasn't been great.

I met with the diabetes team just before Christmas and we came up with a plan to support my low carb eating and I've stuck to it. I've not really noticed any difference in blood sugar yet though.

Last week I started a 2 week trial of the libre blood sugar monitor - it's amazing! I've been scanning all the time to see if I can find patterns in my blood sugar etc. But I'm now faced with the undeniable fact that my blood sugar control seems to have gone out of the window.

I seem to be around 9-12mmol all the time, it's dropped as low as 6.8 a couple of times. I'm generally eating healthily, with the odd occasion where I'll have something more carby- which I account for using the pump wizard - but there are times when I'll try to correct my levels without eating (e.g. First thing in the morning before I've had time to even think about breakfast) and the insulin I have seems to have no impact whatsoever.

I'm really worried about this. I decided I'd give it a month of low carb then go back to the team to ask their advice, but was wondering if anyone had any ideas of things I could try before then?

My pump is currently set at carb ratio of 5g/unit and insulin sensitivity of 1.
I seem to have poor control throughout the day, not just at breakfast (as previously was the case).

Thanks in advance.

 

[CarbsRok]

Simple solution is do a basal test and reset your basals.
You say you are low carbing, does this mean you are having carb free meals of just protein and fat? If that's the case then you must bolus for that protein and fat.

 

[noblehead]

Agree with @CarbsRok , start with the basics and do some basal testing to make sure your basal rates are set at the right amount:

https://mysugr.com/basal-rate-testing/

 

[ljmercer]

I agree with the advice given so far. I would start with that to see if that helps your control in any way.

However, you may not have thought of this - have you tried a trial of metformin as well as your insulin? I've been stuck in a rut for ages with my BG control and my HbA1c; neither of them have come down no matter how many tweaks my team made. So I'm trialling metformin to see if they can lower my resistance.

If all else fails, ask about metformin.

 

[sweaty betty]

Hi - thanks for the responses. I'm already on metformin, but will have a look basal rates. How do I count protein and fat and adjust insulin accordingly?

 

[Ann48]

Hi, I've been on the mini med 554, (Due for an upgrade this month)I recently moved the position of the cannula from my stomach to my thigh, when the cannula was on my stomach my readings were around 12-18 and corrections not working, since moving the cannula to my thigh, glucose readings are much better. Anybody else found this to be a problem.