Freestyle Libre Sensor / insulin problems

[Kimberley2026]

Hi,

I am currently on the Libre sensor and my blood sugars are sky high and I am struggling to get a grip with them! I’ve checked my blood glucose alongside this and they seem to be running extremely higher than normal!

I’m currently one Levermir twice daily
8am =20u
8pm = 18u
Novorapid with meals and corrections
Breakfast 1:10 Lunch 1:10 Dinner 1.5:10
Metformin twice daily
Breakfast 8am
Dinner 6:30-8pm

I’ve done the obvious:

- checked for lumps - can’t see any obvious lumps
- changed the lot number of my insulin
- always do airshots when injecting
- rotating injection sites
- carb counts using the packets / and assisted by the carbs and cals app
- don’t overly fee unwell apart from a cracking head but I put that down to the high blood glucose

I have done DAFNE but with the high levels I feel I am taking bucket loads of insulin and when I look at the sensor graphs when I’m injecting it’s like the insulin isn’t even acting as they seem to rise instead of decrease.

Anything I’ve missed or any advice?

TIA

Kimberley

 

[Deleted Account]

The only thing I would suggest is changing your insulin pens/cartridges as they may be faulty.

 

[Jaylee]

Hi @Kimberley2026 ,

How high are your BGs going? Have you checked for keytones?

I notice from your other posts you also take metformin. After covering all the basics with the insulin. Could you have forgotten your metformin?

Edited to add; you can check your pen is dosing in the ballpark by firing 20u (after an airshot.) up to the mark highlighted in the needle cap picture below.

 

[porl69]

Cant really add to what has already been said, sorry.
Have you been checking for ketones? Type is is a right royal PITA on times. Fingers crossed this is just a small blip in your control. Good luck and keep us upto date on what's happening

 

[porl69]

Just a thought...are you coming down with something??

 

[therower]

@Kimberley2026 . You seem to have covered most things yourself. Just a few other things you may consider.
DAFNE as good a course as it is, it doesn’t really work very well if we are dealing with extreme insulin resistance or sensitivity.
DAFNE guidelines can be a bit to basic. For instance if my sugars are running high 14+ then my ratio will change from 1:10 to 2:10 that’s before I do a correction dose, again if I’m correcting at 14+ I’ll be looking to inject 1unit Novorapid to drop me 2 points if I’m lucky.
Whenever blood sugars play up for no reason then a good place to start is with basal testing. We easily fall into the trap of assuming that our basal levels are okay. They were fine last week, nothings changed this week so they must be right. Sadly this is diabetes and it doesn’t work that way.
We are all different especially when it comes to how insulin works for us. When you say bucket loads it’s quite possible that another person may see the amount as small. It can be a bit scary to start injecting what feels like a lot of insulin.
Another thought when you say your levels seem to rise instead of fall.
Do you pre bolus? I personally have found that over the years my need to pre bolus for a longer period of time has increased.
Depending on what you eat and when you inject can quite often paint a picture of insulin doing nothing especially if your levels are elevated prior to eating.
That’s all I can offer to what’s already been said. Hope you get it sorted. If you don’t then come back with a bit more information, food, dosage, timings etc. I’m sure the solution is there we just need to find it

 

[Energize]

I may be talking out of the top of my head, knowing little re Type 1 but is there any chance you're even a bit dehydtated? Perhaps drinking a quantity of water over a period of time would help?
Apologies if I'm totally off the rails here
Hope your levels resume your 'normal' very soon

 

[Kimberley2026]

The only thing I would suggest is changing your insulin pens/cartridges as they may be faulty.

I forgot to add that to the list - I received a new pen last week as I thought it might be this but things are still the same. Changed batches of insulin to see if it was that too.

 

[Kimberley2026]

@Kimberley2026 . You seem to have covered most things yourself. Just a few other things you may consider.
DAFNE as good a course as it is, it doesn’t really work very well if we are dealing with extreme insulin resistance or sensitivity.
DAFNE guidelines can be a bit to basic. For instance if my sugars are running high 14+ then my ratio will change from 1:10 to 2:10 that’s before I do a correction dose, again if I’m correcting at 14+ I’ll be looking to inject 1unit Novorapid to drop me 2 points if I’m lucky.
Whenever blood sugars play up for no reason then a good place to start is with basal testing. We easily fall into the trap of assuming that our basal levels are okay. They were fine last week, nothings changed this week so they must be right. Sadly this is diabetes and it doesn’t work that way.
We are all different especially when it comes to how insulin works for us. When you say bucket loads it’s quite possible that another person may see the amount as small. It can be a bit scary to start injecting what feels like a lot of insulin.
Another thought when you say your levels seem to rise instead of fall.
Do you pre bolus? I personally have found that over the years my need to pre bolus for a longer period of time has increased.
Depending on what you eat and when you inject can quite often paint a picture of insulin doing nothing especially if your levels are elevated prior to eating.
That’s all I can offer to what’s already been said. Hope you get it sorted. If you don’t then come back with a bit more information, food, dosage, timings etc. I’m sure the solution is there we just need to find it

Hi,

I do pre bolus - around 15-20 minutes beforehand.

I’m also on Metformin 500mg twice a day due to ‘insulin resistance’.

Other than a banging headache I feel generally well - headache I have put down to to the high levels.

I split my basal in two(ish) 8am = 20u of levermir and 8pm = 18u

I think tomorrow I will try a carb free breakfast and see if I’m running out of basal insulin during the night and then carb free lunch on Tuesday. I guess doing a food diary may help increase its my intake of something they I may not be counting for some reason.

If my basal is fine I think I might try increasing my ratio like you have, as it is barely making any difference.

My diet is varied- lots of veg and fruit with either chicken, beef or fish mainly. I tend to make from scratch so it makes the carb counting easier. I weigh all carbs out and use the carbs and cals app as guidance for carb intake. I rarely eat white bread - tend to stick to granary when I eat it.

The Libre sensor is showing they it rarely dips when I have taken an injection and wasn’t sure if my insulin resistance is high and maybe I need to try a different type maybe something that’s quicker acting than novorapid - maybe FIASP.

It feels like a head in hands situation as I feel I’m not getting anywhere with it!

Thank you for the advice! Will also take adding more time to my pre bolus.

 

[therower]

@Kimberley2026 . How frustrating. You’re obviously doing and trying everything possible to get this sorted.
I suppose the next question is how long has this been going on?
Could it be something not related to directly diabetes? Maybe a viral infection from a few weeks back? Stress?
Apologies for clutching at straws.

 

[Kimberley2026]

Hi @Kimberley2026 ,

How high are your BGs going? Have you checked for keytones?

I notice from your other posts you also take metformin. After covering all the basics with the insulin. Could you have forgotten your metformin?

Edited to add; you can check your pen is dosing in the ballpark by firing 20u (after an airshot.) up to the mark highlighted in the needle cap picture below.


View attachment 32611

BG are highs of 24 and barely going below 15- which is unusual for me I usual sit around 8(ish)

I have checked my ketones by blood and the results are 0.1.

Metformin I take with breakfast (around 8am) and evening meal (between 6:30-8pm) - I don’t recall forgetting to take a dose.

Thank you the image - I have just tried this with my pen to see if it matches and it does.

It just seems like a head in hands moment at the minute! It’s far too complicated!! ‍

 

[Kimberley2026]

I may be talking out of the top of my head, knowing little re Type 1 but is there any chance you're even a bit dehydtated? Perhaps drinking a quantity of water over a period of time would help?
Apologies if I'm totally off the rails here
Hope your levels resume your 'normal' very soon

High BG makes me feel really thirsty so am drinking a lot at the moment.

I appreciate all the advice, suggestions and knowledge sharing!

 

[Kimberley2026]

Hello @Kimberley2026 Welcome to the forum.

Hmmm tricky one, I had a similar thing a few weeks ago, I put it down to experimenting by dropping my long lasting insulin by one unit, but that's not 100% confirmed that was the reason. Shoved a shed load of insulin in and it seemed to have little if any effect.

You appear to have covered the bases above the only other things it may be is
Stress true you will be feeling stressed about the numbers, but work, life etc stress that might be playing a part?
Illness, bug or something?
Time of the month I know from some on here can play havoc by becoming insulin resistant.

Mine did after about a week or so come back down to normal levels but it wasn't fun.

I shall see if I can rally the troops to see if the collective can offer anything else, like @Mel dCP , @helensaramay , @therower , @Robinredbreast, @Fairygodmother, @porl69 , @karen8967 , @smc4761

If all else fails it might just be one of those things.

I feel like I’m wadding through mud at the moment.

I don’t feel unwell apart from a headache I’ve put down to high BG. Unless I’m harbouring something and it just hasn’t appeared yet.

Stress - my job is no more stressful than it usually is. Don’t feel stressed at home.

I have a coil so don’t really know when my time of the month is as I don’t have periods and haven’t for 14 years.

I am usually insulin resistant in the mornings so my consultant has started me on Metformin twice a day and it did seem to help. I take it about 8am with breakfast and between 6:30-8pm with my evening meal.

I think I’m gonna try a carb free breakfast one day then a lunch the next to see if my basal is okay or running out.

I contacted my nurse on Friday and she suggested maybe trying FIASP if it continues.

Thank you for the advice. There’s a lot for me to try to see if it will improve!

 

[Kimberley2026]

@Kimberley2026 . How frustrating. You’re obviously doing and trying everything possible to get this sorted.
I suppose the next question is how long has this been going on?
Could it be something not related to directly diabetes? Maybe a viral infection from a few weeks back? Stress?
Apologies for clutching at straws.

It been like this for 2 and half weeks.

I generally feel okay other than a headache unless I’m harbouring something and it just hasn’t shown its face yet.

My job is no more stressful than it normally is.

I don’t generally feel stressed other than the added stress on unruly diabetes! ‍

 

[Kimberley2026]

Cant really add to what has already been said, sorry.
Have you been checking for ketones? Type is is a right royal PITA on times. Fingers crossed this is just a small blip in your control. Good luck and keep us upto date on what's happening

It’s an absolute nightmare when it doesn’t behave!!!

I have been doing regular blood ketones and they are at bay at 0.1 thankfully!

 

[Fairygodmother]

Hi Kimberley,
How long have you been taking metformin for? And did your Consultant take the dawn phenomen and/or the ‘feet on the floor’ syndrome into account? Both occur when the liver dumps glucose to get us going in the mornings - I know that if I don’t add 1.5 to 3 extra units of fast acting into the morning routine then I’ll be high and cursing for much of the day.
Also, how long have you been taking Novo and your basal insulin for? It’s a long shot but I wonder if we cease to respond so we’ll to exogenous insulins that we’ve been taking for a significant time. They’re not a complete match for the ones the defunct beta cells would have produced and that can lead to rejection. Just a personal theory so dismiss it if needed, or if the more science trained amongst us put me right
However, you may find that it’s just one of the multitudinous things that can affect T1 balance, and if it is then I hope it’s short lived!
And if you get towards DKA then please please seek hospital help. And even if it doesn’t maybe a request for a Consultant appointment is needed.
Good luck and commiserations - it’s wretched when things don’t work as they should.

 

[Fairygodmother]

Grrrrr, why does pred text on this site scatter apostrophes like confetti!!!!!

 

[Jaylee]

BG are highs of 24 and barely going below 15- which is unusual for me I usual sit around 8(ish)

I have checked my ketones by blood and the results are 0.1.

Metformin I take with breakfast (around 8am) and evening meal (between 6:30-8pm) - I don’t recall forgetting to take a dose.

Thank you the image - I have just tried this with my pen to see if it matches and it does.

It just seems like a head in hands moment at the minute! It’s far too complicated!! ‍

No problems with the (sorry about the blurred.) image, a picture tells a thousand words.

I'm also a bit of a nupty forgetting Metformin not only helps with insulin sensitivity. But also retards liver dump..

My next question may seem stupid. Here goes. Your long acting basal? What type & dosage do you take & how long does a cartridge last...?
I'm wondering if your basal has gone off.? My reasoning. Where I live, (south UK.) here has been some pretty unprecedented hot weather. (Some great weekends the last couple of weeks.) Could your basal pen have been hit by sunlight through a window?? (Raising its temp during the day.)

Now I've just noticed you edited your original post. I'll start the car...

 

[EllieM]

How have you been going on correction doses? I have high insulin resistance but I can usually bring high sugars down with a correction dose. It may be that you need to increase the insulin for that dose?

And honestly, with your sugars that high for that long -I'd go to my GP and get checked out. As others have already said, illness pushes bg and insulin requirements up. I wouldn't automatically assume that the root cause is the diabetes. Maybe your doctor can diagnose something else that is the issue eg those headaches could be caused by a blood imbalance eg vitamin D deficiency is incredibly common among adults.

Good luck: my vote is for going to see your GP.

 

[Dexta]

I know this doesn’t really address the possible causes but have you changed your exercise routine? I know when I’ve been high the last thing I want to do is take exercise and yet if I take my dog for a walk it can lower my blood sugar level quite quickly. Just a thought.