Sudden loss of control - help!

[HlionC]

Hi everyone,

I've had diabetes for nearly 30 years and a year ago did the DAPHNE course, so my diabetes is usually very well controlled.

I'm currently travelling in South America (nothing new, I travel a lot) and my sugar levels have suddey become totally uncontrollable, either way too high or low.

For example, for breakfast yesterday I calculated I needed 6 units of novorapid, but I had to give myself a 2 unit corrective dose 3 hours later. Today, I had the exact same breakfast, gave myself 8 units and I'm still needing to give myself a corrective dose of 3 units 3-4 hours later. Argh!

The temperatures here aren't extreme (it's basically like an English spring/summer) and I'm keeping my insulin in a cool pack, so the issue shouldn't be that my insulin is going bad. True, I'm 'guesstimating' carbs a lot, but even when I have identical meals my levels go too high or too low. I'm also as active as I am at home.

Any thoughts on what it could be? As I said, I've done DAPHNE before but nothing is jumping out at me as to what the issue is...

Any thoughts would be greatly appreciated.

H x

 

[DCUKMod]

Hi everyone,

I've had diabetes for nearly 30 years and a year ago did the DAPHNE course, so my diabetes is usually very well controlled.

I'm currently travelling in South America (nothing new, I travel a lot) and my sugar levels have suddey become totally uncontrollable, either way too high or low.

For example, for breakfast yesterday I calculated I needed 6 units of novorapid, but I had to give myself a 2 unit corrective dose 3 hours later. Today, I had the exact same breakfast, gave myself 8 units and I'm still needing to give myself a corrective dose of 3 units 3-4 hours later. Argh!

The temperatures here aren't extreme (it's basically like an English spring/summer) and I'm keeping my insulin in a cool pack, so the issue shouldn't be that my insulin is going bad. True, I'm 'guesstimating' carbs a lot, but even when I have identical meals my levels go too high or too low. I'm also as active as I am at home.

Any thoughts on what it could be? As I said, I've done DAPHNE before but nothing is jumping out at me as to what the issue is...

Any thoughts would be greatly appreciated.

H x

Hello there HlionC - I'm only very envious of your current travels, but to your issue.

I'm not T1, nor do I use insulin, so my response is a question, based on observations of similar queries.

How long have you been travelling? Whilst you are keeping your insulin in a cool pack, have you tried new vials of insulin, whilst this has been going on? Do you have access to insulin from a different batch at all?

Hopefully someone with relevant observations will be along soon.

 

[HlionC]

Hello there HlionC - I'm only very envious of your current travels, but to your issue.

I'm not T1, nor do I use insulin, so my response is a question, based on observations of similar queries.

How long have you been travelling? Whilst you are keeping your insulin in a cool pack, have you tried new vials of insulin, whilst this has been going on? Do you have access to insulin from a different batch at all?

Hopefully someone with relevant observations will be along soon.

Thanks for the quick reply!

I've only been traveling three weeks so far and I've switched my vials, but it hasn't made a difference :-(

 

[DCUKMod]

Thanks for the quick reply!

I've only been traveling three weeks so far and I've switched my vials, but it hasn't made a difference :-(

At which point in the 3 weeks did this happen?

Are you more relaxed, or less relaxed than usual? I note from your profile you are female. How are your hormones? Have you started or stopped any medications recently?

 

[HlionC]

At which point in the 3 weeks did this happen?

Are you more relaxed, or less relaxed than usual? I note from your profile you are female. How are your hormones? Have you started or stopped any medications recently?

Started about one week in, changed vial in second week to no avail. Not particularly stressed. Hormones never usually affect me can't see why they would when I'm abroad!

 

[HlionC]

Started about one week in, changed vial in second week to no avail. Not particularly stressed. Hormones never usually affect me can't see why they would when I'm abroad!

And I started taking malarone yesterday, so that won't be it! No other extra meds.

 

[Deleted member 475901]

What about sleep patterns? And are you keeping hydrated?

 

[HlionC]

What about sleep patterns? And are you keeping hydrated?

Sleeping the usually amount (at least 7 hours per day, usually 8) and waking up between 6-8 each day. At least 2l of water per day too!

It occurred to me perhaps altitude (for the last 10 days I have been around 3000m above sea level) although I can't find much in Google to explain why this would have an impact.

 

[Rob87]

Hello, I’m a type 1 and have been for 26 years now. I too have occasional spells where my control hits the fan. I’ve also spent long periods of time at altitude (6 months at around 2500m) every winter for past 12 years and found that whilst my body is adjusting to the altitude I go through a week (more or less) of being both very sensitive and resistant to my insulin. I’ve increased and decreased my fast acting insulin by 50% at times but there has never been any sort of pattern to it. It’s scary every time but it has always calmed down. I’d imagine there may or may not be and argument for the increasing levels of haemoglobin in your blood caused by the lower levels of oxygen at altitude. There are also the other factors such as diet, hydration, stress, sleep, exercise. I’ve recently started self funding for a dexcom G6 CGM which has helped immensely with controlling the “flair ups” it has alarms for rise and fall rates, high and low blood glucose levels which allows me to compensate glucose or insulin in enough time to prevent either from happening. My partner also has the app so if I go low she gets an alert too which is comforting.