Constant High sugar levels

[Paige97]

Hi all,

My partner has recently been diagnosed with type 1 diabetes so he’s very new to all this! He’s currently having problems with his sugar levels being too high constantly. He’s being very cautious with the amount of sugar he has and he has always been very active and healthy. He also always drinks plenty of water. His sugar levels are currently ranging between 12-23. He always checks his sugar levels before meals too.
Would this suggest his insulin units need increasing/ changing? Or anything anyone would recommend? We would really appreciate some help! Thank you.

 

[Shaun*]

Hey I’m in the exact same boat newly diagnosed this week with type 1 and sugar levels always high (around the same as your partner) Im also fit an healthy and drinking plenty of water on a mostly protein/healthy fat based diet.... all new to me and trying to work it out alone is daunting. Anyways sorry for jumping on thread but also keen for advice and mine and your partners circumstances seem similar

 

[urbanracer]

Hi all,

My partner has recently been diagnosed with type 1 diabetes so he’s very new to all this! He’s currently having problems with his sugar levels being too high constantly. He’s being very cautious with the amount of sugar he has and he has always been very active and healthy. He also always drinks plenty of water. His sugar levels are currently ranging between 12-23. He always checks his sugar levels before meals too.
Would this suggest his insulin units need increasing/ changing? Or anything anyone would recommend? We would really appreciate some help! Thank you.

Hi @Paige97 ,

Don't worry too much as it all takes a while to settle down.

There is evidence to suggest that reducing average blood glucose levels too quickly may cause permanent damage to eyesight. It also makes you feel pretty rough too.

Your diabetes management team will probably increase his units slowly to make sure he is not having hypoglycaemia (low blood sugar below 4.0mmol).

Nice and easy does it!

 

[CelalDari]

Hi all,

My partner has recently been diagnosed with type 1 diabetes so he’s very new to all this! He’s currently having problems with his sugar levels being too high constantly. He’s being very cautious with the amount of sugar he has and he has always been very active and healthy. He also always drinks plenty of water. His sugar levels are currently ranging between 12-23. He always checks his sugar levels before meals too.
Would this suggest his insulin units need increasing/ changing? Or anything anyone would recommend? We would really appreciate some help! Thank you.

Is he on a fixed bolus regimen or does he adjust it according to the meals he is having?

I am 18 and was diagnosed a little more than a month ago. Due to the coronavirus situation the hospital is closed and only open for emergencies so I haven’t even seen my dietitian once. As a result I self-taught how to bolus. I know the basics such as carb counting and giving NovoRapid accordingly.

The problem with your partner sounds like incorrect dose of bolus and/or a too low basal

 

[EllieM]

Due to the coronavirus situation the hospital is closed and only open for emergencies so I haven’t even seen my dietitian once.

I don't understand why your diabetic team cannot contact you by phone or email. It's great that you've managed to teach yourself how do your doses but I am shocked that they send people out with a potentially lethal medication without any follow up. You don't need to physically see your advisors for them to recommend your doses, you can do that by phone or email.

on a mostly protein/healthy fat based diet....

This forum is dominated by T2s who need a low carb diet (or lots of meds) to stay healthy, just because less than 10% of diabetics are T1. As a T1 you are free to have carbohydrates, but you have to learn how much insulin to take for those carbs. Remember that T1 and T2 may have the same initial symptoms but are completely different illnesses.

 

[CelalDari]

I don't understand why your diabetic team cannot contact you by phone or email. It's great that you've managed to teach yourself how do your doses but I am shocked that they send people out with a potentially lethal medication without any follow up. You don't need to physically see your advisors for them to recommend your doses, you can do that by phone or email.


This forum is dominated by T2s who need a low carb diet (or lots of meds) to stay healthy, just because less than 10% of diabetics are T1. As a T1 you are free to have carbohydrates, but you have to learn how much insulin to take for those carbs. Remember that T1 and T2 may have the same initial symptoms but are completely different illnesses.

I have no idea. They did follow up calls on me but it was just to check how my blood sugar is for the first week back home from hospital (stayed there 4 days).

I’ve had a diabetes consultant call me twice and she has given me her mobile phone number so I can contact her. I contact her quite regularly regarding my test results (C peptide and GAD antibodies) I also asked her if I can adjust my insulin since I self-taught how to carb count and bolus, she said if you really want to then do it but if your blood sugar goes too high or too low then go back on the fixed bolus regimen. I am aware how potent insulin is, a single unit of NovoRapid can decrease your blood sugar by around 2.5-3 mmol/L so I’m very careful but my healthcare team are so surprised at how “smart” I am mainly because T1D usually affects young children and their parents.

A dietitian was supposed to call me around 3 times and hasn’t even called me once. We have another over the phone consultation on June 1st but I don’t have that much hope. I’m pretty sure I don’t know everything and would like to learn more but I think I can achieve that through a DAFNE course because I was in hospital 4 days and my dietitian didn’t come once, she was supposed to call me a couple of times and she didn’t. She’s actually annoying me so much because this is delaying how I treat myself and what kind of attention I get (I want a CGM and an insulin pump)

edited by moderator to remove offensive content

 

[Paige97]

Hi @Paige97 ,

Don't worry too much as it all takes a while to settle down.

There is evidence to suggest that reducing average blood glucose levels too quickly may cause permanent damage to eyesight. It also makes you feel pretty rough too.

Your diabetes management team will probably increase his units slowly to make sure he is not having hypoglycaemia (low blood sugar below 4.0mmol).

Nice and easy does it!

Thank you for this, we’re seeing his sugar levels slowly decrease over the days so that’s good news. We’re also keeping a diary of every reading we do so that we can take this with us to the diabetes nurse too

 

[Paige97]

Is he on a fixed bolus regimen or does he adjust it according to the meals he is having?

I am 18 and was diagnosed a little more than a month ago. Due to the coronavirus situation the hospital is closed and only open for emergencies so I haven’t even seen my dietitian once. As a result I self-taught how to bolus. I know the basics such as carb counting and giving NovoRapid accordingly.

The problem with your partner sounds like incorrect dose of bolus and/or a too low basal

He currently takes 9 units of Novorapid 3 times a day and 16 units of Lantus once per day. We think his dosage is incorrect however he’s luckily been given an appointment to see a diabetes nurse next week so hopefully this will help.

Thank you

 

[Borobob]

Using a carb to insulin ratio of 1 unit of fast acting insulin to 10g carb is usually advised. I think that getting the background (long acting insulin) is prob. the best thing to get right aswell. Check your blood before bed and soon as you get up before you eat to see if its roughly the same as before bed as it should be. If not add a couple of more units to the long acting till it's roughly the same. This all works better without eating to many complex carbs.

 

[CelalDari]

He currently takes 9 units of Novorapid 3 times a day and 16 units of Lantus once per day. We think his dosage is incorrect however he’s luckily been given an appointment to see a diabetes nurse next week so hopefully this will help.

Thank you

I was started on 16 units of Lantus initially but had to consult with my diabetes team and reduce it to 14 units as I was having 1-3 hypos a day.

9 units of NovoRapid per meal does seem like an awful lot but everyone is different. Usually but not all the time, people start on a 1:10 ratio where they give 1 unit a NovoRapid per 10g of carbs.

At this stage the diabetes team are being very careful because he might be in the honeymoon phase where he will produce his own insulin so additional exogenous insulin can make hypos very likely. The likelihood is that his basal will be adjusted by the diabetes team, he should do a BERTIE course online which will teach him the basics, he might want to start adjusting his dose of NovoRapid but I don’t recommend it to your partner yet because I don’t know him and how much he knows about diabetes.

I was diagnosed 2 months ago, stayed in hospital for 4 days and within a week of coming home I taught myself how to correctly bolus. I initially started matching my food to my insulin rather than the latter because I was on a fixed bolus regimen where I was doing 4u per meal so carb counting and eating 40g of carbs per meal. My diabetes team saw I had very good blood sugars mainly 5-7 mmol/L so when I asked if I can adjust my NovoRapid they said I can try and if I can’t manage then I should return to the fixed bolus regimen. However it worked out great for me but everyone is different.

90g of carbs per meal is quite a lot, assuming his ratio is 1:10. If he is still high after taking so much NovoRapid with 16u Lantus then it suggests the basal may be too high but that would have to be discussed with the DSN

 

[Paige97]

Using a carb to insulin ratio of 1 unit of fast acting insulin to 10g carb is usually advised. I think that getting the background (long acting insulin) is prob. the best thing to get right aswell. Check your blood before bed and soon as you get up before you eat to see if its roughly the same as before bed as it should be. If not add a couple of more units to the long acting till it's roughly the same. This all works better without eating to many complex carbs.

That’s really helpful, I’ll get him to try this. Thank you

 

[Paige97]

I was started on 16 units of Lantus initially but had to consult with my diabetes team and reduce it to 14 units as I was having 1-3 hypos a day.

9 units of NovoRapid per meal does seem like an awful lot but everyone is different. Usually but not all the time, people start on a 1:10 ratio where they give 1 unit a NovoRapid per 10g of carbs.

At this stage the diabetes team are being very careful because he might be in the honeymoon phase where he will produce his own insulin so additional exogenous insulin can make hypos very likely. The likelihood is that his basal will be adjusted by the diabetes team, he should do a BERTIE course online which will teach him the basics, he might want to start adjusting his dose of NovoRapid but I don’t recommend it to your partner yet because I don’t know him and how much he knows about diabetes.

I was diagnosed 2 months ago, stayed in hospital for 4 days and within a week of coming home I taught myself how to correctly bolus. I initially started matching my food to my insulin rather than the latter because I was on a fixed bolus regimen where I was doing 4u per meal so carb counting and eating 40g of carbs per meal. My diabetes team saw I had very good blood sugars mainly 5-7 mmol/L so when I asked if I can adjust my NovoRapid they said I can try and if I can’t manage then I should return to the fixed bolus regimen. However it worked out great for me but everyone is different.

90g of carbs per meal is quite a lot, assuming his ratio is 1:10. If he is still high after taking so much NovoRapid with 16u Lantus then it suggests the basal may be too high but that would have to be discussed with the DSN

That’s the same as my partner, he was in hospital for 4 days but doesn’t seem as though he was given much advice or information when being discharged. They just gave him a load of booklets and sent him on his way! We will definitely ask about the ratios when he sees the diabetes nurse next week along with a whole list of other questions! Thank you for your help though, I really appreciate it