Some days insulin doesn't seem to lower blood sugar at all

[Quinapril]

Hello everyone.

I am still quite new to the diabetes world and recently got back on insulin after my honeymoon period.
Still getting my basal insulin in order and working everything out.

Currently on low carb, taking 6 units basal Abasaglar (which I probably still need to increase) and I take about 2 - 3 bolus units of Fiasp with meals.

I have noticed something interesting and was hoping that maybe someone could tell me what's up.

On some mornings and days, it seems that I can control my blood sugar pretty well and it stays around 5 - 6 - 7 mmol.
However, on some days my sugar just seems to want to stay in the 8 - 9's for example today. I ate a meal that raises my blood sugar very little and I would only bolus 1 unit for it but my blood sugar was 9 so I took 3 units for correction. 2 hours later blood glucose is at 8.7 took 2 more units for correction and now about 1.5 hours after the correction my sugar is still around 8 when in the good days 2 units would lower my sugar by 3 - 4 mmol.

I was wondering whether this could be because I still don't have my basal set up right because glucose seems to raise to 8 or more during the night.
Also, could stress be the cause of this? Because I am a student and have a lot of study work at the moment which needless to say makes me quite anxious and maybe even panicky.

Any ideas or advice is highly appreciated!

Edit: Probably worth noting that I use freestyle libre CGM so I can constantly have an idea of where my sugars are at any given time

 

[EllieM]

I am still quite new to the diabetes world and recently got back on insulin after my honeymoon period.
Still getting my basal insulin in order and working everything out.

My guess (and any honeymoon I had would have been 50 years ago) that it may take a while to work things out. My understanding is that your honeymoon period may be a bit on off....

I was wondering whether this could be because I still don't have my basal set up right because glucose seems to raise to 8 or more during the night.
Also, could stress be the cause of this? Because I am a student and have a lot of study work at the moment which needless to say makes me quite anxious and maybe even panicky.

Both of the above could be true. Stress absolutely pushes blood sugars up. And honestly, if you're still partially in the honeymoon period, that can mess things up.

Do you know how to do basal testing? That is the first thing I would work on. Then it'll be much easier to calculate correction dose ratios and carb to insulin ratios.

Also, you probably know this, but it is pretty easy to stack correction doses ie take a correction dose when you're previous bolus or correction dose is only half used up. You then end up with a hypo...

It's great that you have a cgm. I just wish that everyone who wanted one could get one.
ps And going slightly off topic. When I was a student, back in the early glucometer days, I found that a very significant hypo warning signal was a sudden inability to do maths

Good luck.

 

[In Response]

To add to the great advice from @EllieM I would check the meals that should only have 1 unit of bolus.
Are these very low carb meals? If so, you may need to bolus for protein.
Personally, I find low carb meals very difficult to bolus for due to the protein factor
If we eat no carbs, our bodies breakdown protein for glucose. Unfortunately, the insulin to protein ratio varies a lot depending what the protein is. Nuts have a different ratio to eggs which have a different ratio to salmon which has a different ratio to prawns and I don't eat meat so never needed to work out the different ratios for beef, pork, ham, salami, pepperoni, sausages, lamb, etc.

I quickly gave up with low carb because it made my Type 1 diabetes harder to manage.

 

[Quinapril]

My guess (and any honeymoon I had would have been 50 years ago) that it may take a while to work things out. My understanding is that your honeymoon period may be a bit on off....



Both of the above could be true. Stress absolutely pushes blood sugars up. And honestly, if you're still partially in the honeymoon period, that can mess things up.

Do you know how to do basal testing? That is the first thing I would work on. Then it'll be much easier to calculate correction dose ratios and carb to insulin ratios.

Also, you probably know this, but it is pretty easy to stack correction doses ie take a correction dose when you're previous bolus or correction dose is only half used up. You then end up with a hypo...

It's great that you have a cgm. I just wish that everyone who wanted one could get one.
ps And going slightly off topic. When I was a student, back in the early glucometer days, I found that a very significant hypo warning signal was a sudden inability to do maths

Good luck.

Thanks for the advice!

I am actually not sure how to do basal testing could you tell me more about this?

Regarding the stacking of correction doses, yep I am aware of this and actually try to use it to my advantage

For me the main issue with doing maths is procrastination

 

[JustLucky]

Maybe take a walk around the block or do some light exercise if bg is higher then expected after a meal. That works for me, especially with libre, you can see the activity on the graph...

 

[Quinapril]

To add to the great advice from @EllieM I would check the meals that should only have 1 unit of bolus.
Are these very low carb meals? If so, you may need to bolus for protein.
Personally, I find low carb meals very difficult to bolus for due to the protein factor
If we eat no carbs, our bodies breakdown protein for glucose. Unfortunately, the insulin to protein ratio varies a lot depending what the protein is. Nuts have a different ratio to eggs which have a different ratio to salmon which has a different ratio to prawns and I don't eat meat so never needed to work out the different ratios for beef, pork, ham, salami, pepperoni, sausages, lamb, etc.

I quickly gave up with low carb because it made my Type 1 diabetes harder to manage.

Hmm, this is very interesting.

I'm not sure how to describe the meal its sort of like pancakes with meat just that instead of regular flour it consists out of almond flour.
I tend to use almond flour everywhere to help me on my low carb journey lol

 

[JustLucky]

To add to the great advice from @EllieM I would check the meals that should only have 1 unit of bolus.
Are these very low carb meals? If so, you may need to bolus for protein.
Personally, I find low carb meals very difficult to bolus for due to the protein factor
If we eat no carbs, our bodies breakdown protein for glucose. Unfortunately, the insulin to protein ratio varies a lot depending what the protein is. Nuts have a different ratio to eggs which have a different ratio to salmon which has a different ratio to prawns and I don't eat meat so never needed to work out the different ratios for beef, pork, ham, salami, pepperoni, sausages, lamb, etc.

I quickly gave up with low carb because it made my Type 1 diabetes harder to manage.

Sorry to be off topic a bit, but actually I was just thinking in this direction these days. As I seem to have better results when not eating too much protein, especially meat... It raises my BG 4+ hours after eating. I think I'll wander into the vegetarian forum these days, for some advice... Thanks