Raised blood sugar dilemma

[edcadmel]

Hi all I am new to this forum,but have come here for some assistance and feedback. I am a 29 year old who has had type 1 diabetes since the age of three, so 26 years. My bloods have never been perfect but over the last few years I have been trying my hardest to get my diabetes steady. However over the last few months it really just feels like my own body is against me and that I am doing everything I should be, but it's just not good enough. My blood sugars have been raised and stopped reacting to insulin nova rapid like they used to. I also hadn't had a known hypo for over two months whereas before I was on less insulin and had hypos all the time. We now think it may be to suffering from night time hypos and my liver compensating by pumping out glucose which then in turn had an effect on my blood levels for the rest of the day. However the diabetes nurses are trying to figure out what it is. However what is annoying me is that they are assuming that I just don't know how to carb counts and that this is why they are raised, even though I used to carb count and never used to hVe any problems and it is literally something that started about six months ago. Any way they are trying to get me back to basics and find a basic non carb counting related dose pre meal for me to give myself and have given me set amounts to take regardless of what I eat and whether I snack. I was doing this and although I reduced my intake and carb intake drastically my bloods were still raised so I would give myself a correction dose after breakfast and after lunch and then would end up with hypos from dinner time to bed time. I the. Provides my diabetes nurses with my results who said that I was not to give myself and correction doses because if I did they were not able to analyze my blood results properly and compare the insulin doses they have asked me to take again the carb amount of each meal, so that they can eventually work out a carb ratio. Anyway I started doing this yesterday and since the. I have had blood sugars if between 15 and 22. Today has been awful raised all day I gave myself my bed time insulin early at 9 in the hope it would bring down my bloods slightly at that time my bm was 19 and the. Just before bed it was 22! I hadn't snacked or anything. I'm really not comfortable with this having highs all day and a high bm before bed it just makes me feel physically and emotionally rubbish and sick. They tell me it won't do me any harm to have these highs while they try to sort my doses out but I am so concerned and wondered if any one else has had the same ordeal? It is frustrating to know my cure to highs is in my insulin but I am being told I can't have it!

 

[Mrs Vimes]

Have they told you to check for ketones? I would refuse yo run at those levels as I would feel awful- which sounds like what is happening to you.


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[edcadmel]

Have they told you to check for ketones? I would refuse yo run at those levels as I would feel awful- which sounds like what is happening to you.


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No they've not asked me to check for ketones but I do Anyway. I did say to them well if they are constantly raised you are telling me not to have a correction dose and they said yes. I just don't know why they won't say if your bm is raised just take a couple more units before your meal. Anyway now that it's the weekend and they are closed until Tuesday I am half re
Noted to go to my go for their opinion on the matter. Going to bed with a 22 and waking up with a 18 means I am not feeling too great!

 

[edcadmel]

No they've not asked me to check for ketones but I do Anyway. I did say to them well if they are constantly raised you are telling me not to have a correction dose and they said yes. I just don't know why they won't say if your bm is raised just take a couple more units before your meal. Anyway now that it's the weekend and they are closed until Tuesday I am half re
Noted to go to my go for their opinion on the matter. Going to bed with a 22 and waking up with a 18 means I am not feeling too great!

I meant I am tempted to go to my gp

 

[Mrs Vimes]

When are they expecting you to feed back your blood sugars? Have you got a planned appointment? If not I'd get onto them. But to be honest and I'm not medically trained, I'd be correcting for sugars that high especially over an extended weekend.
Running at 9 bothers me. Running higher just makes me feel sick.


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[Daibell]

HI. You don't mention your Basal insulin in your post? Have you checked your morning fasting sugars which should be between 5 & 7. From what you say about your sugars during the day it implies your Basal units might be too low; just guessing. I very rarely use rapid for correction as it's best used very much as an exception. How much Basal do you use each day? Are you having sensibly low-carb diet?

 

[Spiker]

They are disbelieving you, and insisting you take a backwards step onto a less flexible regime. This is terrible. What they should be doing is helping you tune your basal dose(s) and your insulin to carb ratio, as well as investigating if there is any serious reason why it has changed. The main reason your insulin needs increase is if you exercise less which reduces insulin sensitivity, and diet can also affect that. But it also can just change over time.

Did you do DAFNE? Does your DSN know DAFNE? That's how they should be addressing this problem, by dose adjustment, not by taking you off carb counting. :-(

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[Spiker]

Specifically, if you are higher than pre meal BG at 4 hours after a meal you should take a correction dose, and if this happens three times in a row at the same meal, increase your insulin ratio for that meal. Repeat this process until your 4 hour post meal BG is basically the same as pre meal BG, and you are no longer needing correction doses after.

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[Spiker]

Going to bed with a 22 and waking up with a 18 means I am not feeling too great!

This probably means your basal dose is basically right (good) and the small overnight drop is due to kidneys dumping glucose out of your urine (not so good). So focus on increasing the carb ratio.