Type 1: Extremely high blood sugar levels

[BilliamWills]

Hello guys, it's been a while. I've recently informed my consultant that my insulin is not working or is working at about 95% efficiency. For the last 2 weeks I've been injecting as usual, but to no avail. BG levels currently running at a steady 20-30 mmol/l, which being a t1 diabetic I know is very bad. Ketone levels are 0.5 mmol/l but the doctors will not prescribe any more?
I'm feeling the full effects of the hyperglycemia..
Anyone have any advice at all?

Thanks guys
Bill - T1 Diabetic for 5 years

 

[ME_Valentijn]

Can you demand a second opinion?

 

[BilliamWills]

Unfortunately Medway hospital in Kent isn't very good for things like second opinions

 

[catapillar]

Follow sick day rules to correct ketones - https://www.stockport.nhs.uk/documents/PIL/50647_MED127.pdf

If you think there's something wrong with your insulin just bin it and start a fresh vial/pen.

I don't know what you mean by "prescribe more" if you are needing more insulin, just give yourself more insulin.

Maybe the increase in blood sugar over the last couple of weeks is connected to a decrease in activity/increase in weight/increase in stress/development of an illness.

 

[Juicyj]

Hello guys, it's been a while. I've recently informed my consultant that my insulin is not working or is working at about 95% efficiency. For the last 2 weeks I've been injecting as usual, but to no avail. BG levels currently running at a steady 20-30 mmol/l, which being a t1 diabetic I know is very bad. Ketone levels are 0.5 mmol/l but the doctors will not prescribe any more?
I'm feeling the full effects of the hyperglycemia..
Anyone have any advice at all?

Thanks guys
Bill - T1 Diabetic for 5 years

Hi Bill - what's your regime and what insulin are you on ?

When you say your doctor isn't prescribing you any more do you mean insulin ? As a type 1 diabetic they cannot refuse you insulin - as you need medication to live. If this is the case then you need to make a complaint to the practice in question.

Reasons for why insulin does not work can be down to a number of reasons, so ineffective insulin, illness, stress, lifestyle changes, as long as you've ruled these factors out then you should be comfortable making insulin adjustments to bring your levels down.

Let us know more so we can help

 

[BilliamWills]

Follow sick day rules to correct ketones - https://www.stockport.nhs.uk/documents/PIL/50647_MED127.pdf

If you think there's something wrong with your insulin just bin it and start a fresh vial/pen.

I don't know what you mean by "prescribe more" if you are needing more insulin, just give yourself more insulin.

Maybe the increase in blood sugar over the last couple of weeks is connected to a decrease in activity/increase in weight/increase in stress/development of an illness.

Sorry I should've emphasised, Ketone sticks are expensive and the doctors will not prescribe any more.
In terms of weight, I've lost 6 kg this week alone, I'm very active and eat healthy.
Thank you so much for the help.

 

[BilliamWills]

Hi Bill - what's your regime and what insulin are you on ?

When you say your doctor isn't prescribing you any more do you mean insulin ? As a type 1 diabetic they cannot refuse you insulin - as you need medication to live. If this is the case then you need to make a complaint to the practice in question.

Reasons for why insulin does not work can be down to a number of reasons, so ineffective insulin, illness, stress, lifestyle changes, as long as you've ruled these factors out then you should be comfortable making insulin adjustments to bring your levels down.

Let us know more so we can help

I am on novorapid and legends insulin, on a basal-bolus regime.
The doctors will happily give me insulin but Ketone test strips, they're very apprehensive. Sorry I should've been more specific.
I inject 20u of novorapid about 4 hrs ago, which in the first 2, brought the BG levels down by 2 mmol but at the 4 hr mark about 10 mins ago, I'm 6 mmol higher than when I injected.

It's starting to worry me as they've been very sporadic for the last 14 days and no lower than 20 or so mmol.

Thanks for the help, much appreciated

 

[BilliamWills]

I am on novorapid and legends insulin, on a basal-bolus regime.
The doctors will happily give me insulin but Ketone test strips, they're very apprehensive. Sorry I should've been more specific.
I inject 20u of novorapid about 4 hrs ago, which in the first 2, brought the BG levels down by 2 mmol but at the 4 hr mark about 10 mins ago, I'm 6 mmol higher than when I injected.

It's starting to worry me as they've been very sporadic for the last 14 days and no lower than 20 or so mmol.

Thanks for the help, much appreciated

I have also lost 6kg in weight in just under 7 days. Which is also a worry

 

[himtoo]

Hi @BilliamWills
with a weight loss of 6kg in a week and high bloods and type 1 for 5 years -- I would suggest you need to get back to your GP for further discussions..........................
in addition I would be doing some basal testing to get your basal insulin sorted --
link here https://mysugr.com/basal-rate-testing/

 

[eventhorizon]

An infection would be my bet. But get some brand new bolus and basel insulin ASAP (like now) and follow sick day rules.

 

[donnellysdogs]

Do you ever basal test?

Do you adjust your insulin yourself?

 

[eventhorizon]

Are you confident with correction doses?

 

[donnellysdogs]

With the info provided we dont know if you are high constantly or are dropping at night or whether younare correcting or adjusting your insulin, or whether you
are eating more and not working out your insulin correctly or whether you have changed your insulin/pens etc...

Some info would assist..

 

[MelissaC]

@BilliamWills I would definitely try a new vial of insulin in case there is a problem with the current one - it's worth a shot. If that doesn't work, you should keep in regular talks with you GP/DSN as a continued period of very high sugars is obviously not good for your health.

I expect the weight loss could be down to the higher sugars perhaps? I think this is something the body does in response to not getting enough insulin.

Hope you manage to get sorted soon.

 

[andi140373]

I agree with what has been said - the weight loss will be down to the high blood sugar levels as your body is burning fat for energy. Have you tried injecting in a completely different site to ensure proper absorption? Have you been ill - possible infection? This has a major affect on my BG levels. Even if your background insulin is incorrect, injecting 20u of Novorapid should have had a much bigger impact on your levels than it did.
Do you have a diabetic clinic at your local hospital - last week I phoned on the Thursday to say my sugars were running high (10-12 on waking) and they saw me on the Friday. (My pump was past it's warranty and the piston was sticking and not delivering enough insulin.) After 29yrs of T1, I've come to realise that my past and present GP's have all been lovely but useless when it comes to any form of intervention.
Let us know what is happening

 

[rfmiles]

With the info provided we dont know if you are high constantly or are dropping at night or whether younare correcting or adjusting your insulin, or whether you
are eating more and not working out your insulin correctly or whether you have changed your insulin/pens etc...

Some info would assist..

I've read that doing at least a few tests in the middle of the night should help determine if you are dropping enough at night that you need to look up dawn phenomenon.

 

[donnellysdogs]

Something is odd here, as BilliamWills isnt responding...

 

[azure]

I've read that doing at least a few tests in the middle of the night should help determine if you are dropping enough at night that you need to look up dawn phenomenon.

Dawn Phenomenon is a rise in blood sugar prior to waking. It is not a response to a low.

I think you mean the Somogyi Effect.

 

[ME_Valentijn]

Something is odd here, as BilliamWills isnt responding...

Hopefully he got himself to the hospital.