Type 1 Cant get blood sugar down

[Tubzi]

Hi All,

My blood sugar seems to hover around 10mmols all day no matter what i do.

I wake with high/out of range levels so i've recently upped my lantus dose which seems to have helped but im still stuck at 10mmols during the day.

I currently carb count and take novorapid on a 1:10 ratio and correct with 1 unit to bring it down 3mmols.

When i am above high and i correct with that ratio it works. But if i use it to correct when im at 10mmols...nothing!

Any ideas on what i can do?

Thanks in advance

 

[noblehead]

Many of us find we become insulin resistant when our bg levels are in double figures @Tubzi

I'd do some basal tests to make sure your lantus is giving you a full 24 hour coverage, after that you can look at your I:C ratio's.

 

[Scott-C]

Hi All,

My blood sugar seems to hover around 10mmols all day no matter what i do.

I wake with high/out of range levels so i've recently upped my lantus dose which seems to have helped but im still stuck at 10mmols during the day.

I currently carb count and take novorapid on a 1:10 ratio and correct with 1 unit to bring it down 3mmols.

When i am above high and i correct with that ratio it works. But if i use it to correct when im at 10mmols...nothing!

Any ideas on what i can do?

Thanks in advance

That's a puzzle. I sometimes have spells where bg seems to get "pinned" into a certain range no matter what I do. Fine when it's 5 or 6, not so good if it's 9 or 10!

If you're hovering stably at around 10, it suggests you're basal is maybe ok, even though the level is too high, as that's the point of basal: keep you at the same level without bolus. Basal alone won't get you to 5,6 if you're kicking around in the tens.

Obviously can't suggest doses here, but just mention in passing that Lantus makers have a calculator as a starting point based on weight:
https://www.lantus.com/hcp/dosing-titration/dosing-calculator

It's in lbs but also works out as weight in kilos divided by 5. Coincidentally, my weight divided by 5 is the same as what I'm currently taking and libre confirms I'm fairly stable on that.

So, I'm wondering whether it's more a bolus thing. You say you're on 1 to 10. That's a fairly standard ratio taught on carb counting courses, but some, even doctors, seem to think it's set in stone. It's not. It's a starting point. Personally, I'm nearer 1.5 to 10.

Difficult to say without knowing how you arrived and got stuck at ten. For example, if you were 5 or 6 pre-meal and ended up at 10 post meal and stuck there, I'd say that your bolus ratio is wrong, basal is right. But if you were already 10 pre-meal, and then stuck at 10, ratio is right.

If I was stuck at 10 for an extended period I'd definitely be tempted to forget about 1 to 10 and correction ratios, and up it a bit. It's possible, and sometimes necessary, to do that to suit circumstances without going into full on rage bolusing mode.

 

[Tubzi]

I decided to give an extra unit with dinner to get below 10 and am now at 3.2! Cant understand whats going on ):

 

[Scott-C]

I decided to give an extra unit with dinner to get below 10 and am now at 3.2! Cant understand whats going on ):

Aaw, hen, you seem to be a total basket case at the moment!

Some possibilities:

Stuck at ten for a while, so were you stacking multiple correction doses and they all caught up in one go?

Miscalculated the carb content of the last meal?

Anyway, you're down at 3.2 now, obviously too low, but closer to where you should be than 10, don't know what your usual hypo response is, but is there a chance that you tend to over-treat and send it back up to 10? If I was 3.2 and reckoned it's not a hard continuing drop, I'd only be having about 10g to nudge it back up again.

 

[Tubzi]

Last time i injected was at 1.30pm so i dont think there was any active insulin left in me.
I weigh my food out religiously so i dont think i miscalculated the carbs.
I usually treat a low with a small carton of orange juice that has 15.2g carbs in it and normally i go from the 3's to the 6's.
Am currently back up to 10!
Quite reluctant to give myself any more insulin just yet though.

I really am at my wits end right now ):

 

[Tubzi]

Just to let you know this has been happening for the last 2 weeks, before that everything was going as okay as it could be

 

[himtoo]

hey @Tubzi !!
sorry to read of the tough time you are having.

this may not help but possibly stress is causing the higher highs , or also the recent hot weather , .

have you a 1/2 unit bolus pen -- that might help to "fine tune" your fast acting doses a bit more ??

 

[Tubzi]

Hi!

You could be right about the weather, i may start to go back to normal now its cooled down a bit (hopefully).

I dont have a 1/2 unit pen but im going to ask for one at my endo appointment next week

 

[Scott-C]

I usually treat a low with a small carton of orange juice that has 15.2g carbs in it and normally i go from the 3's to the 6's.
Am currently back up to 10!

I get that a few times...just look at food and I'm way up.

One of the basic rules taught on DAFNE and such like is that 10g will raise by 2 to 3. So your 15g orange juice will likely kick you higher than you want.

It's surprising how little sugar is needed to nudge it up a bit. I'm cheating a bit by using a libre - I've often watched it drifting down towards 4, taken 5g, and then it nudges back up by 1 or 2 without going overboard.

 

[Tubzi]

I started using a libre on friday, havent found it accurate at all. My readings have ranged from 1-3mmols higher than what my normal meter says. Love being able to see what goes on overnight though.

I think i'll do some testing and rethink all my ratios.

Thanks for everyones help!