What happened with my BG levels?

MyNameIsAlex

Active Member
Messages
37
Type of diabetes
Type 1
Treatment type
Tablets (oral)
Hi, everybody! I opened this thread because I'm looking for some explanation.. I've been a type 1 diabetic for 2 years but I've always been told by my GP that I manage my diabetes very well. And I knew that it was right . I used to have very good BGs until 2 weeks ago when my 2 years relationship with diabetes has broken. My BGs are incredible high even at 3-4 hours after a meal. I increased my doses but everything seems to be inutile. I try to count my carbs but it's not working. I checked my BG this morning, it was 5.6 (I'm happy with that) but then I had my breakfast (100 grams of musli, That means 63 grams of carbs, with a little bit of milk). I injected 7 units of Lantus, the highest amount of Lantus I've ever injected. Usually I inject 4-5 u, every morning. After more than 2 hours, I checked my BG again.. it's 9.6 It's incredible high for me, especially because I've only had some musli with milk and I felt it wasn't enough. I still feel hungry and it's lunch time. I don't have a GP right now because I moved to another part of UK. The only solution to ask on this forum. Thank you!
 

azure

Expert
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It could be a number of things @MyNameIsAlex

Firstly - change all your insulin pens for new ones in case they've 'gone off'.

Then - could you be ill?

Finally, it might be your honeymoon period coming to an end. The first sign of that I got was higher blood sugar after meals.
 

azure

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I've just noticed that you said you injected Lantus for your breakfast - is that a typo?
 

MyNameIsAlex

Active Member
Messages
37
Type of diabetes
Type 1
Treatment type
Tablets (oral)
Yes.. since I was diagnosed, I always injected Lantus in the morning, before breakfast. This is what my GP told me to do. But the same situation with the fast insulin, Novorapid. It seems that is not working anymore, even if I increased my doses.
 

azure

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Type of diabetes
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Yes.. since I was diagnosed, I always injected Lantus in the morning, before breakfast. This is what my GP told me to do. But the same situation with the fast insulin, Novorapid. It seems that is not working anymore, even if I increased my doses.

Ok, so you did have Novorapid before your breakfast? That's good as that's the meal time insulin to cover the food you eat.

The Lantus is your basal/background insulin to keep your blood sugar level without food.

I repeat my advice to start fresh insulins - both Lantus and Novorapid. That's the first thing to do.

The honeymoon period is the period after diagnosis when you can still make a little of your own insulin. Gradually this ability goes, and your body's own insulin production reduces a lot. That's the end of the honeymoon period.
 

azure

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If your blood sugar still stays high with fresh insulins, then it might be that your doses need adjusting. If you're not sure about doing this yourself, speak to your doctor or nurse for help.
 

MyNameIsAlex

Active Member
Messages
37
Type of diabetes
Type 1
Treatment type
Tablets (oral)
Ok, so you did have Novorapid before your breakfast? That's good as that's the meal time insulin to cover the food you eat.

The Lantus is your basal/background insulin to keep your blood sugar level without food.

I repeat my advice to start fresh insulins - both Lantus and Novorapid. That's the first thing to do.

The honeymoon period is the period after diagnosis when you can still make a little of your own insulin. Gradually this ability goes, and your body's own insulin production reduces a lot. That's the end of the honeymoon period.

No, I didn't have Novorapid for breakfast. I use it only for lunch and dinner meals. But I said it's same struggle with Novorapid as well, it looks that is not working anymore. My BGs are still high after lunch and dinner
 

MyNameIsAlex

Active Member
Messages
37
Type of diabetes
Type 1
Treatment type
Tablets (oral)
I changed them not long ago.. they're almost full
 

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azure

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No, I didn't have Novorapid for breakfast. I use it only for lunch and dinner meals. But I said it's same struggle with Novorapid as well, it looks that is not working anymore. My BGs are still high after lunch and dinner

Well, that could be your problem then. You probably need Novorapid for breakfast too.

(Even if you've only recently changed your insulins, it's good practice to change them again if you suddenly get unexpected highs. It's a sensible first step : ) )
 
D

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I am a little confused.
Lantus is a long acting insulin which us used as basal and typically taken once or twice a day. My understanding is that our basal needs are not dictated by what food we eat so I had never heard about carb counting for Lantus. It is used to "mop" up the glucose our liver "drips" out throughout the day and usually lasts for 23 to 25 hours.
Novorapid is a short acting insulin which is usually taken with each meal which is why we carb count. For simplicity, we usually assume one insulin to carb ratio throughout the day but sometimes it differs. NovoRapid usually last for about 4 hours but the peak is near the start which is why we may test 2 hours after eating.

So what I am thinking is
- until now, you have been advised not to take NovoRapid with your breakfast. This may be because your insulin to carb ratio in the morning is very low. You may need to start taking some NovoRapid with breakfast ... but may be at a lower ratio to the rest of the day.
- you seem to be carb counting for your Lantus. This seems counter-intuitive as it is usually a fixed amount (which may vary slightly due to illness, stress or exercise). The Lantus you take with (but not FOR) brerakfast may not be enough. This may be because you are eating less carbs for breakfast so calculated a different dose. If you can find any notes from when you were first prescribed Lantus, this may give you a hint as to how much you should be taking. Or your needs have increased. This is less likely as your pre-breakfast BG is ok.

I think your best bet is to talk to your local diabetes team.
If they are not available, take a small amount of NovoRapid with breakfast and increase it gradually. If it was me (and I am not a medical practitioner), I would start with a ratio of 1 unit to 20g carbs and do lots of testing. This is easiest to adjust if you stick to the same breakfast everyday.

My last suggestion is to find out your correction ration (maybe called something like Insulin Sensitivity Ratio) so you can correct if your BG gets too high. Take care with this and always remember the NovoRapid which may still be in your system for 4 hours after injecting - this is called insulin on board or IOB.
 
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Engineer88

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I suggest you get yourself to the GP ASAP. you need both novorapid and Lantus before breakfast - the lantus will do nothing to lower your blood glucose in the short term.
 
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