Rising bsl

[sjdad]

Hi. Anyone else found that increasing your insulin actually increases your bsl? Sounds weird I know! Am a T2D and was metformin only for 15 years! Gradually my bsl increased and was put on victosa. Few years later on insulin. Strange thing is that it's not controlling my bsl. Up to 46 units insulatard morning and still in the high teens. Comment or suggestions welcome

 

[kitedoc]

Hi @sjdad, And welcome to this forum.
The following is from my experience as a type 1 diabetic on insulin for 51 years, not as health professional advice or opinion.
If you google, 'pictures of insulin profiles' and those of Insultard in particular, you will see the onset, peak and duration of action. (this 'action' is its blood-sugar lowering effect).
You will note that Insultard takes quite some time to reach a peak of action.
If you compare Insultard's 'profile' with that of a short-acting insulin, say Novorapid, or Humalog etc etc you will see that these latter insulins have quicker onset, peak at 2 to 3 hours and taper off to zero at 6 to 8 hours or so.
If you then look at what happens with your BSL on the same time scale, the BSL peaks some 2 hours after your meals.
So you see that Insultard injected before breakfast is not well matched to deal with the after breakfast rise in BSL, compared to one of the shorter-acting insulins.
Increasing the dose of Insultard only increases its effect hours after the BSL from breakfast has bolted and may lead to hypos near its peak of action ? 4 to 6 hours later.
Perhaps you could discuss this with your health team and ask them whether a modification of your insulin regime to include short-acting insulin before meals is appropriate.
Time is not always of the issue, but timing is. Best Wishes.

 

[Mep]

If you're like me and no longer produce sufficient insulin yourself then you're probably better off on both a bolus and basal insulin regime as @kitedoc has mentioned. I've not ever been placed on a basal only or mixed insulin because of the test results my endocrinologist had showing my c-peptide result in the red. I wouldn't think a mixed or basal only would work well for me either as I'm also insulin resistant. It's a lot better to have that control on your carb to insulin ratio.

 

[DCUKMod]

Hi. Anyone else found that increasing your insulin actually increases your bsl? Sounds weird I know! Am a T2D and was metformin only for 15 years! Gradually my bsl increased and was put on victosa. Few years later on insulin. Strange thing is that it's not controlling my bsl. Up to 46 units insulatard morning and still in the high teens. Comment or suggestions welcome

Could you describe what you mean by increases yourBSL? Do you mean your scores after you eat are up? Is your A1c up, or your overall fingerpick numbers are up or you need more and more insulin to keep the scores down?

Finally (although I’ll probably think of more questions shortly!), how long have you been on insulin and is your weight stable- not going up or down?

I’m good at asking questions!!