High readings

EllieM

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Why does my wife feel very very tired when she has high readings of 14 to 17

Unfortunately tiredness seems to be a fairly common symptom of high blood sugar. Is she able to adjust her insulin doses to minimise the times at these levels?
 

grahamrb

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Yes what we have done is change the breakfast ratio
The ratios now are
Breakfast 1 to 7 (previously 1 to 8)
Lunchtime 1 to 10
Dinner time 1 to 8

The correction factor is 2 in all cases
We’ll try this for 3 days and if this doesn’t work then change breakfast to 1 to 6
 

grahamrb

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No change.
readings still high between 14 and 20
Nurses don’t seem worried
Wife worried sick
I proposed upping daily dose from 16 to 18 but nurses do not agree
Can’t fathom why readings are high
Plod on regardless
 

DisFanJen

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I don’t know your personal circumstances but 14 - 20 would worry the heck out of me. That’s flirting with DKA territory.

This may be considered to be controversial and I’m talking about my own experience, so please take it as what it is and not as gospel.

When I was having issues getting my numbers under control, I trusted my doc implicitly and they switched me onto some new pills that would “fix things”.

I DKAd within 2 weeks.

After a scary week in hospital, an apology from the doc (when they do that you know they screwed up), and moving to insulin. I basically decided to take control of my own health. I will listen to them but I decide what my body needs and what I should do to keep healthy. I’m polite and I do listen (in fact I’m working with them now to try a new regime that is pills only), but I have the final say.

Since I started doing that, my numbers are in the 5s and I’ve lost over 10st in weight.

Like I said, I’m not saying sticking two fingers up at your medical professionals, but become more engaged and be your own advocate.
 

StewM

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I don’t know your personal circumstances but 14 - 20 would worry the heck out of me. That’s flirting with DKA territory.

This may be considered to be controversial and I’m talking about my own experience, so please take it as what it is and not as gospel.

When I was having issues getting my numbers under control, I trusted my doc implicitly and they switched me onto some new pills that would “fix things”.

I DKAd within 2 weeks.

After a scary week in hospital, an apology from the doc (when they do that you know they screwed up), and moving to insulin. I basically decided to take control of my own health. I will listen to them but I decide what my body needs and what I should do to keep healthy. I’m polite and I do listen (in fact I’m working with them now to try a new regime that is pills only), but I have the final say.

Since I started doing that, my numbers are in the 5s and I’ve lost over 10st in weight.

Like I said, I’m not saying sticking two fingers up at your medical professionals, but become more engaged and be your own advocate.
I feel it's worth adding some context to all this.

Graham's posted a few times in the Type 1 forum, so I'm pretty sure his wife's Type 1 and not Type 2. The advice he has been given is consistent with what inexperienced Type 1's are given, without going on a massive tangent, let's just say there's good reason for this and it certainly won't be the health team's intention to keep his wife's levels that high forever.

As DKA is quite uncommon amongst Type 2's it suggests that your situation is highly unusual, which does make it debatable how much your situation applies to Graham's wife.

I'm only throwing this out there, as Graham might not be aware of any of this context.

*edited due to typo.
 
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EllieM

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I proposed upping daily dose from 16 to 18 but nurses do not agree

Normally you only increase the basal dose if the morning level is higher than the evening one. The last thing you want is for her to get hypos at night.

Unfortunately it will take time to get the doses right and I suspect that the nurses are very unwilling to let your wife go hypo because of her age. A hypo induced fall for instance could put her in hospital if she broke a bone. High readings are damaging in the long term. (With the proviso that she doesn't get a DKA, but I assume you have testing strips for ketones.)

Please don't give up, things will get better, but you need to be careful to increase the doses gradually. (Disclaimer, that is not a medical instruction, just trying to explain why I think your team are being slow to change up the doses).
 
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DisFanJen

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I feel it's worth adding some context to all this.

Graham's posted a few times in the Type 1 forum, so I'm pretty sure his wife's Type 1 and not Type 2. The advice he has been given is consistent with what inexperienced Type 1's are given, without going on a massive tangent, let's just say there's good reason for this and it certainly won't be the health team's intention to keep his wife's levels that high forever.

As DKA is quite uncommon amongst Type 2's it suggests that your situation is highly unusual, which does make it debatable how much your situation applies to Graham's wife.

I'm only throwing this out there, as Graham might not be aware of any of this context.

*edited due to typo.

As the expression goes, devil’s in the details.

If they are type 1 and new to insulin that puts things in a totally different light.

But to be fair, that’s why I said this is my own experience. :)
 
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Fenn

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Hi, as so so many thing can raise bg I would monitor to see what happens, I am not very well controlled so those numbers would be quite normal for me, I am not saying it’s ok, just no need to panic, little adjustments seems like a good plan, could just be an underlying infection or cold. You sound like the husband I wished I was lol good job :)
 

grahamrb

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Normally you only increase the basal dose if the morning level is higher than the evening one. The last thing you want is for her to get hypos at night.

Unfortunately it will take time to get the doses right and I suspect that the nurses are very unwilling to let your wife go hypo because of her age. A hypo induced fall for instance could put her in hospital if she broke a bone. High readings are damaging in the long term. (With the proviso that she doesn't get a DKA, but I assume you have testing strips for ketones.)

Please don't give up, things will get better, but you need to be careful to increase the doses gradually. (Disclaimer, that is not a medical instruction, just trying to explain why I think your team are being slow to change up the doses).

Thanks Ellie
To be honest we haven’t used the keytone strips for ages only when we get a reading of above 20.
Current regime is
Morning basal 16 units

Breakfast- ratio of 1 to 6
Lunch 1 to 10
Evening meal 1 to 8

The correction factor depends on the reading above 8

Eg if the reading is 11
We subtract 8 and divide the result by2

11 _8 = 3

3/2 =1.5 = correction factor to add to that calculated using the ratios
 
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grahamrb

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As of today a new regime as suggested by the Dr

Morning 14 units (2 units less)

Breakfast ratio 1 to 5 (instead of 1 to 6)

Lunchtime 1 to 10 (as before)

Evening 1 to 8 (as before)

Adjustment factor 1 to 3 instead of 1 to 2

We will see what this brings

Also may do a low carb diet to stop putting on weight (type 1)
 

EllieM

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Also may do a low carb diet to stop putting on weight (type 1)

I find that that works for me, and is also a lot easier on the insulin spikes. How many carbs is she having at the moment?
 

grahamrb

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She is currently having about 100 to 150 carbs per day
During this hot weather having salads, still coming to terms with not being able to do anything spontaneously without having to consider insulin taken/about to take etc
Both of us now tire very easily/often
 

Hopeful34

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Sorry you're tiring easily and often, you've both had a difficult few months and emotional stress is very draining, as are too high and hypo glucose levels.
How are your wife's blood sugar levels with the new regime? Hope this is helping, although I know it's only been a week.
In case you're not aware, some of us find that a change to warmer weather means we need less insulin, whilst for others it can mean more insulin is required.