Help please! Insulin not working as normal

Daver

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48
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Hi all,

I've usually got relatively good control over my glucose levels but over the past day or two I can't keep it in check! Last night was the worst: I was a tad high before dinner (9.2) so accounted for this in the pre-dinner shot. Two and a half hours after dinner, I was 19.4 (no idea why). I took a correctional dose of 5.5 units of novorapid, an hour later I was 23.2! I left it for half an hour but was still in the 20's so took another 6 units. This time I could see the results working much more quickly (was down to 14 within half hour) but ended up hypo-ing in the early hours (and the swinging begins!). This morning, I was 7.8 before breakkie, took the usual 5 units as per normal with this cereal and two hours later... 14.8! Arrrggghhh!!!

Up until recently, I've always worked on carb counting to allow one unit of novorapid to bring my glucose down by 2.5. (So be being 19.4 - the correctional dose of 5.5 should have seen me at around 6 ish).

I've been diabetic for just 3 and half years. I also take 27 units of levemir, which I've had to increase over the last week due to waking up high (I was on 25 units). I exercise, always fire an air shot before injecting and test regularly so really can't work out what's going on.

If anyone has been in the same boat or can offer any explanation - PLEASE let me know.

Worried and frustrated

Dave
 

Daibell

Master
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12,642
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LADA
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Hi. I can't readily explain what is going on other than the obvious question of whether the two insulins have been stored correctly in the fridge before use and discarded after 4 weeks. I've read that sometimes injection sites can become resistant and you need to change sites? Your Levemir dose seems a bit high so I wonder whether you are a bit overweight and hence insulin resistant; I may be guessing wrongly. If you do have some insulin resistance then you may be moving into a vicious circle with the insulin and may need to reduce carbs to help resolve. Apologies if I'm wrong on this.
 

Ambersilva

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Messages
715
Type of diabetes
Type 1
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I don't know what is going on but have you considered that the Novorapid bolus is not working because it does not seem to be dealing with your food intake consistently? Maybe that particular cartridge or pen is faulty. If it were happening to me I would discard the pen or cartridge and start a new one.

Perhaps someone who is experienced with the effect of exercise on BS levels will be along soon to offer some advice. I know Sam is very knowledgable and helpful.

I see Diabell has responded with similar ideas.
 

Daver

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48
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Hi,

Yes, thanks to you both and no need to apologise for the trains of thought; I do exercise regularly and I'm not overweight, but good points to cover.

I do keep the insulin in the fridge etc but good idea on starting a new cartridge; I've never had to doubt the insulin itself before but perhaps that's my naivety. I generally move the injection sites around but didn't know that you could become resistant to it in one zone.

I have since read some other forums and found some good points regarding the affects of cooler weather on blood glucose and a great article on spikes after a meal: http://www.diabetesselfmanagement.com/a ... pike-ii/1/

I will consider the carb reduction too; however, I do go swimming so need the carbs before-hand to prevent hypo-ing in the pool. It's such a flippin' balancing act with everything.

Much appreciated and if anyone else can share their thoughts, they'd be gratefully received.

All the best ~ Dave
 

noblehead

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Faulty insulin/lack of, illness, stress and anxiety can all lead to increased bg Dave as your no doubt well aware, it might just be that your coming down with a cold or flu and the symptoms have yet to show themselves, I've had this happen before and 1-2 days later....bang!
 

dilbert56

Member
Messages
9
Hello Dave,

I've been a type 1 for approx 20 years and this still happens to me but this could be due to a number of reasons.....

Firstly the insulin (novorapid) may be collecting in pockets underneath the skin. This may cause you to be getting the hypos later on at night-BUT this should only really apply if you don't vary the injection site. I think the flu/cold thing more likely as per noblehead's comments. I seem to have to really up my short acting dosage in order to compensate for this. Think I'm a bit less active than you tho!!!Rule of thumb when carbs are concerned. If the exercise is of short duration e.g 1 hour or so, don't be too heavy on the starchy stuff, it will bash your blood sugars upwards later in the night from my experience! Also warm lantus has this effect to a degree- not sure if it applies to levermir (never tried it)! Good luck chap! :D
 

Daver

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48
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Thanks noblehead, thanks dilbert.

It has been really stressful at work over the past few weeks, now you come to mention it and there's loads of coughs and colds going around (I had a flu jab a few weeks ago, no side-affects but I guess nothing's full-proof). It's nice to know that there may be some reasoning behind it and I'm not completely out of touch! Will work on injection site changes too!

Thanks again to everyone! Dave
 

Riri

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It doesn't help you and neither does it answer your question directly but every nov/dec I have unexplained rises in BSs. My DSN team are baffled and suggest the usual bug, stress, cold weather. I had the flu jab mid Oct and didn't see an immediate problem so I have discounted that one. I'm leaning towards a change in the weather that causes mine as I don't feel ill and my daily routine doesn't change much. Oh the joys of unpredictable high blood sugars :crazy: Others have suggested good things to look at as well if you continue to have problems. All the best
 

donnellysdogs

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I always have to increase bolus n basals after the clocks change in winter and alter back in the spring.
 

iHs

Well-Known Member
Messages
4,595
Daver said:
Hi all,

I've usually got relatively good control over my glucose levels but over the past day or two I can't keep it in check! Last night was the worst: I was a tad high before dinner (9.2) so accounted for this in the pre-dinner shot. Two and a half hours after dinner, I was 19.4 (no idea why). I took a correctional dose of 5.5 units of novorapid, an hour later I was 23.2! I left it for half an hour but was still in the 20's so took another 6 units. This time I could see the results working much more quickly (was down to 14 within half hour) but ended up hypo-ing in the early hours (and the swinging begins!). This morning, I was 7.8 before breakkie, took the usual 5 units as per normal with this cereal and two hours later... 14.8! Arrrggghhh!!!

Up until recently, I've always worked on carb counting to allow one unit of novorapid to bring my glucose down by 2.5. (So be being 19.4 - the correctional dose of 5.5 should have seen me at around 6 ish).

I've been diabetic for just 3 and half years. I also take 27 units of levemir, which I've had to increase over the last week due to waking up high (I was on 25 units). I exercise, always fire an air shot before injecting and test regularly so really can't work out what's going on.

If anyone has been in the same boat or can offer any explanation - PLEASE let me know.

Worried and frustrated

Dave

Hi

A bg level of 9.2 is a tad high to be eating a carb meal on, even with doing a correction dose. Insulin like Novorapid will struggle because its onset is slower than Humalog and Apidra but its acting time is slightly longer. I've used all 3. With Novorapid it does pay to wait for a bit for bg levels to lower and then eat the carb meal otherwise its struggle time as you found. All insulins will struggle a bit though but Novorapid moreso, that's why people get advised to inject it about 20mins in advance to give it time to work. Next time you are high, think about eating a low carb meal as that will have less of an impact on bg levels that are already elevated or wait for bg levels to lower, then eat the carb and bolus.
 

Picci

Well-Known Member
Messages
300
Type of diabetes
Type 1
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Pump
Hi Dave, I've been type 1 for 34 years, and never stop learning. Lots of super comments on here, I'd to say that sometimes erratic readings are a mystery and will settle with time and patience. . Over the years I have racked my brains as to why I had erratic readings no matter what I did....i think we have to accept sometimes we have 'blips' and there is no explanation. I hope you've settled down and not become poorly. Take care, Christine


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