Running high for over a week now..

[Juicyj]

Thank you @noblehead appreciate your help. I will post results if I do get to the bottom of this.

 

[humaject]

I`ve been type 1 for 47 years i am now 60 years old since 1975 i have weight trained mon to frid 90 minutes per session this has kept my blood sugars well under control with a few hypos the only problem 2 weeks ago i bought a rode cycle ( racer ) There is a 7 mile country route near the town i live in,i cover that in 24 minutes when i get home my heart rate i 120 bpm soon droping back to 60 bpm not bad for a 60 year old For all of the diets on this site and now is the fridge to cold !! Make no mistake the only sure way of keeping your blood sugars down and your circulatory system in good health is daily exercise.

 

[Heathero]

Had this problem for several years all ok for a while/ or if not at work. Correction doses needed frequently. Thought to be stress related due to work .No one can help blood 4-6 at night then 16 + in morning 5 am checks no hypos.Lantus Doses split. Now going to try pump . Done Daphne inject 2 units to 10 carbs. Pump fitting next Monday. Hope it improves for you, I do not exercise much but adjust when I do. Now 54 had since 5years. Despite this problem hba1c around 8.

 

[staffsmatt]

To be honest if you keep going high I'd say your basal dose is probably too low, especially if you're waking up high (and have if you've ruled out nighttime low's). You're not on your own, my basal rate seems to change according to which way the wind is blowing...

 

[dave howard]

Thank you @noblehead appreciate your help. I will post results if I do get to the bottom of this.

Hi JuicyJ I have read this entire thread with interest, I went through this almost identically25 years ago. What worked almost overnight for myself and what stands out to me is that you are not taking enough long acting or short acting by quite a lot. I take 50 units of Levemir nightly and my Novorapid ratio is 3 units per 10g of carbohydrate. Try taking more and see if this helps you, it turned my diabetes round within a week and is still working well. My regular diabetic blood checks at the clinic have always been easily within the accepted "norm" ever since. Hope you get this hiccup sorted out soon, all the best Dave.

 

[Juicyj]

Couldn't agree more about exercise, I went out yesterday afternoon on the bike and came back and had a hypo.. It always gets me back in range, however at present with running high it's only a temporary thing. Today woke high again at 14.4 but been off work and walking around town with my daughter and managed to stay around 6, but it's now over 12.. Am going to increase my basal again tomorrow, as have upped it 3 units this week already but still not making any impact. Still haven't heard from my DSN either, although today I am actually feeling a bit unwell so not sure if it's been manifesting itself for a while and maybe coming out now.. Am tracking all results on Diaconnect which is brilliant for recording results and I can email these to my DSN when she finally makes contact to see if she can work it out, but not sure if this is connected but my mouth is sore at the sides also, as the skin has cracked ?

 

[Juicyj]

Hi JuicyJ I have read this entire thread with interest, I went through this almost identically25 years ago. What worked almost overnight for myself and what stands out to me is that you are not taking enough long acting or short acting by quite a lot. I take 50 units of Levemir nightly and my Novorapid ratio is 3 units per 10g of carbohydrate. Try taking more and see if this helps you, it turned my diabetes round within a week and is still working well. My regular diabetic blood checks at the clinic have always been easily within the accepted "norm" ever since. Hope you get this hiccup sorted out soon, all the best Dave.

Hi Dave, thanks for your reply. I switched to Tresiba about 4 months ago, before I was taking a very high dose of Levemir which wasn't working, so did the classic of upping the dose but with no results, it took me 6 months of running high and as my DSN had left I just 'fumbled' my way through it taking correction doses and putting on weight. Once I switched to Tresiba I was hypoing loads so started to reduce my dose, I thought I had levelled it out but maybe it needs upping, to be honest I thought I was taking too much compared to others on it so this is why it wasn't on my radar to increase, but as I've upped it 3 units with no impact this week will try another increase.

 

[staffsmatt]

I may be wrong but as tresbida lasts for so long is there a lag between changing dose and seeing an effect? I know with pants (which is only supposed to last 24hours) you're supposed to wait 3 days once you change it.. Mind you if you feel unwell it's probably that.

 

[donnellysdogs]

It is meant to be 3 day period for increasing tresiba doses.
There is no fixed doses for basals... Don't worry if you need more than others.. We're all different.

Myself and my consultant looked at tresiba for me. Currently we have stuck to levemir because of being active at odd times of days and no days being the same for activity.

It maybe that long term wise you may need metformin??

Arms are a good place to use.

 

[Juicyj]

An update, I've still not managed to get hold of my DSN, I tried my hospital team yesterday and left a message and no one called me back from there, and still woke at 15.1 this morning, I feel like I'm waving my arms and shouting but no one is there. I have upped my Tresiba 5 units already this week, which is the level I would normally take if due on, and am getting into single figures after about 3pm until I eat at 6, then I just start rising again, last night before bed after chicken and salad tea I was at 18.8 (I still took 5 units of QA..), I changed both insulins again as partner said what if thats gone off, so though let's be logical and change again, have rotated sites, but still at a loss as to work out why..

 

[staffsmatt]

Have you tried getting a new batch from the chemist? Could your fridge have gone on the blink / had a power cut at some point you're not aware of? Oh the other thing that affects me is being up in the night with our 1 year old, always high if I'm awake a lot in the night...

 

[Juicyj]

Hi Matt - thanks for your message. Our fridge has got a screen on the outside so always know the temperature, if we have a power cut then i have to reset it, so fortunately I know it's ok. I called up my local hospital this morning spoke to a super helpful lady, she's helped me reset my insulinx to adjust my ratios for my morning quick acting and also my corrections, am working on 2 units of QA per 10g carb, and now taking 1 unit of QA to reduce me by 2 units (instead of 3). Now after 4 hours I am still at 15.2, so no change from breakfast.

Although feeling incredibly fed up I still feel determined to sort this out.. otherwise might have to have a very large glass of wine tonight..

 

[donnellysdogs]

When over 12.0 bg you should consider giving yourself more than the standard correction dose. I have to double mine.

 

[Juicyj]

Thanks for this I hadn't thought about increasing this, and as previous corrections are not bringing me down am going to give this a whirl, will wait till my current load has depleted first tho !!

 

[donnellysdogs]

I had some extreme set failures on my pump and on 2 occasions went nigh on 30.... Stayed out of hospital but whacked 200% extra basal through me and doubled my corrections. Still took 10 hours to get to normal.

For myself. If I am very rarely 12.0- 16.0 I whack through an extra 50% bolus correction. If above 16.0 it would be doubled.

I'm not on pump anymore.. Highs are very rare for me really. My ratio's only work well for corrections if they my levels are under 12.0.

You should aim to be at your target by 5 hrs after a correction but for me if I was higher than 12.0 I would expect to need 10 hours really and possibly 2 corrections before lowering to my target level.

I do not risk overdosing on corrections so I will normally wait 5 hours before giving a 2nd correction if needed.

 

[Heathero]

Really helpful to read this I also have to take large correction doses. Works eventually . Getting pump Monday hope night time highs will improve.

 

[ann34+]

Hey slip - thanks for your reply.

I changed to Tresiba about 4 months ago as was on Levemir and had become resistant so was taking over 36 units a day and still running high, I subsequently put on over a stone in weight from QA correction doses and consultation switched me over to Tresiba, which up until a few weeks ago was working fine, I take about 16 units of basal a day, store insulin in the bottom of the fridge so it's in the coldest part, I inject basal in my bum, sites are rotated daily, QA goes in my tum which has a few sore red spots but no lumps, have changed cartridges to rule out bad insulin. I have thought about possibility of running low in the night, but normally I wake and know immediately to take glucose, also my meter does my correction doses so feel this shouldn't be the case, however oddly enough last night I did wake at 3.18am which is when I am at my lowest but didn't feel low. I haven't had a hypo in about a month which on one hand is fab but on the other hand its telling me i'm not getting in my range. I generally try to eat dinner early in the evening so when I test again my meter can calculate the right correction doses I need to try and get down, but even doing this I am still taking above 12 each morning.

Hi, Juicyj, just in case the highs are not just a lengthy virus - and it does sound to me the most likely reason - have you lost the bit of extra weight you mentioned you had gained?
In some Type ones even small weight changes can have a big effect even if you are in the ok BMI range - a fairly small gain leads to increasing insulin resistance, and a fairly small weight loss leads to more insulin sensitivity. I find that even a few pounds up leads to my having to use more insulin, esp in the morning. When i recently dieted, I lost 12 lbs over 2 years, and went from 24 units TDD, to average 18 units TDD, 25% less insulin.

 

[Heathero]

Will finish personal input to this discussion now. Good luck Juicy hope all your support/ advice from others has been useful.

 

[Juicyj]

Hi, Juicyj, just in case the highs are not just a lengthy virus - and it does sound to me the most likely reason - have you lost the bit of extra weight you mentioned you had gained?
In some Type ones even small weight changes can have a big effect even if you are in the ok BMI range - a fairly small gain leads to increasing insulin resistance, and a fairly small weight loss leads to more insulin sensitivity. I find that even a few pounds up leads to my having to use more insulin, esp in the morning. When i recently dieted, I lost 12 lbs over 2 years, and went from 24 units TDD, to average 18 units TDD, 25% less insulin.

Hi Ann thanks for your message - I haven't lost any weight, although am out on a road bike 2/3 times a week doing an hours ride each time, so am still a stone over my target, even with low carb and exercise no change. My partner seems to think it's a virus as not been right all week but it's difficult to work this out against the effects of high BG. I've adjusted all my ratios on my meter and yesterday afternoon managed to get down to 3.9, but this is a regular pattern every afternoon and I always seem to dip then and then rise again in the evening. I don't think its my basal but a virus now seems a likely possibility.

 

[tim2000s]

To me it looks as though you have two choices. The first is to do nothing different for a week and find out whether you are going down with a virus. If it is the case, you will recover and everything will return to normal.

If nothing changes, I'd suggest you are going to need to basal test and address whether you are using enough basal insulin.