Type 1 30+ blood sugar

[picklebean]

Is a blood sugar over 30 dangerous in itself? In other words, should you only seek medical attention if ketone levels are high or does the blood sugar itself require some intervention?

My blood sugar is currently 31.2 but I have no way of testing for ketones as the ketostix the doctor gave me (after much persuasion by me!) are out of date and my blood monitor doesn't test for them.

I've had a minor surgical procedure in the last 2 weeks which is supposed to take 4-6 weeks to heal, possibly more and I'm also in the middle of lowering my Lantus dose and adjusting my Humalog ratios for carb counting, so that might be affecting things. My sugars often run a bit high anyway (around 12 but not usually higher) but they've been steadily rising over the last few days. (I know because I'm currently doing my hospital's version of the DAFNE course so I'm monitoring my levels and insulin timings and doses really closely. They were sort of 17-20 but now they've shot up to 30.

I'm due at the diabetes clinic on monday morning for the next session of the course with the DSN. They have meters there to test for ketones, so I'll be able to check then. I'm just wondering if a blood sugar of over 30 on its own is dangerous. I doubt ketones would have built up enough in this last couple of days to worry about that too much - or maybe I'm wrong. I don't know how quickly they develop..... aaargh, I can barely think straight right now and I feel horrendous.


Any thoughts or advice are welcome.... thank you!

Oh and in case my sig doesn't show for some reason, I've been type1 for 21 years, on Lantus and Humalog, plus metformin & victoza.

 

[donnellysdogs]

I got to ask why you are reducing insulin when you say your levels are around 12 which is double what they should be.


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[donnellysdogs]

A level over 20 is dangerous. How long have you had these levels?

A level of 30 can put you in danger of sleepiness and unclear thoughts if sustained, and worse.


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[picklebean]

My background Lantus insulin has been too high and has been making me drop too low in my sleep, meaning I have a hypo and am not waking up and my blood sugar levels are constantly rebounding backwards and forwards. We're trying to get the Lantus level right so that my bed-time reading and waking readings are the same +/- 2mmol and that's meant having to reduce it. Then I have to work out the correct ratio for carbs bolus with the Humalog.

I hope that made sense.

 

[picklebean]

I've only been over 20 in the last 2 days, and then 30+ this evening.
I'm staying at my mum's rather than on my own at my flat, and I'm not planning on going anywhere, so I'm safe enough.

I've taken the first of the correction doses of Humalog that I've been advised to do, so now I'm waiting 4 hours to retest my levels and take another correction dose then.

 

[philchap1]

Your readings are far to high, if it was me I would take extra fast acting insulin to bring the levels down and at levels of 12 and more you should be increasing insulin doses not reducing them, if your levels don't come down seek medical help good luck

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[iHs]

Picklebean, how do you know that youve been going low bg overnight. Have you been getting up and testing or had a cgm going?

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[picklebean]

Actually I do need to get my Lantus level correct first and that level needs lowering, for the reasons I stated above. Once that's correct, then I can increase my fast-acting insulin to carbs ratio and hopefully get my overall blood sugar levels down. Unless the Lantus is right first, nothing else is going to be right.

 

[philchap1]

You need fast acting insulin now to lower you down from 30+

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[picklebean]

Picklebean, how do you know that youve been going low bg overnight. Have you been getting up and testing or had a cgm going?

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Because the DSN and I have been monitoring my sugar levels over the last few months and the pattern has been that without any carbs or fast-acting insulin in my system, so only Lantus being present, then my blood sugars are dropping far too low when they should be staying steady, including having hypos in the night which I have woken up to and treated. I haven't purposefully woken myself up to take middle-of-the-night readings to see if I'm going too low. But I'll go to bed at a level of, say, 10 and will wake up at 4. Or I'll actually wake to a hypo. It's not supposed to drop that much, with only Lantus in my system it should be staying fairly level.

Up until the last few days it was working fine, I was no longer getting any super high readings and no longer having lots of hypos, I've been much steadier and with readings of 4, 5, 6, 7, 8.... nothing like this high of 31.2

 

[Riri]

Hope your numbers are reducing picklebean. If they continue even with corrections then you should get ketones tested in case.

 

[picklebean]

thanks all for your replies so far! Sorry if I'm not explaining myself very well.


I have taken 3u of Humalog extra. That's working on the assumption that 1u will decrease blood sugar by 2-3 mmol/l.
I've been told by the DSN not to give more than 3u in one go if it's a 'correction dose' taken to correct a high blood sugar (I still don't fully understand the reasoning on that one!)
Then I'll test in 4 hours (the length of time the Humalog will be working for) and see what my reading is and can then take another 3u correction dose. So it has to be done slowly rather than all in one go to prevent an overdose. Right now I'd gladly go swimming in the **** stuff if it makes me feel better.

 

[iHs]

Not sure what is going wrong here Picklebean, but bg of 30mmol is mega too high so get it down with bolus correction and then sort out the basal.

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[smidge]

Picklebean,

Your BG is dangerously high. You need to bring it down now. You need to take corrective doses of rapid acting insulin every 2 hours or so until your BG is at worst under 14mmol. Obviously test frequently. Whatever you are attempting to do with your basal insulin, this is not the time for experimenting. I would be taking about 6 units rapid acting immediately - obviously assuming you haven't recently taken any. As a rough guide, 1 unit rapid acting will drop you by about 3mmol. If you do not know how much 1mmol drops you by, then go with that.

When we are ill or stressed our bodies often need vastly more insulin than normal. Your operation will have stressed your body an that might be why this is happening. Personally, I would go back to the hospital tomorrow to make sure your wound isn't infected as that would certainly push your BG up.

Your priority at the moment is to get your BG down to safer levels. Drink plenty of water.

Smidge

 

[picklebean]

Thank you Smidge, that sounds like very sensible information.

I think I've had all these DAFNE rules drummed into me in the last week and we haven't covered sick-days yet. So I wasn't trying to reject everyone's suggestion of taking more fast-acting insulin, and I have already taken some extra, I was just trying to stick to the rules I've been taught recently. But I guess a blood sugar reading of over 30 is kind of a different situation that needs immediate action.


Thanks everyone. I'll keep on testing and jabbing

 

[robert72]

Blood sugars over 12 are very detrimental to the healing process, so even more important to get those levels down after your recent op. I had a lot of highs after an operation last year and the Drs were getting very concerned when I went into double figures. Hope you get control soon.

 

[smidge]

Hi Picklebean,

Sorry if my reply sounded terse I was just concerned for you. DAFNE actually tells you to test for ketones above 14mmol and the amount of rapid acting you take depends on the level of ketones. They say at low ketones take about 10% of your total daily dose every few hours and at higher levels of ketones take 20%. They also say that when you are ill you might need to increase your basal a little too. As you can't test for ketones, you must assume they are present with a BG of 30mmol and act with urgency.

Is there anyone with you who could go to an on-duty chemist to get you some ketostix?

Smidge

 

[picklebean]

Oh no, you didn't sound terse at all Smidge, don't worry!

I was simply trying to explain why I seemed so determined to only take 3u every 4hours. The extra info you've given, or maybe it was just the way you put it, made it clear to me that I need to take more than that at this point. So thank you. And thanks every else too! Much appreciated!

 

[picklebean]

update: 2 and 1/2 hours after the 31.2 reading I'm down to 20.1 now, so definitely heading in the right direction!

 

[donnellysdogs]

You should NOT take any fast acting insulin every 2 hours to lower readings.. Sorry smidge, this advice is wrong.OP Is right to givea dose and wait 4 hours.
Normally if over 12 a higher percent correction dose should be gicen, bilut never inject a quick acting injection to correct more than 4 hours apart.


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