Advice high blood sugars and ketones

[Svodop]

So I have had unexplained high blood sugar levels (up to 20) for a couple of weeks, but I am breastfeeding so I’m in the best control at the moment although my hba1c was 6.6 a month ago.

I decided that I had better get on top of the highs so I started treating them quite aggressively to no effect.

Yesterday I started to feel queasy so I tested for ketones and got a 0.6. Novorapid plus dinner got that down to 0.1 before bed.

I changed both levemir and novorapid to new pens.

So today I took more levemir than usual (6 instead of 4 units) and it seems to have had no effect. I feel like I am keeping the ketones at bay with novorapid (the highest has been 1.1).

To top it all off, I’m due my third covid vaccine tomorrow. I don’t know whether to cancel.

What could it be. Could the levemir just be failing?

 

[Hopeful34]

Welcome to the forum @Svodop. Lots of things cause blood sugar to go up. Are you stressed, or brewing an illness etc? Have you done a lateral flow test to rule out Covid for example, as some people have no symptoms. You could also check that your basal rate is right (although I don't know how breastfeeeding will affect that), as it may be that you're having to use novorapid to correct too low an amount of levemir. There again you may not be, and the only way to find out is a basal rate test.

Re the Covid vaccination, maybe turn up for it and ask the dr or nurse if you should have it. Hope you get your blood levels down soon, as high levels make you feel awful. I'd think that is probably what was causing your nausea.

 

[Antje77]

What could it be. Could the levemir just be failing?

Hi @Svodop , welcome to the forum!
What type of diabetes do you have and how long have you been diagnosed?

The amount of insulin we need changes over time, and even more so when hormones are playing a bigger role, like during puberty, menopause, pregnancy, breastfeeding and even having your period.

You're on a low dose of Levemir with your 4 (or 6) units. Have you contacted your doctor or diabetes nurse on your high numbers and possibly needing a change of dose?

 

[Svodop]

I’ve had type 1 for just over 10 years and was age 30 at diagnosis. I’ve always been on very low doses. 6 units would normally have me battling hypos all day.

I have an appointment with the diabetes team in a few weeks so I was waiting but, considering the last few days, I will call up on Monday and see if they can see me sooner. I think the ketones changes the game somewhat.

I only saw the diabetes team one month ago and they suggested reducing my levemir as I was hypoing at night with the breastfeeding.

 

[jonathan183]

think the ketones changes the game somewhat.

I think I heard somewhere pregnant and breastfeeding women can be in ketosis (ketones but normal blood glucose) ... I can't remember where at the moment - but your support team should know.

... I'll post a link if I remember / encounter it again

Youtube here not the one I was thinking of will keep looking ...

 

[Antje77]

I think I heard somewhere pregnant and breastfeeding women can be in ketosis (ketones but normal blood glucose) ... I can't remember where at the moment - but your support team should know.

... I'll post a link if I remember / encounter it again

But with high BG's accompanying ketones it's alarming.
Still, curious if you find what you have read!

 

[Svodop]

Welcome to the forum @Svodop. Lots of things cause blood sugar to go up. Are you stressed, or brewing an illness etc? Have you done a lateral flow test to rule out Covid for example, as some people have no symptoms. You could also check that your basal rate is right (although I don't know how breastfeeeding will affect that), as it may be that you're having to use novorapid to correct too low an amount of levemir. There again you may not be, and the only way to find out is a basal rate test.

Re the Covid vaccination, maybe turn up for it and ask the dr or nurse if you should have it. Hope you get your blood levels down soon, as high levels make you feel awful. I'd think that is probably what was causing your nausea.

Welcome to the forum @Svodop. Lots of things cause blood sugar to go up. Are you stressed, or brewing an illness etc? Have you done a lateral flow test to rule out Covid for example, as some people have no symptoms. You could also check that your basal rate is right (although I don't know how breastfeeeding will affect that), as it may be that you're having to use novorapid to correct too low an amount of levemir. There again you may not be, and the only way to find out is a basal rate test.

Re the Covid vaccination, maybe turn up for it and ask the dr or nurse if you should have it. Hope you get your blood levels down soon, as high levels make you feel awful. I'd think that is probably what was causing your nausea.

I had a cold around a week ago and have very slight leftover symptoms from that. Covid was ruled out.

I’m not unusually stressed.

I had a positive pregnancy test a few days ago but now have my period. This is what prompted me to start tackling the highs aggressively. Could it be this?

 

[Svodop]

But with high BG's accompanying ketones it's alarming.
Still, curious if you find what you have read!

This is correct. I had it when pregnant. Perfect blood sugar levels with ketones and vomiting. I had to be treated in hospital with an insulin and glucose drip.

 

[Antje77]

I had a cold around a week ago and have very slight leftover symptoms from that. Covid was ruled out.

I’m not unusually stressed.

I had a positive pregnancy test a few days ago but now have my period. This is what prompted me to start tackling the highs aggressively. Could it be this?

It could be both the cold and the positive pregnancy test.
If you had a positive test something hormonal is going on, which can definitely affect blood glucose.
Also, don't assume right away you're not pregnant now you have your period, it's possible to confuse implantation bleeding with a period.
I'd contact your diabetes nurse or ob/gyn monday and let them know about your high numbers and a possible pregnancy.

 

[Svodop]

It could be both the cold and the positive pregnancy test.
If you had a positive test something hormonal is going on, which can definitely affect blood glucose.
Also, don't assume right away you're not pregnant now you have your period, it's possible to confuse implantation bleeding with a period.
I'd contact your diabetes nurse or ob/gyn monday and let them know about your high numbers and a possible pregnancy.

Thanks, I will contact them on Monday.

I’ve now got ketones rising from 0.2 to 0.7 and from 4.3 to 6.8 for blood sugar. I feel queasy. I’ve nearly doubled my night time dose of levemir to 4 units (was 2.5) so will see what happens.

 

[Svodop]

In hospital now, blood sugar 6.8 and ketones 2.5!

 

[Antje77]

In hospital now, blood sugar 6.8 and ketones 2.5!

Glad you're being looked after, sorry you needed the hospital.
I hope they'll be able to sort you out soon, wish you all the best!

Please keep us updated.

 

[Svodop]

They gave me two bags of fluids in hospital and got the ketones down to 0.1 and sent me home to continue managing with double my normal doses. I need to keep hydrated and eating.

I’ll speak to my diabetes specialist on Thursday to hopefully get to the bottom of it.

One of the many annoying thing about diabetes is cleaning your teeth before bed and then realising that you are heading for a hypo. ‍