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B.S. level constantly high

R

Rking

Member
Messages
7
Type of diabetes
Type 1
Hi.
My stepsons blood sugar levels have risen to between 20 and 30.
We don't seem to be able to get them down, even after taking corrections.
Should he take even bigger doses?
His pen only goes up to 30 units, so he is facing taking 2 separate injections at a time.
Any advice would be great.
 
Have you tried changing insulin? What doses has he been taking? Have you checked for ketones? Is he unwell? X
 
Depends what insulin stepson is on..

30 units of what insulin?

Does stepson carb count, basal test etc?

Is sson aware of sick day rules (levels that go above 14 will need extra insulin?)
 
What exactly is his blood sugar? Between 20 and 30 is quite broad.

What has gone on today with levels, doses and food?

Do you know what his correction factor is? How much does 1 unit lower his blood sugar?

Have you checked for ketones and followed sick day rules? Ketones will alter the correction factor efficacy because ketones need insulin to be dealt with.

How long ago was the last correction? If I'm in double figures a correction won't move my blood sugar for at least 90 minutes, if not longer. The insulin has to climb up to the top of the wall of high blood sugar before it can start breaking it down. If he's in the 20s that's a really high wall for the insulin to climb.

Swap all insulins for new pens fresh out the fridge to check the insulin hasn't just got too hot or expired etc.
 
How old is he? What caused the rise in bs initially? Is he unwell?

How long are you waiting after correcting?
How frequently are you testing to see if levels are changing? What is the current figure?

Sorry for all the questions but the best advice can only really be given when the facts are known.
 
kaylz91 said:
Have you tried changing insulin? What doses has he been taking? Have you checked for ketones? Is he unwell? X
Click to expand...
We haven't changed insulin yet.
He's on Novorapid.
His ratio is 1:7.
So have been taking doses according to levels and carbs.
His ketones have been 1.5 or below in past 2 weeks and care now 0.5.
He's not been too unwell. Is suffering from ear problems.
He's 15.
 
Rking said:
Hi.
My stepsons blood sugar levels have risen to between 20 and 30.
We don't seem to be able to get them down, even after taking corrections.
Should he take even bigger doses?
His pen only goes up to 30 units, so he is facing taking 2 separate injections at a time.
Any advice would be great.
Click to expand...

Is he ill? Did he miscount his meal carbs? Did he miss any insulin injections today?

When did you do the corrections?
 
donnellysdogs said:
Depends what insulin stepson is on..

30 units of what insulin?

Does stepson carb count, basal test etc?

Is sson aware of sick day rules (levels that go above 14 will need extra insulin?)
Click to expand...
He's on Novorapid.
He does carb count and he's taken the correct doses. His ratio is 1:7.
 
For a dose of more than 30 units you can inject the first 30 units and then without removing the needle dial up the rest of the dose and inject more.
 
catapillar said:
What exactly is his blood sugar? Between 20 and 30 is quite broad.

What has gone on today with levels, doses and food?

Do you know what his correction factor is? How much does 1 unit lower his blood sugar?

Have you checked for ketones and followed sick day rules? Ketones will alter the correction factor efficacy because ketones need insulin to be dealt with.

How long ago was the last correction? If I'm in double figures a correction won't move my blood sugar for at least 90 minutes, if not longer. The insulin has to climb up to the top of the wall of high blood sugar before it can start breaking it down. If he's in the 20s that's a really high wall for the insulin to climb.

Swap all insulins for new pens fresh out the fridge to check the insulin hasn't just got too hot or expired etc.
Click to expand...
His blood sugar within last hour was 27.
His levels have been around this all day.
His correction is 1:4 and changed ratio to 1:7.
Ketones are 0.5 at present.
His last correction was at 6.30pm and at 9pm hid bloods were 27.

Basically he woke up this morning with bloods of 18 had 3 shots of insulin, went back to sleep and when he woke they were even higher.
This keeps happening. We give correct dose and corrections and they keep going higher.
And this is happening with a change in ratios ( Novorapid, Lantis and carb ratios).
 
@Rking Phone 111 for advice. I'd also change to a new nsulin cartridge/pen in case that's the issue.

If you haven't been able to get his BS down all day, you need some medical input, I think.
 
Rking said:
His correction is 1:4
Click to expand...

So 1 unit brings him down 4mmol/l? Why would he be having more than 30 units to correct? If he's 27 and you want to get him down to 7 you want him to come down by 20 and you know 1 unit drops by 4, so 20/4 = 5 unit correction.

Or do you mean he needs 4 units to bring him down by 1 mmol/l? Because that would be 20 x 4 = 80 units correction.

That would be an incredibly high correction factor. The default starting point is usually 1 units brings you down by 3 mmol/l. By comparison the default starting point insulin to carb ratio is 1:10. So if he's on 1:7 he seems to have a fairly normal insulin sensitivity that would make a correction factor of 4 units to bring you down 1 mmol/l seem pretty unusual.

If it's been like this for a few days and you've not started fresh insulin that might be a cause. If he's got an ear infection, that migh be a cause.

If you are doing such large corrections it would be a good idea to call 111 for some medical input.
 
You only mention novarapid.

What basal insulin is he using?

If he's high constantly it may not just be the bolus...

I think you need to contact 111..
 
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