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Blood sugar high

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gmacdonald89

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Hi I have been Type 1 for about 2 years but lately I have been having trouble controlling my blood sugar. For example just this morning I woke up and tested and it was at around 16 which is high. After eating a small bowl of cereal I took my insulin of 20 units of lantus which is what I have been taking for about a year. Then I took novorapid, yesterday I took 17 units this resulted in my sugar still being high. So I upped it today to 20 units. Yet my blood sugar is now in the 20s. 20 units of novorapid is the most I have ever taken especially after eating so little (also I eat the same food yesterday morning). I have no idea how to lower it, I dont know why it is high, I dont know why the insulin isnt doing anything...Can anybody here help? Thanks
 
You need to speak with your diabetes team as soon as possible and have them look at your bg diary and assess where you are going wrong, those levels are far too high and do need to be brought down, remember to check your urine for ketones ....but do seek help sooner rather than later and if in doubt ring NHS Direct.
 
Sounds like your Lantus is too low. Is there a difference between your bedtime and before breakfast levels? If it increases then you need more lantus - providing you didn't eat anything a few hours before bed.

I agree with noblehead, get yourself an appointment with a diabetic specialist nurse, I'm sure they will figure things out for you.
 
When my blood sugar suddenly goes high and insulin won't bring it down it usually means I have an infection. If you are feeling unwell then you should see your GP to rule this out. You don't mention anything in your post but if you are taking certain medications, such as steroids, that can raise your blood sugar and make your insulin less effective.
Having said that though, if you wake up each morning with consistently high blood sugars (without having eaten before bed) then your Lantus may need increasing. You may be suffering from Dawn Phenomenon. This is where hormones produced in the early hours of the morning cause the blood sugar to rise.
NovoRapid is supposed to be taken before you eat not after. The only exception to this is if the food you are eating is very slow releasing like pasta or pizza. I have oats and whole-meal toast for breakfast each morning and usually find that I need to take my NovoRapid 10-15 minutes before I eat. This ensures that the insulin is the your blood at the same time as the glucose from the food and should help prevent spikes from the food. If you check your blood sugar two hours after your breakfast(or any other meal) and it is consistently high then this would mean that your insulin to carb ratio needs adjusting too. I find that mine vary by time of day and also seem to completely change every few months.
With blood sugar as high as 16 you should definitely be checking your blood or urine for ketones too.
 
I've had dawn phenomenon since day one, so perhaps you have that too and need to focus on increasing your lantus. Increase by a few units and see if this helps (remembering that lantus is a 24-hour insulin). If not, increase it again. As has been said, you need to have novo rapid before meals, not after.

Also, check your levels before and after every meal for a day or two to see if you can work out a pattern - this should help you work out where you may need to increase your insulin units. Good luck!
 
gmacdonald89 said:
Hi I have been Type 1 for about 2 years but lately I have been having trouble controlling my blood sugar. For example just this morning I woke up and tested and it was at around 16 which is high. After eating a small bowl of cereal I took my insulin of 20 units of lantus which is what I have been taking for about a year. Then I took novorapid, yesterday I took 17 units this resulted in my sugar still being high. So I upped it today to 20 units. Yet my blood sugar is now in the 20s. 20 units of novorapid is the most I have ever taken especially after eating so little (also I eat the same food yesterday morning). I have no idea how to lower it, I dont know why it is high, I dont know why the insulin isnt doing anything...Can anybody here help? Thanks
Click to expand...

Just to add to what's already been said, the Novorapid you took had to do two jobs: cover the carbs in your breakfast, and correct for the high blood sugar you woke up with. As others have said, it sounds like your Lantus may need adjusting to get your waking levels right. If you try and change everything at once you won't know what has worked and what hasn't so it's probably an idea to get the Lantus sorted first.

It may be that you don't actually need to change the amount you take of Novorapid (although I would agree with taking it before rather than after eating) because your level after eating (how long after - you didn't say) was not a huge amount higher than before, and I normally find that if my blood sugar is high to start with I am more insulin resistant so the bolus dose of insulin doesn't work as well as if my levels were normal.

You might need to give yourself an extra correction dose of Novorapid to bring your levels down. If it doesn't seem to be working, could it be that your insulin is out of date, or have you left it in the sun or in a car where it could have become overheated? If so it's worth trying a new cartridge/vial.

I also echo what others have said about talking to your diabetes team asap.
 
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