Type 1 Bloods won’t come down

[Jon Wag]

Hello,
Over the last few weeks I’ve been having high readings half hour after waking. I wake at 6am with levels between 5mmol and 7mmol and within half hour the rise starts, it can go up to as high as 28mmol in some cases. This happens if I eat breakfast or even if I don’t.
I’m not running low at night so it’s not a bounce back.

The fall only starts happening around midday even if I’ve taken a little bolus to catch the rise (normally 2 units).

I’m beginning to think my insulin is having no effect at all?

By dinner time each night things seem to settle but form 6am to 4pm my life has become a constant battle with my own body

 

[Jaylee]

Hello,
Over the last few weeks I’ve been having high readings half hour after waking. I wake at 6am with levels between 5mmol and 7mmol and within half hour the rise starts, it can go up to as high as 28mmol in some cases. This happens if I eat breakfast or even if I don’t.
I’m not running low at night so it’s not a bounce back.

The fall only starts happening around midday even if I’ve taken a little bolus to catch the rise (normally 2 units).

I’m beginning to think my insulin is having no effect at all?

By dinner time each night things seem to settle but form 6am to 4pm my life has become a constant battle with my own body

Hi,

Welcome to the forum.

Is this after getting up for work? Yep, could be liver dumping "foot to the flor syndrome.?"

What insulin/s do you use?

 

[Jon Wag]

Hi,

Welcome to the forum.

Is this after getting up for work? Yep, could be liver dumping "foot to the flor syndrome.?"

What insulin/s do you use?

Hiya

I’m on Apidra and Lantus. My ratios are 10.1 in the morning (when I eat). 9.1 at lunch and 8.1 at dinner.

I take 16 units of Lantus each evening at 7:30pm

 

[Incidentals]

What are your ketones doing? it could just be your hungry

 

[Jaylee]

Hiya

I’m on Apidra and Lantus. My ratios are 10.1 in the morning (when I eat). 9.1 at lunch and 8.1 at dinner.

I take 16 units of Lantus each evening at 7:30pm

OK,

I do Lantus. (But dose later in the evening to yourself.)
I can wake with some lovely FBGs maybe 4 or 6 am for work, but at some time during the morning routine sugars go up, maybe 3or 4 Mmol i don't do breakfast at all. But i do need a correction dose to catch the rise.

If this is only a recent affair with the BGs for you. Have you considered changing the your Lantus cartridge to a fresh one, or try a different batch?

 

[Jon Wag]

What are your ketones doing? it could just be your hungry

Ketones seem fine at the moment. I did think maybe I should eat but the worry that numbers will go up puts me off

 

[Jon Wag]

OK,

I do Lantus. (But dose later in the evening to yourself.)
I can wake with some lovely FBGs maybe 4 or 6 am for work, but at some time during the morning routine sugars go up, maybe 3or 4 Mmol i don't do breakfast at all. But i do need a correction dose to catch the rise.

If this is only a recent affair with the BGs for you. Have you considered changing the your Lantus cartridge to a fresh one, or try a different batch?

It’s been steadily increasing since June last year in all honesty. I’m injecting 2 units to catch the rise but perhaps that’s just not enough?

I changed my Apidra cartridge earlier when my wife mentioned it had been worse since the last change and numbers have levelled out for the first time today. Although having said that it’s normally around the same time as normal.

So man variables make things so stressful

Someone suggested maybe splitting my Lantus but I’m not totally sure how I go about it and if I should giving my FBS at night seems so good.

I’m still only 6 years in as a diabetic and it’s driving me insane

 

[Daibell]

Hi. Do you have any excess weight? If so, are you having too many carbs in your diet? if you become insulin resistant it can make injected insulin less effective. I'm only guessing so apologies if you are normal weight. Correction doses of the Bolus should follow a correction rule. Is your '2 units' just a guess or based on the amount of mmol you are trying to reduce on your reading? Apidra is a less common Bolus insulin. Nothing wrong with that but it might be worth changing to something like the common NovoRapid and see if that helps; discuss with the GP. I now split my Levemir Basal as it doesn't last 24 hours. Lantus does last longer so there is less need to split. I assume you have balanced your Lantus?

 

[ert]

The variability is difficult to understand. Just follow (sugar surf) your numbers. And keep trying things. You should try new insulin vials for both basal and bolus. My insulin becomes less effective as I use a vial. If your insulin is over 2 weeks old you could try ordering some more. If this doesn't make a difference, then try testing your basal by meal skipping and see if your blood sugars hold level. If not you may need more basal. If you think this will cause you to hypo, you may need a basal you can split the dose for. Then I'd go for extra correction bolus doses with my meals.

 

[searley]

I would first suspect the cartridge you are using if it's only happened whilst using that cartridrlge/pen


Failing that.. For me I found lantus lasted max 16 hours with a peak around 4 hours after taking in the 12 to 16 hour period it had minimal effect

So if you are similar and you are taking at 7 pm.. And getting a wake up rise.. It maybe there is not enough lantus to help at that time.. You could take it later unless you are going to bed at 7 pm

If your levels are OK overnight I wouldn't take more as you could hypo over night

So if a new pen/cartridge or taking later has no effect I would consider a change of insulin to tresiba which has a much longer acting time of between 48 and 72 hours.. So you wouldn't run out in the morning

But this is something to discuss with your gp/dsn as the may even suggest spit dose of lantus

 

[Jon Wag]

Hi. Do you have any excess weight? If so, are you having too many carbs in your diet? if you become insulin resistant it can make injected insulin less effective. I'm only guessing so apologies if you are normal weight. Correction doses of the Bolus should follow a correction rule. Is your '2 units' just a guess or based on the amount of mmol you are trying to reduce on your reading? Apidra is a less common Bolus insulin. Nothing wrong with that but it might be worth changing to something like the common NovoRapid and see if that helps; discuss with the GP. I now split my Levemir Basal as it doesn't last 24 hours. Lantus does last longer so there is less need to split. I assume you have balanced your Lantus?

Hi Daibell,

I’m in good health and have a good weight ( I run and do resistance training weekly). So probably not that although I have put on a stone in the last 4 months due to it

2 units is a bit of a guess to be honest. My thinking being that someone in my early stages said an average of 1 unit being levels down 2.5 mmol

I was thinking of telling the nurse tomorrow I’d like to try NovoRapid.

I’m not sure that your mean by balancing my Lantus sorry

Thanks for getting back to me btw

 

[Jon Wag]

I would first suspect the cartridge you are using if it's only happened whilst using that cartridrlge/pen


Failing that.. For me I found lantus lasted max 16 hours with a peak around 4 hours after taking in the 12 to 16 hour period it had minimal effect

So if you are similar and you are taking at 7 pm.. And getting a wake up rise.. It maybe there is not enough lantus to help at that time.. You could take it later unless you are going to bed at 7 pm

If your levels are OK overnight I wouldn't take more as you could hypo over night

So if a new pen/cartridge or taking later has no effect I would consider a change of insulin to tresiba which has a much longer acting time of between 48 and 72 hours.. So you wouldn't run out in the morning

But this is something to discuss with your gp/dsn as the may even suggest spit dose of lantus

Much appreciate mate, I’ll give this a go. I actually ordered a new pen earlier as mine has been jamming a little