Bolus working for corrections but not for food? I'm also taking Amitriptyline.

[Catsymoo]

Hey all.

Been poorly the last month and no answer yet but it seems like a nerve issue or muscle problem in my neck causing constant migraines, nausea and weakness and a bunch more symptoms but that is another can of worms. I'm taking amitriptyline but have not taken any for 48 hours.

Noticed my sugars have been a lot higher than usual (my hba1c is bad enough as it is) and I'm hitting low to mid 20s every single day after I eat.

If I take a correction dose of Novorapid, it seems to lower my levels ok.

I'm not seeing any rising of sugar levels over night or when I do not eat.

It is only happening when I eat.

Today my sugars were 14 upon waking. I took 2 units of Novo and it went down to 12 after an hour. I then ate a soft bake bar (exactly 30g carbs, I took 3 units) and 3 hours later my sugar level is 16 which obviously does not add up. I have changed my vial to a brand new pack of Novorapid to ensure it did not go off.

Any idea why this might be? I'm kinda afraid to eat now.

I also recently started supplements of vitamin D 4000 - 8000 IU and K2.

 

[NicoleC1971]

IF this quite sudden then it would suggest you've got a virus on board meaning your liver is chucking out more glucose and your insulin resistance has gone up meaning it takes more insulin to get the glucose into the cells.
It is very hard to correct your blood sugars with extra bolus doses. Best to get ahead of the curve and to increase the basal conservatively e.g. x 1.5 initially. You should ask your team though and try to get to the bottom of whatever is causing the other symptoms.
I hope you feel better and less sugary soon.

 

[Catsymoo]

IF this quite sudden then it would suggest you've got a virus on board meaning your liver is chucking out more glucose and your insulin resistance has gone up meaning it takes more insulin to get the glucose into the cells.
It is very hard to correct your blood sugars with extra bolus doses. Best to get ahead of the curve and to increase the basal conservatively e.g. x 1.5 initially. You should ask your team though and try to get to the bottom of whatever is causing the other symptoms.
I hope you feel better and less sugary soon.

Thank you. I did wonder if increasing Lantus would help. My Lantus dose has been too high for a while but every time I lower it slightly, I end up having problems.

My recent bloodwork showed high white cell count and low vitamin D but I had a cold about a week ago during the test. I was supposed to have another blood test today to check my white cells again and B12 but I was feeling too ill to walk to the clinic alone.

My GP has been rather negligent of the symptoms I'm having, I'm scared its something serious. I've been calling them a lot but often get dismissed or told no appointments even though I put my foot down and say I'm a diabetic.

I had covid in November and noticed no change to my sugars.

If this is a virus I'm baffled as to what kind could last a month and cause symptoms of anemia/migraines, vertigo and weakness going down my arms.

 

[Antje77]

Today my sugars were 14 upon waking. I took 2 units of Novo and it went down to 12 after an hour. I then ate a soft bake bar (exactly 30g carbs, I took 3 units) and 3 hours later my sugar level is 16 which obviously does not add up.

Why wouldn't it add up?
Your insulin to carbs ratio, or amount of insulin you need for x grams of carbs isn't static, it changes over time. It can also vary a lot throughout the day. I guess you're on a 1 to 10 ratio, as you took 3 units for 30 grams of carbs. 1 to 10 is often a starting ratio, from where you adjust to find your own ratios.
We usually need more insulin with any kind of illness or infection too, so if you felt too ill to walk to the clinic today, that might be the cause of the change in your insulin needs.

 

[Catsymoo]

Why wouldn't it add up?
Your insulin to carbs ratio, or amount of insulin you need for x grams of carbs isn't static, it changes over time. It can also vary a lot throughout the day. I guess you're on a 1 to 10 ratio, as you took 3 units for 30 grams of carbs. 1 to 10 is often a starting ratio, from where you adjust to find your own ratios.
We usually need more insulin with any kind of illness or infection too, so if you felt too ill to walk to the clinic today, that might be the cause of the change in your insulin needs.

I thought sick day rules were only for infections and things your body actively fights off such as cold and flu? I didn't think migraines or a neck injury/nerves (If that's what's wrong) would impact sugars? I've only noticed the insulin resistance this week. Even when I had a very weird and mild cold last week my insulin was working.

I'm not really one to suffer from high sugars when I'm sick. Mine don't sky rocket. Not even when I had covid.

 

[EllieM]

I'm not really one to suffer from high sugars when I'm sick. Mine don't sky rocket. Not even when I had covid.

Insulin ratios vary widely from person to person and can change with time. I second the suggestion that your reduced exercise and/or illness may have changed yours.

I hope you feel better soon.

 

[dancer]

I thought sick day rules were only for infections and things your body actively fights off such as cold and flu? I didn't think migraines or a neck injury/nerves (If that's what's wrong) would impact sugars? I've only noticed the insulin resistance this week. Even when I had a very weird and mild cold last week my insulin was working.

I'm not really one to suffer from high sugars when I'm sick. Mine don't sky rocket. Not even when I had covid.

Pain can cause stress and stress can increase blood sugar. Many things affect blood sugars. Even season changes can cause a rise or fall in blood sugar, so appropriate changes of insulin doses may be required.

 

[oldgreymare]

I thought sick day rules were only for infections and things your body actively fights off such as cold and flu? I didn't think migraines or a neck injury/nerves (If that's what's wrong) would impact sugars? I've only noticed the insulin resistance this week. Even when I had a very weird and mild cold last week my insulin was working.

I'm not really one to suffer from high sugars when I'm sick. Mine don't sky rocket. Not even when I had covid.

If you are in significant pain, your cortisol levels may be elevated and I believe that can contribute to raised blood sugars and possibly increased insulin resistance. Also the raised WBC count does suggest an active infection which may still be with you, even if this has nothing to do with your pain issues. As others have suggested, time to experiment with your ratios and maybe increase your basal Lantus.

 

[NicoleC1971]

Thank you. I did wonder if increasing Lantus would help. My Lantus dose has been too high for a while but every time I lower it slightly, I end up having problems.

My recent bloodwork showed high white cell count and low vitamin D but I had a cold about a week ago during the test. I was supposed to have another blood test today to check my white cells again and B12 but I was feeling too ill to walk to the clinic alone.

My GP has been rather negligent of the symptoms I'm having, I'm scared its something serious. I've been calling them a lot but often get dismissed or told no appointments even though I put my foot down and say I'm a diabetic.

I had covid in November and noticed no change to my sugars.

If this is a virus I'm baffled as to what kind could last a month and cause symptoms of anemia/migraines, vertigo and weakness going down my arms.

I am guessing virus just because of the higher bgs and tis the season. If you have had a booster that can make your temporarily vulnerable to infections too.
The other thing to do would be to google vitamin B deficiency including B12 which you will eventually get tested for or try eating more mushrooms, eggs, squash, broccoli, turkey, sardines, cheese. These foods will also provide vitamin D and could help pending any diagnosis. My info comes from Patrick Holford's Optimum Nutrition Bible. B vitamins work best eaten with each other which is why I've listed common sources from food.
I note that some vitamin B and D deficiency symptoms include anxiety which isn't to say you are over reacting to your symptoms but that being anxious makes you feel even worse about them and this again can raise blood sugars all by itself.

 

[Antje77]

I thought sick day rules were only for infections and things your body actively fights off such as cold and flu?

Sick day rules are a starting point too, but this doesn't mean that every sickness needs the same adjustments in insulin. Amitryptyline can affect BG, but there are countless other thing which can affect the amount of insulin you need too:
https://diatribe.org/42-factors-affect-blood-glucose-surprising-update