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Crazy hyperglycaemias

Dontworrybehappy

Member
Messages
8
Type of diabetes
Type 1
Treatment type
Pump
Hello fellow diabetics!

What do you do when having hyperglychemias that won’t go down? And what do you find are the usual causes to this? I’ve had T1D for about 8 years (I’m 17), and I’ve never had this experience before:

What happened:

Yesterday:
Woke up early, ate a little cake as breakfast (first and last time doing that) and all of a sudden sky high. Did a little strength training and ate a better breakfast (scrambled eggs). Went out on a walk, blood sugar came back down hours later but it reacted in a hypo that I treated. I had to walk home (12 000 steps in total now) but after eating lunch I was up in 20 mmol/l. I put on new insulin infusion set and sensor and took insulin through my pen/syringe which led to almost no reaction. Ate dinner and injected insulin by pen again. High bloodsugars continuing after this. Ketones (thankfully) only at 0,1.

Fast forward to the night:
Around 1 o’clock all the insulin and movement caught up and a major drop and hypo occurred, I woke up 50 minutes into the hypo by myself and was in survival mode, eat a sandwich, cookie, some chocolates and some dextrose while drinking ~1 dl juice. Took insulin right after the hypo was over (spoiler alert, that didn’t work). I had to change my infusion set AGAIN while taking insulin through pen AGAIN. Hypo after ~3 hours and some normal blood sugars after that.

This morning:
Woke up, strength trained (about a 15 min work out), ate and took insulin. Now I’m back at 17 mmol/l.

Reasons I’ve found:
- yesterday I started the day with cake, stupid decision
- I’ve not been 100% good with my insulin injections, injecting them minutes AFTER eating, not before as I should
- insulin being old/bad (even though newly retrieved from the drugstore)
- infusion sets not working
- carb ratio (hope it’s the right word) not being set to me waking up this early in the morning, and all the late times we’ve been eating (routines have not been held up this summer)
- strength training making my blood sugars go up (I don’t know if this is a thing, but this is what’s really new)
- hormones…?

Please bless me with you knowledge and tell me what you think. I’m really confused and would like some outside thoughts on this.

Thank you x-x
(I’m going out on ANOTHER walk now, bye)

PS: if anyone knows of former threads regarding this matter, please write where to find them. I also hope I put this thread in the right “folder”.
 

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I think you shuld get in touch with your Diabetic Nurse or Dr regarding this. Mind you re the cake I have done that too. had a flap jack cos I was sick of being good. high lasts for 2 days or so no matter what I do, only ever had false hypos though and last one was rather scary on a walk out in woods no one about light headed and shaking I had never been so grateful for some jelly babies ever
 
I would hardly suggest hormones, because at the age of 17 the hormonal restructuring of the body is almost complete. I'm not sure about your gender, but if you're a girl, then I guess by the age of 17 you already know how your bg behaves during menstruation. bg usually drops from training, although stress increases, but it seems to me that the reason is in the cake

if bg has dropped to hypo, then your insulin has definitely worked. With high bg, our insulin resistance is higher than usual and it usually takes longer for it to take effect. Sometimes, when I do stupid things like pizza/cake and my bg goes crazy, I usually completely eliminate carbohydrates from my diet the next day and give insulin injections only for BG reduction with a break of 3 hours until bg normalizes (I don't know which strategy with pomp would be the right one, I've never used it), sometimes it still goes into hypo, but I don't allow myself to drink more than 1/3 cup of juice
 
Are you on a closed loop pump or one that needs set profiles and more active management? I can see from the images that it’s Medtronic. I’m guessing it’s not closed loop as insulin would be suspended when the CGM told the pump you were becoming hypo.
Either way, it’s probably best if you take the problem of fluctuating blood sugars to someone who’s aware of the setup, a nurse or doctor you’ve dealt with before.
I think many of us will have felt hungry enough to grab food without bolusing and waiting the required time, and some insulins do require time, especially if blood sugars are high.
I hope your team can help with ratios, exercise settings, basal doses and everything that’ll help you.
 
By the way, there’s a Pump Forum on this site, the people there may have some helpful things they can say.
Good luck getting it all sorted.
 
Thank you for writing!

I will have a meeting with my diabetes team this week, so bringing up this issue will be of priority.

Thanks @MarkRawlinson , I thought I was alone in doing such a thing, and I’m starting to think it was the soul reason to this whole happening. I have (kind of) tried eliminating carbs today like @Zhnyaka suggested, to a certain extent at least. It worked fairly well! (Probably not the hormones as you say, I just blurted out some “possible” reasons XD)

And to answer your question @Fairygodmother , I don’t know really. My pump has this algorithm thingy so it usually stops giving me insulin before and during hypo, while giving extra when hyper. It also looks at how former days have played out and affects basals and boluses that way(I don’t really know how to describe it). It is a mildly infuriating system as I can’t do corrections, temporary basals or other things myself if I don’t turn off the smart algorithm, that I often need (the pump is called Minimed 780G). Maybe it needs set profiles…? (I’ve never heard of these kinds of pumps in English as of not living in an English speaking country, so am a bit confused… I’ll have to look these up later)
 
Yes, we have the Medtronic 780g in the U.K.
I hope your team can help, maybe change the settings on the pump so that it all works better for you.
Good luck!
 
Are you carb counting? I have the 780g with Guardian 4 sensors and it's essential to count your carb intake. Don't know where you are in the world but here in the UK we have something called a DAFNE course. Dosage adjustment for normal eating. I'm sure you would have something very similar to this. It's really worth doing.
Good luck in sorting this out.
 

Yes, I’ve been carb counting since I was 9, even though I’m mostly going on my gut feeling these days (no way I’m weighing etc. everything I eat) so everything might not always be perfect. I know my way about it though so it is usually correct. My problem is remembering to take my insulin before eating though (I’m really bad at setting routines, have to work with that), so that’s usually what disturbs my bg. Even though going through old “courses” might be a good idea in general since I have to become more independent with my T1D.

Thank you XD
 
At the mo all I can see is a yo yo effect going on here - which would drive anyone mad, the effect of high/low isn't great for you physically or mentally.

Things i've learned with t1d - carbs for breakfast are a nightmare, so I avoid them and eat low carb first thing, otherwise it can take till lunch to bring them down, fighting highs with corrections will eventually take you right down to hypoland so keep a steady BG will help you cope better and take the effort away from the hyper vigilance in managing your BG levels. Start the day with protein and fat so eggs, yoghurt, meat, small bolus for protein but that's trial and error, as in the absence of carbs we convert protein to glucose, so no free meals here.

Yes it's good to pre-bolus if using say novorapid as that can help counter a high, but better still is getting onto a quicker acting insulin such a Lyumjev which starts working straight away and can be a game changer.

Your age of course with hormone production can also play a part too, but take care with exercise as this can also cause a crash, it's good for bringing down levels and particularly walking or weight training, but you need to counter the balance of this with careful vigilance and watching the BG's, I tend to avoid exercise if I have quick acting on board and my levels fall to 6 mmo/l or 108 in the US, as they can easily crash to hypo from here due to the delay on the sensor reading, and will often have fast acting glucose at this level to avoid the low.

A few careful tweaks and you can improve your morning, but also look for repeated patterns, if this high day was a one off then consider it a yo yo day, as levels can swing wildly if you start with a hypo.
 
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