Diabetes and shortness of breath?

[mistados]

Hi,

I was diagnosed a couple of years ago. I recently moved to an area of the country where there seems to be little to no help for diabetic patients. My GP just passes me over to the practice nurse who tells me to test more each day and inject more insulin.

I have tried everything and my blood glucose levels are still really high, this morning my levels were 31mmol.

I have been struggling for breath for a while now too, heart palpitations and severe anxiety. It feels lke i can't get a satisfying breath of air into my lungs.

I'm only 31 and not overweight or anything, BMI of 21.

Could my shortness of breath be caused by my high levels? Has anyone else experienced difficulty breathing, or at least the sensation of finding it difficult to catch a breath.

I was a smoker for about 12 years and quit recently, perhaps it could be my lungs clearing up?

 

[mo1905]

High BG levels will certainly make you feel unwell. This could include ahortness of breath, however, so could many other conditions. Early signs of asthma maybe ? You mentioned you quit smoking ( fantastic ), this often gives people a sort throat as the tiny hairs grow back but again, not sure if this would cause shortness of breath. I know you are not happy with your care team but I really think you need to go see them I'm afraid. Gokd luck.


Sent from the Diabetes Forum App

 

[mistados]

I got an emergency appointment and saw a doctor and she said to just increase my lantus and see what happens. She laughed when i told her i felt i could not catch my breath and that i felt anxious and blew it off as being my imagination.

 

[rachy0121]

i was taken into hospital when my bloods were that high and like you i couldnt breathe at all and felt no matter how much i inhaled nothing was going in. i do think that your high mmol has something to do with it. i wouldnt worry yourself though just maybe inject a little more insulin?

 

[desidiabulum]

Shortness of breath can be a symptom of many different things, but you should definitely make sure that they are checking it out properly. I had recurrent shortness of breath, often after hypos, and thought there was maybe some diabetic link, but no doctors were interested, and I assumed maybe I was just out of condition. Finally I changed to a different GP who said it was worth getting checked just to be on the safe side -- no problems with lungs in breath test, and cardio stress test was fine except for a very slight anomaly. Cardiologist said it was probably nothing, but ordered CT scan just so that we could definitely discount cardio issues-- result was they found two blocked arteries so I have just had an angioplasty, and feel very lucky that it was caught early before something really serious happened. I'm slim, fit, don't smoke -- it was a complete shock.
It's more than likely that there is a much less alarming explanation for your shortness of breath, but beware of treating everything as a complication of diabetes, because diabetes clinics are not interested if it doesn't fit. Shortness of breath CAN be an indication of cardio problems -- it doesn't need to be combined with chest pains (little-known fact, since verified by nurses and cardiologist!).
Good luck!

 

[SamJB]

I experienced anxiety when I was diagnosed too. Like you, I was told very little information. Hypos made me incredibly anxious, I had panic attacks, heart palpatations and the shortness of breath that you describe. So, what you're describing sounds like anxiety and not anything physical, although I'm not a doctor so it would be worthwhile running this past your GP.

Can you give us a bit of info on your treatment plan? What insulin are you on? When do you test? Many of us on here are experienced enough to help you bring your morning levels down, but it's certainly because you don't have enough insulin in you.

 

[mistados]

Iv'e been poked and prodded my entire life it seems. I have had Cancer twice and two bouts of acute pancriatitis whch lead to my diabetes, or so the doctor thought.

I'm currently on Novorapid and Lantus. I must confess that i sometimes forget to take my Novorapid when i eat a main meal and am not the best at testing.

I'm on 34mg of lantus before bed so i guess that's not enough?

 

[SamJB]

That must have been incredibly difficult. There's a few people on here that have had pancriatis which supposedly led to diabeted.

Regarding your Lantus question, it depends on what your levels were before bed. Your before bed and before breakfast readings need to be within 1.6 mmol/l of each other. Here are the steps to figure out your Lantus dose:

Make sure you don't forget to inject your evening meal Novorapid. Don't eat, or inject Novorapid within 4 hours of bed as this will influence the reading. If your bedtime and pre-breakfast readings differ by more than 1.6 mmol/l then you will need to adjust your Lantus by 10% accordingly. So if your pre-breakfast reading is 3.2 mmol/l higher than your bedtime reading then you will need to increase your Lantus by 20%.

 

[mrman]

Would add to check for ketones with those levels and symptoms. If your not able to pop to a and e and request they do it.

Sent from the Diabetes Forum App

 

[mistados]

Yea i have tested fir keytones and all good on that front. How long does Novorapid work for? i know it's fast acting but does it work for 4 hours? is that why you suggest not eating anything between then and testing before bed?

 

[mrman]

Yep, although quick acting it will last for 4~5 hours. So of basal testing overnight you must wait for the full effect of your qa to be out of your system. Also to not ready anything in between as to effect your basal test.

Sent from the Diabetes Forum App

 

[BaliRob]

Notwithstanding that I had had an inexplicable weight loss of some two stone - it was only after I told the doctor that I had breathing difficulties after extreme exertion did she decide to have my blood tested leading to the diagnosis of Diabetes. It was only then that I associated being out of breath climbing stationary escalator stairs (in a mall) that I confirmed that shortness of breath IS one of the symptoms of Diabetes together with sudden weight loss.

 

[SamJB]

It lasts up to a maximum of 5 hours, but by 4 hours nearly all of it will be out of your system. And yep, that's why you shouldn't eat or inject at least 4 hours before bed.

 

[Sabantha]

If/when my bg is high I'm very short of breath! If have as much as 0.5 ketones I can get breathless doing stairs ect. I'm 26 year old healthy (other than D) mum for 2. Try get levels down, see if helps any but it a major symptom/sign I'm running into high dangerous levels


Sent from the Diabetes Forum App

 

[mistados]

Interesting that my levels are at 13mmol at the moment and i am finding it easier to breath. What i don't understand is this.

Say for example you have Novorapid with dinner and 4 hours later you test just before bed and your levels are in the optimum range, say 6-7mmol, surely then taking Lantus (background insulin) would cause you to have a hypo during the night?

I can't think of a worse tme to have a Hypo, when your asleep, you might not wake up.. :shock:

I just don't understand why we need background insulin if Novorapid or another fast acting insulin brings the levels down to where they need to be anyway.

Is it best to go to bed with slightly high levels to avoid a hypo? or is Lantus just very slow acting?

So confused..

 

[SamJB]

It's because throughout the day and between meals, your body always needs glucose, so your liver is constantly producing a trickle of it. Because of this glucose, you also need insulin, which is what your Lantus is for. If you had no Lantus in you, after the Novorapid has run out your levels will increase.

Lantus is specifically engineered so that is "crystallizes" once injected. This crystal gradually disolves over a 24 hour period so that you have a constant supply of background insulin to cover what your liver is producing.

 

[mistados]

Thanks Sam,

I don't think i inject enough Novorapid, i never know how much to do, how much does 1 unit lower your blood glucose by?

If i had blood glucose of 15mmol before eating, how much would i need to inject? I know the more carbs a meal has the more i need to inject, but how do you figure that out?

Also, just spoke to a GP and i'm getting a chest x-ray done next week.

 

[Sabantha]

Average of 1unit brings down 2-3 Mmol although everyone is different. Do you possibly need a refresher on things? Surely you should know your correction doses ect?


Sent from the Diabetes Forum App

 

[mistados]

It was never really explained to me by anyone, i have some leaflets but they are a bit vague..

 

[SamJB]

Glad you're getting it looked at by a doctor. Well, as you'd no doubt be surprised to hear, everyone is different regarding their insulin sensitivity. Most people start out with a ratio of 1 unit of Novorapid per 10g carbs, you may find that works or you may find that it needs tweaking. With insulin to mmol/l ratio, most people find that 1 unit of Novorapid will drop their levels by 3 mmol/l; again, you may find this needs tweaking. For me, I'm 1 unit of NovoRapid for 7g carbs and 1 unit of Novorapid drops me by 2 mmol/l.

Before you start playing figuring out your Novorapid doses, it's absolutely imperative that you get your Lantus dose correct first, because if this is wrong it will influence your mealtime readings, you may go high or hypo between meals and it's difficult to figure out exactly why things are going wrong. If you follow the steps I gave above (1.6 mmol/l change requiring a 10% Lantus change) and spend a few days getting that right, then you can start working on your Novorapid dose.

BTW, when you calculate the amount of carbs in a meal, make sure you count everything in a meal and not just the starchy carbs (break, pasta etc) as it all adds up. Also, when calculating your insulin:carb ratio try to keep the carb amounts to a minimum as it reduces the margin for error. Try to keep it to around 30g, which is about 2 slices of bread.