difficulties managing glucose level

[Sinni]

Hi guys,


my name is Sini,I have T1D for 40 years.About a year ago I switched to a low carb diet which,in general, changed my life to so much better (my A1C used to be around 6.8%,now it is in the 5.3 - 5.6% range).I am using FreeStyle Libre and FreeStyle Precision Neo to monitor my glucose.

However I do have an issue with glucose level management.

I noticed that approximately every 4-6 weeks it happens that my glucose goes off,usually not higher than 10mmol/l.It used to last 2-3 days and then it would get back to normal.As much as I can remember it started about 1.5 years ago.

Today is the 8th day that I'm out of my normal range and trying to find out how to manage it.

My diet is pretty steady,when everything is fine I keep my levels between 4.0-6.5mmol/l without any problem.

I've tried several things

- increased Novorapid insulin up to 4 units per meal

- increased long acting insulin Toujeo 3 units

- made sure to change pen needles and check if insulin pen is working properly

- tried to use "new" insulin and started using new pen

- changed injection sites


Unfortunately no change yet!

I would really appreciate the feedback if there are others who experienced the same thing.


Thank you,


Sini

 

[Juicyj]

Hello and welcome @Sinni

Changes in your blood glucose control can happen for many reasons, hormones, stress, exercise, heat, sometimes we can’t even put a reason to it, are your corrections managing this ?

 

[ert]

This happens to me when my insulin is 2-4 weeks old even though it/s been in the fridge.

 

[Jollymon]

You are counting all of the carbs, right?

Another issue might be injection spot scar tissue. That’s going to slow absorption rates. We all develop this over time, so w have to keep our injection spots moving.

 

[Jollymon]

Hello and welcome @Sinni

Changes in your blood glucose control can happen for many reasons, hormones, stress, exercise, heat, sometimes we can’t even put a reason to it, are your corrections managing this ?

Stress and hormones are factors in bs management! Becoming upset about why a number is so large might not help you regain control of that number due to the stress of it.

 

[Sinni]

Hello and welcome @Sinni

Changes in your blood glucose control can happen for many reasons, hormones, stress, exercise, heat, sometimes we can’t even put a reason to it, are your corrections managing this ?

Thank you for your reply!

I totally agree about what you're saying,it just feels frustrating when nothing seems to be working.Good thing is that my glucose levels are not that high,previously - before I started low carb diet my glucose would be between 15-20 mmol/l.
Two days ago I got a new insulin pen and today is the first day that I feel much better and glucose is more under control.
It could be that the pen I was using was faulty ( I got it about 1.5 years ago).

Thanks again

Sinni

 

[Sinni]

This happens to me when my insulin is 2-4 weeks old even though it/s been in the fridge.

Hi,

I haven't noticed anything like that so far.So what do you do regarding insulin storage?

 

[Sinni]

Stress and hormones are factors in bs management! Becoming upset about why a number is so large might not help you regain control of that number due to the stress of it.

Yeah,you're right about that one.I guess what I need to do is after excluding possible "suspects" stay calm knowing that it'll soon go away

Thank you

 

[Sinni]

You are counting all of the carbs, right?

Another issue might be injection spot scar tissue. That’s going to slow absorption rates. We all develop this over time, so w have to keep our injection spots moving.

Hi,
I am not counting carbs because the majority of the food I eat consists of about 15-20 items that I keep rotating for different meals.Those are my favorite ones which normally have no or very little effect on my glucose.

 

[Jollymon]

Hi,
I am not counting carbs because the majority of the food I eat consists of about 15-20 items that I keep rotating for different meals.Those are my favorite ones which normally have no or very little effect on my glucose.

But are you certain? Some meats cooked in some sauces aren’t carb free.

If you’re relatively lo carb and you have to dose 4 units per meal, something isn’t right. Either with the meal, or your basal insulin rate. If there aren’t any carbs in the meal, you shouldn’t need any insulin, other than the already injected basal insulin.

I just ate 4 carbs of asparagus and fish for dinner. I dosed .4 units for that, which is what I need per my i:c ratio. I’m going for a walk, and then I should be fine.

I was going to guess that maybe you might be having an infusion set issue, but saw you’re taking a long acting basal insulin. So that’s not it.

 

[ert]

Hi,

I haven't noticed anything like that so far.So what do you do regarding insulin storage?

I have a frio bag for the current insulin, but it still becomes less effective after the vial is opened. I time the quick acting insulin to see how long it takes for my blood sugars to drop 0.3 mmol/l before eating. I have to wait up to an hour with insulin over 2 weeks old. I have to change my meal ratios also.