Every So Often... Bloods just won't go down.

Long time reader, first time poster... please excuse any forum etiquette faux pas I might make.

I've been Type 1 for just over 20 years, and generally have pretty good control . Every so often, though, I have a day like today, and I'm getting to my wits' end.

The long description:
Last night, I tested my bloods at about 645pm right before eating - 7.4. We were out, and I had a medium carb meal, and took the same amount of insulin I would normally take for what I was eating. An hour and a half later, I started feeling really off, and tested - 21.9. I assumed that I had massively underestimated the content of the meal and took more insulin, and tried to relax -but by 11pm I hit 24.2. I took more insulin (6 units), as well as my long-acting. By 0045 it was dropping again, and at 16.7. By 0530, it was back to an acceptable level of 6.4, and I relaxed and finally went to sleep properly. Got up at 0615, and it had climbed slightly, 7.3. OK. Had a bunch of things to do, didn't have breakfast, and by 0930 it was pretty stable at 7.8. 1030 it was 11.2 - without any insulin or food. Took a small shot, and my 12-hour. Midday, down to 9.4. OK. It's coming down, maybe I can have some lunch - nope. It starts climbing again, and by 2pm when we're settling for a picnic out at a country park, after hiking 4 miles, it's climbed to 11.5, so I take another small shot and watch the wife & kid tuck into pasta, stomach grumbling. By 1445, it's gone up further, hitting 12.2. Another small shot. 1530, it's sloping slightly downward again to 11.0. Crossing my fingers, I leave it for an hour 1545 - and it's gone back up to 13.5! Another shot. After an hour, it's dropped to 12.5 and by 1845. I'm down to an almost acceptable level of 8.2. 2000, I get to 7.5. Finally. But I'm still wondering if it's going to shoot back up.
By this point, I've not eaten for over 24 hours, and have only drunk water / coffee (no sugar, obvs). I'm exhausted from no sleep, and feel terrible due to the body chemistry being all over the place. I've taken more insulin that I would normally take on a day when I'm eating normally. I've been physically active. And the blood sugar levels just keep trying to go UP! When I refer to a "small dose" above, it's generally a 4-unit shot - which SHOULD be enough to bring me well down into range in a relatively short period, and allow me to eat. I also started my first insulin cartridge a couple of days previously, and it had been acting fine up to last night. I changed cartridge this morning, so a new cartridge was having no real difference in effect to the previous.

The short description:
Over the last 24 hours, without eating, and liberally taking doses of insulin every time I climb into double digits, and being active, my blood sugars keep trying to climb.

I'm otherwise in good health and active, taking part in a number of sports. This sort of day is an aberration, I normally don't have this sort of issue. Every few months though, Diabetes just seems to want to remind me that I am at its mercy.

I'm not due to see my consultant for my annual review for a couple of months, and unfortunately my GP is worse than useless as far as this sort of thing goes. His obsession is with smoking, and would likely blame today on the fact that I only quit 10 years ago...

If anyone can offer any insight into what might be happening, and / or what can be done when this inevitably happens again, I'd be incredibly grateful.

urbanracer said:

So just out of interest, what are you using to get these readings/results?

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Accucheck Performa Nano. Always been pretty reliable, up to press. I seem to get days like this a few times a year, and my wife suggested I see if anyone might be able to suggest anything here. It generally goes back to normal the day after, sometimes with a bit of a shaky morning.

urbanracer said:

Any chance it could be linked to this.....

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Thanks for the info (I had to remove the link to reply) - I checked the lot numbers just in case, no matches, so I don't think so. I would have been surprised, as my feeling absolutely awful matched well with the readings - and if I had taken that much insulin with my actual levels being lower, I'd be pushing up daisies three times over!

Fairygodmother said:

I sometimes have a day like that too, in fact the last 36 hours have been like that. I’d not been able to isolate a cause this time until it became obvious that my nano echo was on the blink with a broken connector. I didn’t realise it was until it broke completely.
I thought it’d lead to better results once the correction doses had kicked in but it took much longer and turned into one of those days. Usually it’s not as easy to allocate the blame.
I think that it’s just part of the magic of T1. There are so many possible causes to choose from when trying to analyse the problem: fighting a possible bug or infection; a change in activity; inaccurate pen or pump; the weather and blood viscosity; unseen ingredients in a meal; injection site and subcutaneous thickening; needle problems; GI of food; that I usually find that my most fruitful response is to curse that T1 was left on my doorstep, speak out my envy of the ease of non-D people and continue to give correction doses.
I know I could be more scientific, and usually I can find a cause, but every now and again it seems to happen without an ostensible reason.

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Thanks for the "I'm not alone" - it's amazing how much difference that makes.
I've not been feeling unwell, and I can normally tell when I'm starting to come down with something. I don't think it's the readings or the insulin / pen, because all these behaved normally until last night, and the readings match the way I've been feeling over today, plus I've changed insulin cartridge, strip batch, and needles during the problem period. I vary my sites every injection. Today was pretty hot, but I normally find exactly the opposite problem in hot weather, I have to be careful not to go low!
I originally laid the blame on what I ate last night (maybe they put a bag of sugar in the sausages!), but it just seemed to last way too long for that to be the sole cause, so there has to be something else acting in conjunction.
I'm quite a logical type of person, and I like to have cause-> effect explanations, which I know don't always (or even often, it seems!) happen when we're talking about anything biological, but I still can't help looking!
I'll join you in cursing the Fates today, though most days I'm just thankful that I landed a (normally!) fairly obedient and controllable case and can manage all the things I used to do 20+ years ago pre-T1.

Thanks for the response @therower - I think you may have well hit the nail on the head with #1. When this happens,and I can't figure out why, I get frustrated and annoyed (to put it mildly, I have to be careful my son doesn't learn any new and interesting words...). I wasn't aware of stress etc "making it worse" - if you get a chance, would you (or anyone else who knows about these things) be able to expand on that? Does stress actually raise blood sugars / increase insulin resistance?
I don't know if I'll be able to shrug it off, but I'll sure give it a go in conjunction with #3. I normally, like I described in the novel above, go into fasting mode, with shot after shot to try and bring it down. Continuing to eat with extra correction is worth a try.
To be honest, if someone told me that only breathing through my left nostril worked, I'd give that a try too....!
There's no sign of #2 being a factor, following a broken night of waking up to check every 2 hrs and microdosing where needed, I was pretty much back to normal this morning. Sleepy and grumpy, but that's normal, as my long-suffering wife will certainly attest!

Thanks for the keywords @therower, much appreciated.
http://insulinnation.com/treatment/how-stress-hormones-raise-blood-sugar/ was a major eye-opener.

@ everyone, sorry if I seem to have ignored, I didn't get any notifications that there had been further posts, and only saw these by chance!
Everything's been fine & dandy since the day after, just like every other time - I just get that day or so where for no observable cause it just will not do as it's told.

@phdiabetic - I don't have access to anything other than a standard meter. Because my hba1c is pretty good and I haven't developed any complications over the 20+ years since diagnosis, I'm pretty much just left to my own devices. I understand my local NHS will recommend additional resources for people with less stable control or complications only - I wouldn't even know what to ask for! I'm due my annual review in August, I think maybe this time, rather than just answering the standard questions and being vampired, I ought to do a little research on here first and ask some questions about things that might assist.

@Tony337 I do the mad prof thing too... Or at least I used to. Normally, if I start creeping up or down, I can manage it without any issues - it's purely these few times a year where NOTHING seems to make any difference that I get frustrated.

@JP808 I definitely take on board what you're saying. The part about not stressing about the odd day in a lifetime condition is definitely one I need to work on.

@Mel dCP - I LOVE that pic...