Having a bad day

[donnellysdogs]

Your 12 noon indicated that because you did not go up by much that its the basal rates even after you ate the 7g of carb. Your rise was minimal.

You should not have to starve.... But basal testing is a necessity.... Have a look at the link iHs given...

My rates jump enormous when I get up. You need to note down your getting up times....

I think I was started on a flat rate of 0.45 per hour.. Not one of my rates has ever been that since!!

 

[PepperTed]

Basal rates are definitely the problem but my DSN doesn't want me changing them drastically without talking to her about it. She's working today so I'm sure she will agree we should put them up during the day.

I'm not on a flat rate, currently on three different rates throughout the day. But these have doubled since the initial dose we set when I got the pump, and I know she is nervous about how much insulin I'm on. From 3-6am it's set at 3u per hour, which seems to be dealing successfully with dawn phenomenon. I know it's a lot but if it's what I need, it's what I need.

 

[dtennant9]

@PepperTed

With any correction of insulin whether by pump or injection then you should come down to normal target by 5 hours.....you should start to see a drop by 90 mins.. But it won't be the biggest drop in bg.. This will occur 2-3 hours after that correction.

What pump are you on?

I can second that, this tallies with when I start to see a correction kicking in.

 

[Engineer88]

I'm on an Animas Vibe with Novorapid. My sugars today have been:

2am - 9.5 (1.5u correction)
6am - 9.8 (3.25u correction)
10am - 11.6 (7g of carbs and 7.45u)
12pm - 12.4 (3.5u correction)
1pm - 13.2 (FED UP, 12 units of correction!)
2pm - 12.6 (1.2u correction)
3pm - 12.1 (5.8u correction)
4pm - 11.4 (0 units, thought I'd had enough and it was finally coming down...)
5pm - 11.4 (4.9u correction)
Now - 11.2 (is there any flipping point in trying to correct???)

So I make that 33 units correction units with apparently no effect. Most of the changes could be due to natural margins of error from my blood meter. I've had 7g of carbs the entire day, and hardly any food, where the heck is all this insulin going?

Obviously my basal needs to be raised. A DSN called me at 3pm and told me to put a temp +20% basal on, which I did. So far it doesn't seem to have made any difference.

I've just had a pretty carb-y dinner, just in case the lack of food / carbs was somehow contributing to this - I don't really understand it all yet. Had parsnips, carrots, peas, flour (yorkshire pudding) and a small bit of cake for dessert. Let's see how bad it gets now

Have you always been on Novorapid? When I started my Vibe i was also on novo but doing so made me realize it wasn't working well for me. Not something i would do right now but maybe look at getting a change to Humalog when you feel more settled?

 

[PepperTed]

Yes, I've been on Novorapid for a very long time. Maybe 10 years?

My team have decided they don't want me upping my basal rates any more because it's too much insulin. They've started me on Metformin to see if it lowers my insulin resistance. They haven't mentioned Type II, so I don't know if they think I have both types... I remember when I was diagnosed as an only-very-slightly-chubby 10 year old I was on pretty high doses - I think my static Actrapid dose was about 20 units. There is no diabetes whatsoever in my family, even though I have 10 aunts and uncles and well over 80 cousins.

I had a shock this morning because my BG was 22.1 when I woke up! I had a bolus dose and smelled insulin, quickly realised something had happened in the night and my infusion set was leaking. I haven't felt that ill in a long time, even with dawn phenomenon I'm rarely over 14 when I wake.

 

[CarbsRok]

Try a different type of insulin Ted, some people have a dreadful resistance to analogue insulin's. Have you ever considered humalin or animal insulin in your pump?. Metformin will take about 6 weeks to work so you will have a long wait n that dept Other option is to use the U500 insulin.

 

[LucySW]

Good luck Ted! What an ****** pain. I'm sure you'll sort it given a bit of time.

BTW I think Metformin with insulin is a brilliant idea, it's what I want to do. Insulin resistance is really, really not what we want.

xx

 

[PepperTed]

Try a different type of insulin Ted, some people have a dreadful resistance to analogue insulin's. Have you ever considered humalin or animal insulin in your pump?. Metformin will take about 6 weeks to work so you will have a long wait n that dept Other option is to use the U500 insulin.

My nurse said I should see a small immediate effect, and then it will take two weeks to kick in fully. I can barely stand the thought of another fortnight like this, let alone over a month. I wouldn't use animal insulin but U500 sounds very interesting - I'd never heard of that before. Having said that, Novorapid has worked well for me for years. I've had excellent control from the afternoon until the early morning, it's once dawn phenomenon hits that everything goes wrong.

I'm back at work and I don't remember the last time I felt this ill. I'm so tempted to take a week off, but I have five major deadlines due. At this rate I'm going to have a nervous breakdown.

That bad day is turning into a bad month!

 

[Spiker]

@PepperTed, my first couple of months on the pump were like that on and off. The very first thing I have learned (the hard way) to do is change the infusion set if anything unusual or unexpected happens. Next step change the insulin as well (or just do both as well). Only if the problem persists do I start thinking about Temporary Basal Rates, illness, etc.

It's really demoralising when correction doses stop working, not least because you get ill fast when that happens. But in my experience it's an infusion set failure 9 times out of 10.

 

[georgeley63]

I just need to vent somewhere where other people will understand. I've worried my family by talking about how bad I feel, because they don't understand and think it's more serious than it is, which has made it even worse.

I have had type 1 for 15 years but finally went on to a pump a week ago. Because none of the settings are right my control has gone out of the window. My average BG for the week has been 12.2, and since I usually have quite good control I'm feeling awful. I have an almost constant stomach ache (one of my main hyper symptoms) plus slight nausea. This has been pretty much constant for the week.

I was talking to my DSN every day but of course she isn't there at weekends, so I've had nobody to talk to since Friday morning. None of my corrective doses are working... BG 13.4, take six units, test after 90 minutes and it's still 13.4. Take another six units because I'm sick of feeling sick, test again, ... 12.8. My corrective doses have worked since I did DAFNE seven years ago and to suddenly find that they aren't making the slightest difference is really frustrating because I JUST DON'T UNDERSTAND! There are so many settings to change on the pump that I'm having a massive crisis of confidence.

It finally caught up with me an hour ago and I came downstairs to have a cry on my own, in the dark. But my husband heard me and came down to ask what's wrong, followed by my mum (she's disabled and lives with us) and when I sobbed that I'm tired of feeling ill, she panicked and called 111. So then I had to convince them that I don't need to see a doctor urgently, and I'm okay. Now I feel bad for making my family feel bad, bad for wasting the NHS people's time, and bad for feeling bad!

On top of that I really don't think I should go to work tomorrow or I will end up bursting into tears at my desk, but taking sick days always makes me feel massively guilty no matter how sick I am. I feel like I need a holiday from diabetes.

I just needed to get that off my chest

An insulin pump is an option for me at the minute and obviously from this post it doesn't sound very good? Would you advise getting one or sticking to injections?

 

[CarbsRok]

An insulin pump is an option for me at the minute and obviously from this post it doesn't sound very good? Would you advise getting one or sticking to injections?

Pumps are fantastic devices as long as you put the work in to set them up properly and have the right cannula in the first place.
Please give a pump a try if you can test and adjust your own insulin and carb count then you will be fine I've had a pump for almost 8 years now and love it.
They are hard work but you only get out what you put in

 

[Lorraine deer]

Thanks Bufger. I warned my boss (and HR) that this might happen, and they have been very supportive. The guilt is all coming from me!

I still haven't had a call back from the DSNs though. I know they must be seeing patients but I desperately want to talk to someone. I've taken the plunge and upped my basal by 10% because this is getting ridiculous. My BG was 13.4, I got fed up and took 12 units to see if it would have any impact, an hour later and it's 12.6. So frustrating. I just want the nausea to go away.

Peppermint tea can help with the nausea . I hope you get sorted soon.

 

[Debloubed]

Lots of advise already but your story reminded me of when a similar thing happened to me, I struggled all day with corrections and no joy then I changed my infusion set! Sometimes, they can be faulty or have wiggled out somehow. I'd say after 8 hours or so of no response after correction then a site change would be in order

 

[PepperTed]

Thanks again everyone. Just an update that I upped my basals after discussion with my nurse, and I've really turned a corner over the past few days. My BGs haven't gone over 10 and my insulin:carb ratios and insulin sensitivity factor seem broadly okay - perhaps just tiny tweaks needed.

@georgeley63 you have to remember I've only been on the pump for a fortnight, although it feels longer. I've had a rough time with it but it will definitely be worth it in the end!

 

[georgeley63]

Thanks again everyone. Just an update that I upped my basals after discussion with my nurse, and I've really turned a corner over the past few days. My BGs haven't gone over 10 and my insulin:carb ratios and insulin sensitivity factor seem broadly okay - perhaps just tiny tweaks needed.

@georgeley63 you have to remember I've only been on the pump for a fortnight, although it feels longer. I've had a rough time with it but it will definitely be worth it in the end!

Thank you for the advice, hope all gets better!

 

[donnellysdogs]

Thanks again everyone. Just an update that I upped my basals after discussion with my nurse, and I've really turned a corner over the past few days. My BGs haven't gone over 10 and my insulin:carb ratios and insulin sensitivity factor seem broadly okay - perhaps just tiny tweaks needed.

@georgeley63 you have to remember I've only been on the pump for a fortnight, although it feels longer. I've had a rough time with it but it will definitely be worth it in the end!

Glad to see you posting with lower levels... Did the DSN tell you how to change them on an ongoing basis? Is she prepared to let go of the reigns a little?