High BG and out of solutions.

[MeiChanski]

Hello Diabuddies!

How are you?

The tables have turned and I've been experiencing double figures during late morning - noon time/afternoon.

I cut my Tresiba by half on the advice of my DSN, I spoke to her on 17th April and from there onwards Tresiba has been doing okay, I was running mildly low between 3.5-4 during the night and early morning. But lately, the past 4-5 days I've been running high, I don't know if i'm stressed, experiencing hormonal imbalance or the blood monster monthly visits or coming down with something, but novorapid takes a while to kick in.
I do indeed give it that 4ish hour time window before another correction and I also don't know if I am slightly insulin resistant.

Another note, I have increased my Tresiba by 2 units, so currently at 6 units because this has happened 5 days in a row with double figures around the same time.
Also I don't know if it's dawn phenomena.

However, today i'm doing better because I woke up around 11:30 am, I was in double figures and I have been doing small corrections to combat it.

Again, I won't see my DSN until June and my consultant until July. So I don't have anyone to turn too for help or at least get any thing sorted such as Fiasp, CGMs or insulin pumps. So the best I can do is multiple corrections and increase my Tresiba and hope for the best.
Oh, I think I do have lumpy injection sites as well.

 

[MeiChanski]

I have added another example.

 

[Juicyj]

Hi @MeiChanski

There could be multiple reasons for the double figures, so illness/infection, bad insulin, bad sites, hormones, change of Tresiba dose and even time of year, yep a change in seasons affects my levels.

It would difficult to pinpoint any of these unless your certain it could be one, before changing anything change your insulin though as this is the first thing I'd start with, then if you start changing your Tresiba dose then give it at least 4-5 days before any further increases to see if it's hit the mark, but don't change your quick acting ratios, just correct as you would do normally.

Try not to stress though it's a minor hurdle to overcome in the grand scheme of things

 

[MeiChanski]

Hi @MeiChanski

There could be multiple reasons for the double figures, so illness/infection, bad insulin, bad sites, hormones, change of Tresiba dose and even time of year, yep a change in seasons affects my levels.

It would difficult to pinpoint any of these unless your certain it could be one, before changing anything change your insulin though as this is the first thing I'd start with, then if you start changing your Tresiba dose then give it at least 4-5 days before any further increases to see if it's hit the mark, but don't change your quick acting ratios, just correct as you would do normally.

Try not to stress though it's a minor hurdle to overcome in the grand scheme of things

Hello!

Yes i've checked everything And I did give Tresiba a good 3-4 days to adapt and I don't think I'm unwell. So I've narrowed it down to lumpy injection sites, dawn phenomena, menstrual cycle and stress.
I'm still doing 1:1 ratio + correction on top, ketones were present but nothing serious enough to go to A&E for.

 

[MeiChanski]

Interesting, I dropped my Tresbia by one unit in total and my sugars went AWOL and had a real fight, must say I was surprised to read that your DSN half the amount.

I know at least one person on here the the time of the month causes her to become very insulin resistant which may be a reason your running high numbers, but also agree with @Juicyj it is a tricky one to pin down.

Hello, it indeed is. I was running extremely low during the night along with rubbish hypo awareness so 8 units went to 4 units and that was fine up until the last 5 days. So my body is tanking these high readings with a slight case of ketones so I'm pretty much out of ideas. I like to note that I hardly run this high when I was on Levemir.

my midriff is a bit hard and I can only reach my buttocks to a certain extent, so I have thighs left to attack.

 

[MeiChanski]

I would bin the insulin in your pens and use a new cartridge out the packet, have done that a few times when things appear to be getting out of control, which has also worked.

I'd like too, but my consultant only gave me a box of prefilled tresiba pens to try out (it's not on my usual prescription) and I think that will last me until June, I'm down to 3 pens at the moment. I forgot to ask him what to do after I've finished it. With novorapid, I can bin them.

 

[MeiChanski]

Hmmmmmmmmmmmmmm sorry chuck I don't know what to suggest.

Now sat here rather drunk, looking at your figures yeah running high, I would get up earlier and inject but being an old fart I'm up early wheather I want or not.

T1 is so wonderful in many frustrating ways all I can offer is a HUG! and no doubt tomorrow I'll be fighting highs as well

If you're an old fart, then I'm ancient.
I appreciate it, It'd mean I would be doing more injections and my consultant will be breathing down my neck. Because he suggested I cut down on snacking so less injections, less hypos. But now it's like well I'm running high, I'm still doing more injections.
By the way, what is tonight's drink that is making you drunk? I'm interested.

 

[MeiChanski]

@Knikki I would also like to know since binning insulin is one suggestion, Could I bin diabetes as well?

 

[MeiChanski]

UPDATE: I finally got my hands on a libre sensor, that thing is harder to buy than limited edition make up. So I'll see whats happening during the night until tomorrow noon. Maybe there will be something interesting to look out for to tell my Diabetes team.

 

[MeiChanski]

I would love to bin diabetes even if it was just for 8 hours.

I was diagnosed when I was 18 months old back in 1965 so I'm not sure if that makes you "ancient"

As for drunk, half a bottle of wine, the usual drink of choice but I do have some Hitel Chocolate liqueur in the fridge that I'm slowly working through as well.

T1 is a bit of a balancing act while riding a unicycle while drunk, sometimes you'll get right sometimes you'll fall off. It is just one of those things, you do everything right but you end up hyper to hypo.

Sometimes you will run high and inject more to correct, I do it, in fact I bet most T1's do BUT that's not a green light to follow me.

You could be getting the old DP which is why your high at 11:30 but if your up say an hour or two earlier and eat/inject you might find that the highs are more easily managed, it's only a suggestion, I'm not medically trained, just a cake eating bloody minded T1.

T1 is a PITA but if you get your head round it you should be fine and then be grumpy old git telling young people how to manage their T1.

I really do want you crack this malarkey.

Man I've rambled, sorry. Hope some of that rubbish makes sense

Oh wow, you too must have seen a lot of changes with diabetes and technology. I remember mixtard 30 the old insulin and actrapid as the fast acting insulin. I was diagnosed in 2001, close enough?

Wine eh? red or white?

I feel like multiple corrections is going against DAFNE in some way, although that is guidance and I feel like that's not how T1 diabetics should live. We already have sore fingers and lumpy sites, c'mon.

Sleep sounds more tempting than getting up, so I face the consequences of being slightly high before noon. but it's been happening for the last 5 days, it wasn't this bad before.

I agree, it was a similar agrument that I used when discussing with my GP about therapy because of my accident back in 2013. CBT wouldn't work if my diabetes is out of control or not controlled well. If only my consultant saw me earlier, maybe I would have something sorted for insulin pump therapy or something else, then maybe CBT might help.
It could be, we are indeed speculating it as much as we possibly can. You know at this rate we could qualify to be software engineers because we are trying to crack this code.

 

[MeiChanski]

Beware, most of us find that the first 24 hours of Libre activation can give some 'interesting' readings alway always check with finger prick if you think it's lying, which it does.

Take care.

Thank you, I am indeed torturing my fingers as we speak to let this sensor settle.

 

[LooperCat]

@MeiChanski - is it by any chance the week before your period is due? I need around 25-30% more basal that week, plus extra bolus and corrections.

 

[MeiChanski]

@MeiChanski - is it by any chance the week before your period is due? I need around 25-30% more basal that week, plus extra bolus and corrections.

I assume so, but it's quite odd how things have changed so quickly. I don't recall being this high for 5 days straight

 

[evilclive]

Oh wow, you too must have seen a lot of changes with diabetes and technology. I remember mixtard 30 the old insulin and actrapid as the fast acting insulin. I was diagnosed in 2001, close enough?
...
I feel like multiple corrections is going against DAFNE in some way, although that is guidance and I feel like that's not how T1 diabetics should live. We already have sore fingers and lumpy sites, c'mon.

I was put straight onto actrapid and insultard (both human) in 1998 - no mix for me. Probably different areas doing things differently.

I'm keener on corrections with libre - it's more obvious what's happening. Though I think I most of mine during the day need food rather than insulin, a state of affairs which makes me happy

 

[MeiChanski]

I was put straight onto actrapid and insultard (both human) in 1998 - no mix for me. Probably different areas doing things differently.

I'm keener on corrections with libre - it's more obvious what's happening. Though I think I most of mine during the day need food rather than insulin, a state of affairs which makes me happy

Oh I guess so, I was doing very badly on mixtard 30 - in and out of hospital for DKA on many occasions, until in 2008 they decided to put me on novorapid and levemir, but by then I was already experiencing damage from DKA - horrendous infections etc.
Yes, i'm quite interested in how Tresiba is working since I only have data from when I had levemir and the libre sensor.

 

[LooperCat]

I assume so, but it's quite odd how things have changed so quickly. I don't recall being this high for 5 days straight

Do you track your cycle? I find from day 18 to about day 25, I need a lot more insulin. I use an app to record that called “Period Planner”, so I can easily check when day 18 is approaching! My usual basal pump programme is 19.75u a day and my “shark week” one is 25.45u a day. I also need to add about 20% to my food and correction doses. I found it impossible to increase basal for just a few days on Tresiba, as it takes so long for a change in dose to kick in, which is a very large part of the reason I got a pump. The day I started to bleed, I’d end up going really low - and they don’t like that at all! So I ended up not increasing my Tresiba and making up to 18 Novorapid correction injections a day... they thought my control was great from my Libre graphs until I pointed out how how I achieved it - and they agreeed it was unsustainable.

 

[MeiChanski]

Do you track your cycle? I find from day 18 to about day 25, I need a lot more insulin. I use an app to record that called “Period Planner”, so I can easily check when day 18 is approaching! My usual basal pump programme is 19.75u a day and my “shark week” one is 25.45u a day. I also need to add about 20% to my food and correction doses. I found it impossible to increase basal for just a few days on Tresiba, as it takes so long for a change in dose to kick in, which is a very large part of the reason I got a pump. The day I started to bleed, I’d end up going really low - and they don’t like that at all! So I ended up not increasing my Tresiba and making up to 18 Novorapid correction injections a day... they thought my control was great from my Libre graphs until I pointed out how how I achieved it - and they agreeed it was unsustainable.

I've been on the pill for the last few years and stopped completely on the advice of my doctor, so I've only started to retrack it from the last 3 months up until now. Thank you, I agree, I actually don't see much change with Tresiba at the moment. I was quite high today at 16.0 around 11:30, despite having increased my background. So like you, I didn't change Tresiba continuted as usual, I corrected with novorapid and added my carb ratio on top. I was much better yesterday. I too, think that it's horrible having to do multiple corrections, not factoring in my tiredness.

 

[MeiChanski]

Hey @MeiChanski hows things have you managed to get your high BG down?

Hello, Yesterday I was running a bit high at 16.0 during 11:30 am then settled quite nicely for the night. But unfortunately I've been fighting hypos all night and majority of the morning - until 6am if I remember correctly. So lack of sleep today.
Today started off okay because I woke up extra early and was at 8.6 at 9:48am, with a beautiful arrow pointing straight up. I'm just out of luck, right? only slightly tweaked Tresiba to 6 units, spent 4 days on 5 units and was running high still, this is to combat high blood sugars in the morning to only suffer hypos at night. I've only done one correction today, compared to 3-4.

 

[MeiChanski]

Today and yesterday's party.

 

[MeiChanski]

I would like to add with this kind of control, I hope I pass my exam and this semester by God's grace because I feel like I had a few rounds with Ronda Roussey.