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high blood sugars and keytones

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charlie229

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7
Hi Im wondering if anyone can help as this is my last resort :( .

Im 23 i have been type one for 7 years now i have had two episodes of dka one in december and one more recent and serious case in july i feel let down by my gp and have no consultant im at wits end so if anyone can help would be so grateful.

My normal day i wake up check my bloods they are always between 20-27 then check my keytones they are between 4-6 i then take my insulin 34 noverrapid have some toast and 2 hours after check again my bloods are between 25 and up wards. I will then have my lunch and take extra insulin anywhere up to 60 units this does not change anything and the same with my evening meal. by the end of the day my bloods are reading high and keytones around 5 i then take my night insulin 68 levemir. then start the whole process again the next day. I constanly feel down and ill and am sick of this so any hints or tips to get them down would be grateful.

thanks :)
 
Hi Charlie, I hope one of the experienced Type 1s is along soon with advice.

It seems to me that you are constantly playing "catch up" with your Blood Glucose... waking with an high BG suggests that the basal Levemir is not doing it's job... and ketones also suggests that the balance is not right.

No wonder you feel unwell so much of the time with high BGs. Does that seem like a lot of insulin to you? Any chance you also have insulin resistance?

Can you arrange to see another Doctor or ask your GP to refer you to a Consultant?
 
Hi Charlie

I agree with Pianoman, it sounds like your balance isn't right. Being constantly high, even overnight, does suggest that you need more Levemir to keep your levels lower and stable. Once that has been settled, you might need your Novorapid doses adjusting but you won't know that until you get your Levemir set better.

I think it's appalling as a T1 that you don't have a DSN or a consultant! I would try and ask your GP to refer you to a DSN at the nearest hospital - or like Pianoman says maybe there's another doctor who might know more about Diabetes and who might have more time for you.

The fact that you have ended up with DKA and that your levels are high all the time proves that you need a bit more care and support at the moment, and it is your right to demand it! In the end, it's your health and your life they are messing about with by not giving you that support, and that's unacceptable!
 
I really feel for you ,you must feel absolutely desperate and VERY poorly. Have you lost a lot of weight? Are you under weight now? I wonder how you are managing to make it out of bed on a morning with BG like that around the clock....You must have fantastic resolve so here's to you on that one :shock:

You need to go to your GP and demand to see a Consultant Endocrinologist and for them to refer you straightaway to a Diabetic team. Is it that you have just fallen out of the loop? or, have you never had the medical support?
If it is the first ,we have all done that from time to time when we have had this disease a long time, so don't worry I have found that they still welcome you with open arms however long it is you have not been to your Diabetic team.
If it's the later then I am shocked and disgusted that you are being ignored with such a serious condition which is so obviously in decline. You must see your GP ASAP.

It sound like you are taking quiet a high dose of Insulin there and still have high BG ,so you may be a little bit insulin resistant too. Your Consultant can prescribe meds to go with your injection regime to help your body use up the insulin to get the glucose out of your blood and into your cells for energy.
What is your diet like? I bet you have little energy for exercise at the moment with feeling so bad, but both will help you in the long run. You need to take small steps to get yourself well and the first MOST important one is making an appointment with your GP/or Hospital Diabetic team, you will still be on their records if you have had care before. If not ring the Diabetic department at your local Hospital and ask to speak to a Diabetic nurse on call, they all have them and will return your call the same day.

Good luck and please let us know how you get on.
 
I agree, you do need to see someone else if you can.

Does your surgery have a DN or a practice nurse who deals with diabetes? If so, i'd try and get an appointment with them. If not i would see another Dr.
 
Hi Charlie
I am type 1 diabetic and used to have high sugar levels a lot. You should always seek the help of professionals when altering your injections and I am just talking about my own experience of sugar levels but I was wondering if you varied your rapid insulin according to what you eat. Do you know how many you drop per 1 unit of insulin - I drop 3 for every 1mmol I inject so if I were 25 in a morning I would inject 6 units to take me down to 7 and then I would inject 1 unit for evey 10 g of carbs for the toast so each slice of bread is worth 18 so if I had 2 slices of toast that would be 36g of carbs and so 3 to 4 units of insulin - this would drop me down to the right level. Alongside this I now have a pump (instead of background insulin) which pumps 1 unit per hour - 24 over a 24 hour period. If i were still on injections I would inject 24 units at night of my long acting insulin. I know everyone is differnt and judging by the high number of units that you inject and that you are still quite high you must need more insulin than me and have higher ratios. I think that you really need to see a diabetic specalist to work out your ratios properly to bring you down to the right level. For example If you have a day or perhaps 12 hours without eating any food or any food with carbs in at all and you could test every couple of hours you would be able to see if it was your background insulin that was wrong or if it was your rapid inslin that you take with food. If without eating you are still high you could add one or two extra onto your background and test again etc and repeat until your background is right. Once you have your background right you could then work out how many units to inject to every 10g of carbs. Please be careful as too much insulin can be just as dangerous as too little and if you have too much you will obviously hypo. so just vary it slightly by one or two units and seek the help of the gp or diabetic nurse while you are looking at your levels. I have recorded mine in a chart to help me look at where its going wrong and this has helped. Always have lucozade ready just in case. Hope this helps a bit. Kath x :)
 
Hi charlie,

I think you need to see a Diabetic Consultant as soon as possible.

If you were in hospital with DKA im surprised you didnt see a DSN or a consultant. When ive been in hospital with DKA i couldnt be discharged unless Diabetic team were happy.

Hope you get help soon xxx

Josie
 
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