Type 1 High Blood Sugars

[jemma0866]

Hi ,

I am looking for some advice about my bs please. I am type 1 for around 3 years now. My first year i had pretty good control, was confident in my carb: insulin ratio, and maintained a hba1c of 6% ( this went down to 5.5 throughout my pregnancy ) However, when I was pregnant, my insulin requirements went through the roof, and since then I cant figure out my insulin dosages, and Iam really struggling to maintain good control.
I have spoken to my DSN and consultant several times , but feel that I am still getting no support. I am worried that my insulin is not working anymore , but whenever i mention it , my concerns are brushed aside and i am told i am doing ok and to carry on.
To give a bit of an example ,i went to bed on 6.9 and woke up on 17.5. I have ended up taking around 12 units of novorapid over the day, and my bs just carried on rising until they peaked at 25. Ive had no carbs and increased my basal , but this is now becoming a daily occurance.
Does anyone have any advice for me please? Sorry for the long post...just feeling frustrated and scared. TIA x

 

[Antje77]

Have you spoken about upping your basal with your consultant? If you go high overnight and stay high during the day unless you correct with novorapid it sounds like your basal is not enough. Or are you having hypo's as well?

 

[jemma0866]

Have you spoken about upping your basal with your consultant? If you go high overnight and stay high during the day unless you correct with novorapid it sounds like your basal is not enough. Or are you having hypo's as well?

Hi , thanks for the reply. Yes , i have tried this but was advised to decrease it due to having hypos in the night / early hours of the morning. My consultant said the highs were probably a rebound from the hypo , but now im not havint hypos at that time and my bloods continue to rise
Even if i wake up in range within an hour they go to double figures and my rapid acting doesnt seem to have any effect at all ?

 

[jemma0866]

Hi , thanks for the reply. Yes , i have tried this but was advised to decrease it due to having hypos in the night / early hours of the morning. My consultant said the highs were probably a rebound from the hypo , but now im not havint hypos at that time and my bloods continue to rise
Even if i wake up in range within an hour they go to double figures and my rapid acting doesnt seem to have any effect at all ?

Having **

 

[Antje77]

Yes , i have tried this but was advised to decrease it due to having hypos in the night / early hours of the morning. My consultant said the highs were probably a rebound from the hypo , but now im not havint hypos at that time and my bloods continue to rise

So things have changed with your diabetes. The advise of your consultant was for a different situation than the one you are now experiencing.

Even if i wake up in range within an hour they go to double figures

That's 'feet on the floor effect', where your liver thinks it is helpful and dumps glucose in your bloodstream to get you up and running. Google it. Mine does reliably every day, so I can simply inject quick acting for it before I get out of bed. I figured it doesn't matter if the glucose comes from my liver or from food, it still needs insulin to be dealt with. Injecting for it isn't a good idea of course if it doesn't happen predictably.

 

[himtoo]

Hi @jemma0866
are you able to get hold of a libre( flash glucose monitoring system ) from your DSN -- they are becoming much more widely available - and with your fluctuating BG's and former good control it would seem to make you a good candidate.........this could really help with looking at BG trends.

also ...perhaps have a look at doing some basal testing -- link here -- https://mysugr.com/basal-rate-testing/

 

[EllieM]

However, when I was pregnant, my insulin requirements went through the roof, and since then I cant figure out my insulin dosages, and Iam really struggling to maintain good control.

I would expect your insulin requirements to be a bit weird after the pregnancy - if you're still carrying extra weight then your insulin needs will go up, and the stress of having a small child also affects your blood sugars (stress makes bs rise). And after keeping heroic diabetic control over a pregnancy it's much much harder to keep control after when you're tired and much less motivated. I agree with @himtoo, a continuous glucose monitor would help a lot, particularly with keeping track of overnight trends. Are you sleeping at night?

Other things to rule out
1) overuse of injection sites - if you're overusing them then insulin may not get absorbed properly
2) gone off insulin(s) - change the vials
3) malfunctioning insulin pens

 

[dancer]

If your Insulin and pens are not the problem, you could ask to change from Novorapid to Fiasp which brings down blood sugars much quicker.