Ineffective insulin

[My Armour]

Morning folks,

I woke up this morning, headed downstairs for a whey shake and my usual 30g carbs equivalent rolled oats. Tested before eating and noticed my sugars were running quite high (9.2). Generally I take 1 unit of Humalog to both account for 10g carbs and to correct by 2. Wanted to maintain sugars around 6.5-7 to keep me going through my morning training so I took 4 units; 3 for the oats and another single for correction.

Half an hour later, I test again before starting my training to find my sugars are 20.6....

Now, this isn't the first time I've had this happen. Actually, it's quite common for my morning bolus to be utterly ineffective. This tends to only happen after the first meal of my day but it's becoming a real drain on both my physical performance in the gym but also my day to day mental state.

Any ideas as to why this may be happening? Later on in the day, both my corrective and general bolus doses are effective at about 1 unit per 10/12 carbs.

Thanks guys,

Sam.

 

[CarbsRok]

Have a look at your basal insulin, it sounds and looks like that needs attention. 99.9% of the time it isn't the insulin or the delivery device it's the human body.

 

[My Armour]

Thank you for the reply buddy Really appreciate it.

Would my basal have such an effect on my sugars straight after a meal?

Many thanks,

Sam.

 

[CarbsRok]

Thank you for the reply buddy Really appreciate it.

Would my basal have such an effect on my sugars straight after a meal?

Many thanks,

Sam.

Hi Sam, if your basal was running out then any bolus you gave would be compensating for the lack of basal, perhaps consider skipping breakfast and monitor your blood sugar ever hour and see what it does. Oats are a slow release carb so would be very surprised if they caused such a hike. Another consideration is the timing of your bolus, most people find they need to bolus 20 -30 minutes before they eat.

 

[My Armour]

I'm a training bodybuilder in the process of a bulk (method of gaining mass in the form of mostly lean muscle) so skipping meals is really the last thing I want to do. Of course, if it's essential, it may be a measure I need to resort to.

You've highlighted the fact that oats are a slow release.. What I can't understand is that I don't think my sugars would have peaked that much even without a dose of bolus!

I think I'll start administering my bolus at earlier 10 minute intervals until I find the balance but the fact I peaked so high is still a worry due to my above theory. Hopefully a combination of both an earlier bolus does and a slightly higher basal will crack this issue before developing into anything more serious.

Many thanks, CarbsRok, I really do appreciate your input as maintaining healthy sugars is so very important to me.

Sam.

 

[noblehead]

I would start with some basal testing as Carbsrok says, but some people are more insulin resistant in a morning and less so as the day goes on, if your unsure about doing a basal check take a read of the following:

http://www.salforddiabetescare.co.uk/index2.php?nav_id=1007

 

[tim2000s]

Hmmm. That's a very steep jump, going from 9.2 to 20.6 in 30 mins, but it's not unheard of.

It's possible that there are a number of factors involved.

1. I find that protein shakes cause blood sugar increases unless they are already feeding used muscles (as I've mentioned elsewhere). It's possible that this has been converted to glucose. Prior to training I use BCAAs and only tend to protein shake post workout. If your humalog takes half an hour at least to kick in, this could be the cause.

2. Do you use a different site every time you inject?

You said that your start of day test this morning was 9.2. What has it been on the other occasions? Also what long acting insulin do you use? Sudden increases at the end of the basal dose are not unknown.

 

[drahawkins_1973]

Morning folks,

I woke up this morning, headed downstairs for a whey shake and my usual 30g carbs equivalent rolled oats. Tested before eating and noticed my sugars were running quite high (9.2). Generally I take 1 unit of Humalog to both account for 10g carbs and to correct by 2. Wanted to maintain sugars around 6.5-7 to keep me going through my morning training so I took 4 units; 3 for the oats and another single for correction.

Half an hour later, I test again before starting my training to find my sugars are 20.6....

Now, this isn't the first time I've had this happen. Actually, it's quite common for my morning bolus to be utterly ineffective. This tends to only happen after the first meal of my day but it's becoming a real drain on both my physical performance in the gym but also my day to day mental state.

Any ideas as to why this may be happening? Later on in the day, both my corrective and general bolus doses are effective at about 1 unit per 10/12 carbs.

Thanks guys,

Sam.

Hi Sam,

I'm very inuslin resistant in the morning so it may be you just need to up your bolus for breakfast.

For example I take 1 unit per 10/12 g carbs during the day and evening but for breakfast I need about 1 unit per 3g carb.

Usuall during the day 1 unit of novarapid will lower by levels by about 4 mmol but only by about 1mmol at most 2mmol in the morning so I also need to take a lot more for a corrective dose.

Hope that helps.
Andrea

 

[PaulinaB]

Are you sure it's not a "late" dawn phenomenon? Some people find that they're bg sky rockets right after getting out of bed. If so, as said before, basal testing (skipping breakfast to see what happens) would be my advice.

 

[Engineer88]

agree with @PaulinaB

 

[iHs]

Whenever my bg is sometimes on the high side, i give a correction and increase it by 1u for good measure. I then eat a fried egg, 2 bacon rashers and a tomatoe (no bread). Eating porridge even with a correction wont lower bg levels too quickly unless some exercise is done like running up and down the stairs a few times until a bit breathless

As others have said, have a think about adjusting yr overnight basal so that yr bg is ok when you eat food.

 

[AndyOD]

I would like to add something which maybe an issue, I was told on my course that insulin absorption can be as much as +/- 50%
There are also other considerations:-
http://www.bd.com/us/diabetes/page.aspx?cat=7001&id=7503