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Insulin having little effect

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@lex

Member
Messages
5
I have been type 1 for a little over a year at this point, I have slowly and gradually had to adjust my lantus and novorapid dosages in order to try and keep myself in acceptable ranges.
For the past week or so I have had what I could only assume to be a bad cold which may be something different at this point as now everything I eat has a strange burnt after taste.
My issue at the moment is that insulin (both prescribed types) is having little to no effect on keeping my blood sugar down, I have double my lantus from 14 units to around 30 units and almost 5× the amount of novorapid from 5 units to 25 units And seeing little to no effect I'm reducing my blood sugar levels. Temporarily I have noticed a slight dip back down to normal ranges and then see it shoot back up in little to no time.

Almost at a loss as to what I should do now short of contacting a doctor, any advice/suggestions would be greatly appreciated.
 
Hi @@lex and welcome to the forums.

There are two obvious possible issues here that I can think of.

Firstly if you've been T1 for only a year it's possible that your personal insulin production is still reducing, which would explain the gradual increase in insulin needed.

Secondly insulin needs are known to go up dramatically if you are ill. Your team should have given you sick day rules to apply when you are ill and you also need a way to test for ketones (either with urine testing strips or blood testing strips).

Having said that, such a large increase in insulin needs would have me attempting to contact my team. Maybe 111?

How high are your blood sugars? High bgs plus ketones is a medical emergency ....
 
Hey!

Thats very frustrating. I also had times when insulin didnt ‘seem to work’. Stay careful though not to overdose!

Id do the following:
- check if your insulin didnt become too hot or frozen. If that could be the case, take a new pen or penfill.
- if youre not feeling too bad, go for a walk about 30/60 minutes or even for a run. (Id prefer walking in this case as running with high bgs isnt nice) When i have a walk or run, my sugar starts dropping as soon as I finished the walk/run, so when im back in ‘rest-mode’.
- try to skip carbs jn the morning (bread for example) or even dont eat anything in the morning. For me personally, my body deals best with carbs after 14:00/15:00. If I want to eat earlier in the day without high sugars, i have to skip carbs or go for a walk or run before.
- keep plenty of sugardrinks around in case you accidently overdose while trying to get your bgs down. From 5 to 25 units seems a huge increase. Sometimes it can take a bit longer before insulin kicks in. Give it some time to work. If you take new doses already while the old one still has to kick in, it might lead to hypos. So always stay careful.

Hope anything works
Good luck
 
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I understand needing to adjust my dosages as my pancreas isn't going to be functioning properly anymore is what was explained to me previously so makes sense with regards to that.

I think I read about sick day rules in my help pack given to me at the hospital when I was first diagnosed but completely forgot about it since then if I'm honest, I don't really get ill very often so haven't experienced this before.
I haven't tested for ketones so will get on that, I think my blood tester has that function.

Blood sugar seems intent on staying at around 15 mmol during the night and 10-12mmol average during the day, have had some success at lowering it during the morning and day temporarily by not eating too much, although this in itself probably also isn't healthy as I normally eat 3 decent meals daily. (I was pretty underweight when first diagnosed and not really eating properly).

Just took a keystone test and showing 0.2mmol so should be safe there I'm guessing ?
 
@lex said:
Just took a keystone test and showing 0.2mmol so should be safe there I'm guessing ?
Click to expand...
That's a normal figure. (I was told that under 0.6 is fine)

Here's a link to some sick day rules


But your insulin increase is so massive that I'd be seeking medical advice... (Unless of course your insulin has gone off, in which case be very cautious about hypos when changing the cartridge)

@lex said:
For the past week or so I have had what I could only assume to be a bad cold which may be something different at this point as now everything I eat has a strange burnt after taste.
Click to expand...
Have you done a Covid test?
 

I wondered whether it could be just a pen that had gotten too warm but I just changed pens yesterday and still having issues so I ruled that one out.
I am very active normally and find exercise helps massively with keeping my bgs in range but found it to be having little effect this past few days so have to assume something funky is going on with my body.
I have made sure not to take more than I think I can handle to try and lower my bgs, when I say 25 units that's over a period of multiple hours, say eating at 5 and taking 8-10 units waiting 2 hours watching sugars continue to rise then taking a further 10 units seeing it reduce and then rebounding again later and having to take a further correction dose.

I always keep a bag of glucose in some form nearby for emergencies haha
 
Hi, I was also diagnosed a year ago…one of the things I was taught on the DAFNE course was how to adjust insulin dosages and that you need to get your basal dose correct and steady before adjusting the bolus ratio… Your BG levels seem constantly high so I’m wondering if it’s your basal dose that needs sorting out? I also have a cold at the moment and have seen my BG levels go all over the place…
 
Hi there. It is worrying when this happens with your blood glucose being high. I'm having my 2nd very bad cold/chest infection in 2 weeks. Ever since Christmas eve my BG has been high up to 25mmol & shows no signs of returning to levels prior to me being ill. Last night at midnight it was 22 mmol & at 7am upon waking up was 17mmol. I've increased my insulin & reduced my carbs, followed the sick day rules & so far had no success. Looks like I'll be phoning my DSN. I hope you get sorted too.
 
Hi my Grandson as type one just over 3 years, he is 15 and is hard work not taking his insulin. So I started making him take it in front of me. Long story short, he developed lumps I forgot what the correct term is and he was injecting in the lumps and insulin wasn't going into his body. He was told to change areas frequently and it worked. He had never had these lumps before he just missed doses. Typical gaming teen doesn't seem to get that diabetes can be life threatening. Hope you solve your problem
 
I had that problem too when I caught Covid 19 back in May 2020. Before Covid my glucose levels ranged between 6.0 mmol and 9 mmol. I was in intensive care for close on 8 weeks being ventilated and a further 6 weeks on a ward. I noticed my blood glucose were higher than 20 mmol - unrecordable . My daily dosages were 32 units of Lantus solo star and depending what I ate Nova Rapid dosages. My Diabetic nurse suggested I had 20 units of Lantus at 6 am and another dose of 20 units at 6pm and too increase my Nova rapid to 1 -2 dosage. This only had a slight effect of bringing my glucose level to 18 mmol to 20 mmol. My diabetic consultant came to see me and suggested I should be put into an insulin pump and I had to be put forward for NICE approval before I could have one. I finally got approval in December and was called into the diabetic clinic to choose what pump I wanted. I did my homework before going in to choose and decided on a Medtronic 780G with a Guardian 4 glucose sensor. I had to go back too clinic in March to be connected to my new Medtronic 780G I was also given a new glucose test machine A Accu- CheK Guide Link. I had to use this glucose tester to start with as once it calculates your blood glucose it sends your result straight to the Medtronic MiniMed 780G. They get you to use this method first until you are use to using your pump. The beginning of May I was called back to clinic to be connected to the Guardian 4 sensor. What a difference Now my glucose levels stay between 6.0 mmol and 8 mmol and I stay in range 97% of the time. You change your insulin syringe, mine is a 3ml and giving set every 3 days and the Guardian 4 sensor once a week. While you are changing it you have to recharge the sensor which takes 10-20 minutes. Everything else is near enough automatic. When you eat anything you type in how many portions/ grams of Carbohydrates and the pump does the rest. The sensor communities I think every 3 minutes and if your glucose is rising the pump will give automatically a dose to bring your glucose back to 7.5 mmol. If my glucose falls below 6.4 mmol the pump turns off the insulin supply until your glucose comes up again. It has a alram warning you your glucose level is approaching low limit and tells you if it’s approaching high limit as well. My HB1C has fallen from 77 now down too 52. It’s one of the best things the diabetic clinic has done for me and I now feel much better too.
 
Hi I've been type 1 for about 10 years. I find when I'm in pain my sugars go through the roof! Going for a walk helps lower them down. I also find that if I inject 20 mins before I eat that it helps big time. Also if you tend to inject yourself in the same place regularly it doesn't seem to work. Hope this helps
 
EllieM said:
That is a really good point.
Click to expand...
Wherever there is doubt coinciding with high BG I personally change everything as soon as possible. I use a pump so I put a new cannula,line and cartridge. The longer you wait the worse you feel. As others have said, there are at least two other variables which could influence this high BG though. If you are really sick your insulin requirements can easily double and I would recommend asking for help from a DSN or doctor especially as the O.P. is newly diagnosed and likely to be inexperienced.
 
Could your insulin have spoiled from freezing in the fridge? They are huge increases and quite inexplicable in the circumstances. Best to consult your care specialist and work all the issues logically.
 
My glucose levels rise when I’m unwell, actually before I start to feel under the weather.
I’m advised that it’s my body’s way of getting ready to fight the infection.
Also I’m
1) less likely to exercise when feeling poorly
2) more likely to indulge in comfort eating

If only I knew how my blood glucose altered during illness before I became T1.
 
Hi, I'm a newbie here - although I have been a type 1 for the last 56 years - I have never replied to a Forum post before, as I'm never sure what I want to say is valid, or helpful.
You say you have doubled your Lantus - do you take it in one load or split it into two injections? When I was on Lantus, I always split the dose into two injections (twelve hours apart) to give a better, steadier, background level - as I found Lantus never lasted as advertised.
This cold/flu bug/chest infection thing that's going round is nasty - I had it over Christmas and was on antibiotics - and my glucose levels hardly ever went under 15mmol -it seemed like I could have drank a pint of Actrapid, and it wouldn't have done anything (I didn't!). But, being 'high' also makes you feel worse. So it is worrying, I know. I pretty much didn't eat anything for around 5 days - but kept my fluid intake up, which is more important really. Your body will let you know when it wants sustenance again.
If your taking such high volumes of Actrapid combined with high levels of Lantus- be very careful to regularly monitor your glucose levels. I usually dose myself on a 1 unit of insulin to 4 units of carbs for correction - but when you're ill, that's meaningless coz' your body is going haywire trying to fight the infection, and needs energy to do so. So it releases sugar - but we can't use that because of our type1 - so we take more insulin - the body releases more sugar than we have insulin for, etc, etc. The best thing to do? Ride the storm. Try to keep your levels below 20 - but with so much insulin on board be aware that they can fall drastically quickly as well.
Sorry if it's not much help - I'm not a doctor or any sort of expert - I only know what happens to me when I'm ill, and after 56 years of doing battle with type 1 you get used to it. Almost. Ohh - and follow all the good ideas about exercise and stuff, it will help. Probably. Hope you feel better soon.
 
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