Insulin making blood sugar rise?!

[busydiabeticmum]

OK, I get gd, this is my 8th pregnancy.

Background info:
I'm intolerant to metformin.
Last pregnancy I was low carb and needed no medication,

The first 2 pregnancies didn't need help and gd wasn't bad at all.

All the others I needed very high levels of insulin.

This pregnancy though I'm low carb my blood sugars are "high" but each time the insulin is raised my blood sugars go higher... it's actually very obvious.

I will have the same meal for breakfast and get a reading of 9 but the next day WITH insulin it will be 11 for the same exact meal...

My diabetes team just keep saying raise the insulin and add carbs... but it doesn't make sense... it's like I'm injecting sugar and not insulin! Carbs will raise my bgl hugely.

Is there any advice someone can give me ur even a scientific explanation as to why my blood sugars raise with insulin.

 

[Jaylee]

Hi,

What insulin/s have you been prescribed?

 

[Juicyj]

Hello @busydiabeticmum

Sounds really frustrating, however the advice given from your team doesn't sound very good at all, raise the insulin and add carbs ? No that doesn't make sense at all. Insulin does not raise your BG levels however, things like bad insulin, bad injection sites, hormones, stress etc will. Firstly I would change your insulin in case your current pen has gone off.

As a GD mum and now as a type 1, I can eat the same breakfast every day and get different results, that's the magic of managing fluctuating blood glucose levels and combining that with things like heat, exercise, hormones, stress and many other factors which will affect your control, it's like working with a constantly moving target and hoping to achieve the same result, it's very hard.

It sounds like you are doing well in reducing your carbs, however patterns in your control are important so look for where you see a repeated pattern of events over a few days before making changes with insulin doses and then wait 3-4 days before any more adjustments.

 

[Bluetit1802]

Raising medication, whether it be insulin or tablets, to meet carb consumption is something HCPs are very fond of doing.
I know zilch about GD but as far as ordinary diabetes is concerned, it is a folly and the opposite of what should happen. Surely it is healthier to eat less carbs and reduce the medication. Hey ho.

 

[busydiabeticmum]

Hello @busydiabeticmum

Sounds really frustrating, however the advice given from your team doesn't sound very good at all, raise the insulin and add carbs ? No that doesn't make sense at all. Insulin does not raise your BG levels however, things like bad insulin, bad injection sites, hormones, stress etc will. Firstly I would change your insulin in case your current pen has gone off.

As a GD mum and now as a type 1, I can eat the same breakfast every day and get different results, that's the magic of managing fluctuating blood glucose levels and combining that with things like heat, exercise, hormones, stress and many other factors which will affect your control, it's like working with a constantly moving target and hoping to achieve the same result, it's very hard.

It sounds like you are doing well in reducing your carbs, however patterns in your control are important so look for where you see a repeated pattern of events over a few days before making changes with insulin doses and then wait 3-4 days before any more adjustments.

They have a new meter agamatrix, they made me download the app and basically they see my results. They call me constantly to change my dose based on the readings, mind you I was put on insulin on Thursday but that was lantus night time to control the morning spike... since starting it my after breakfast has gone up so they have started me on Nova rapid and increased both 3 times since then. I have only just got the insulin from them and don't have a spare pen yet (prescription takes 3 days to go through gp not including wk ends)... this is happening over a very short period of time... I am unhappy with the advice and really confused that every time they increase my insulin my bgl increase with it (the app plots the levels and it is a direct correlation)... it's really frustrating as I don't trust them to ask... what do you think? Could the insulin be off/old is it resistance, I'm injecting Lantus into my thigh and the Nova into my belly... could injection site be bad? It doesn't make sense to me... thanks for the answer in advance... that's to everyone.

 

[busydiabeticmum]

Hi,

What insulin/s have you been prescribed?

Lantus and Nova rapid.
I am to inject Lantus at night time b4 bed, I was put on that on Thursday,
Novarapid is fast acting for breakfast and was put on that Friday so started this Saturday morning.

Both have been increased 3 times, via call, text and app. the meter they use is the agamatrix which connects my meter to them. The app for the meter plots the results and medicine on a chart which shows a direct correlation between the insulin starting and the bgl increase.

 

[busydiabeticmum]

Raising medication, whether it be insulin or tablets, to meet carb consumption is something HCPs are very fond of doing.
I know zilch about GD but as far as ordinary diabetes is concerned, it is a folly and the opposite of what should happen. Surely it is healthier to eat less carbs and reduce the medication. Hey ho.

Yeah, I'm very annoyed because they are telling me not to test, they wanted me to join a website forum (theirs) which I said I was happy with this one, I told her about it and that I have been a member for yrs and without the help and advice I would not have been able to reverse type 2 or go through last pregnancy without any medication. They told me not to come here for advice and completely bashed it (probably why I got so defensive and really don't trust their advice at all)
I also didn't tell them I was pregnant until 3 wks ago (30wks now) because I just didn't want to deal with them knowing what they are like... I just got to the point I needed baby to be checked and knew I had to put my own feelings aside for her sake.

 

[Rokaab]

Yeah, I'm very annoyed because they are telling me not to test,

Hang on, they've put you on insulin and are telling you not to test - that is just dangerous advice and I'd actually complain to someone higher up about that, if on insulin you NEED to test

 

[busydiabeticmum]

Hang on, they've put you on insulin and are telling you not to test - that is just dangerous advice and I'd actually complain to someone higher up about that, if on insulin you NEED to test

I'm seeing the consultant midwife because I was so unhappy with the advice and treatment last time I was with them I refused to go back last time and went to a different hospital (their advice was low carb, but it was so far we just couldn't do it this time (1.5hr drive away.)) So I didn't want to come back this time and they wanted to know why and how they can change...

 

[Lamont D]

I no little or nothing about GD, pregnancy, injecting insulin and most of the advice you are getting.
However, you asked about why, your blood glucose levels rise because of insulin.
Unfortunately, too much background insulin, circulating insulin, hyperinsulinaemia will have an effect on insulin resistance and will raise blood glucose levels, as the viscous circle of more insulin, more carbs, more insulin, insulin resistance and so on.
Unfortunately, they don't test insulin levels more widely.

I would ask for a referral and ask the questions, I would definitely not go back to that surgery!

Best wishes

 

[busydiabeticmum]

I no little or nothing about GD, pregnancy, injecting insulin and most of the advice you are getting.
However, you asked about why, your blood glucose levels rise because of insulin.
Unfortunately, too much background insulin, circulating insulin, hyperinsulinaemia will have an effect on insulin resistance and will raise blood glucose levels, as the viscous circle of more insulin, more carbs, more insulin, insulin resistance and so on.
Unfortunately, they don't test insulin levels more widely.

I would ask for a referral and ask the questions, I would definitely not go back to that surgery!

Best wishes

Unfortunately they are the diabetes team for the hospital nearest me! I did go to a different hospital last pregnancy and did fantastically well... but like i said 1.5hr drive to get there... it was a horrible decision to make and I just don't have a choice really.

I will have a look into hyperinsulinaemia, I was looking into something similar and asked them if it could be this and I was dismissed... they just didn't answer my question about it... probably because they just don't know what that is.

I am very low carb and hopefully in ketosis (I am not really sure how to tell never have been) I have lost 2kg in 2wks, my lunch time and dinner time bloods are brilliant b4 and after, breakfast used to be good after eating and in the 6s b4 due to dawn phenomena... as soon as they started me on the night time insulin my fasting went up into the 7s and my after breakfast then went up to the 10s (obviously a knock on effect) so they started me injecting the fast action for breakfast... I did ask if it could be that I am going too low in the night so my body is over releasing glucose to combat low bgl... I told them I wanted to test throughout the night using my own meter and strips but she told me off and told me I was exaggerating, I explained that I wanted to understand better what was happening with my bgl and she said no without giving an explanation as to why not.
I think I will test hrly at night to see if I am dropping too low and my body is trying to combat that... at least I then have a record and a better understanding.

 

[Annb]

Raising medication, whether it be insulin or tablets, to meet carb consumption is something HCPs are very fond of doing.
I know zilch about GD but as far as ordinary diabetes is concerned, it is a folly and the opposite of what should happen. Surely it is healthier to eat less carbs and reduce the medication. Hey ho.

Eat more carbs and take more insulin is what I was told to do by my local hospital (the next hospital is a 4 hour ferry trip and then a one hour drive away). When I asked why, I was told that I have to take insulin and I need the carbs to "feed the insulin". Didn't make sense then and doesn't make sense to me now. Surely if I take less carbs it should result in needing less insulin. The diabetic team don't see it. So I am doing it myself. It's not really working and I am now wondering if I am actually T1 after all. All I know is that if I do eat any carbs, my BG level shoots up to ridiculous heights and stays there - insulin dose or no. Maybe I'm not taking enough insulin, but I am taking quite large doses. I am on Lantus solostar overnight and Humilin S 3 times a day and Metformin twice a day. If that isn't enough medication to control the BG then something isn't right with the regime. That something is carbs. I am probably insulin resistant anyway but I would like to understand what I am doing.

 

[busydiabeticmum]

Eat more carbs and take more insulin is what I was told to do by my local hospital (the next hospital is a 4 hour ferry trip and then a one hour drive away). When I asked why, I was told that I have to take insulin and I need the carbs to "feed the insulin". Didn't make sense then and doesn't make sense to me now. Surely if I take less carbs it should result in needing less insulin. The diabetic team don't see it. So I am doing it myself. It's not really working and I am now wondering if I am actually T1 after all. All I know is that if I do eat any carbs, my BG level shoots up to ridiculous heights and stays there - insulin dose or no. Maybe I'm not taking enough insulin, but I am taking quite large doses. I am on Lantus solostar overnight and Humilin S 3 times a day and Metformin twice a day. If that isn't enough medication to control the BG then something isn't right with the regime. That something is carbs. I am probably insulin resistant anyway but I would like to understand what I am doing.

I laughed at the diet sheet they gave me, apparently I should eat pizza, pasta, chips, rice, bread, chocolate, rice pudding etc etc etc...
Morning I have 3 desert spoons if full fat natural yoghurt with a spoon of peanut butter and a handful of blueberries.... cup of tea.
Lunch is either a salad or omelette. FYI mayonnaise is OK and low carb.
Dinner can be mushroom soup (home made) or a cauliflower and broccoli cheese bake (I use full cream instead of bichamele sauce as is low carb)... cauliflower pizza was surprisingly good. (The base is made from cauliflower lol) may even have a stir fry of mushroom, peppers, broccoli, spinach/kale, etc...
I cut out root veg as they are higher carb... but I can eat until I feel full.
I hope this helps you... even get a few ideas.
I don't feel so alone now thanks.

 

[Bluetit1802]

I think I will test hrly at night to see if I am dropping too low and my body is trying to combat that... at least I then have a record and a better understanding.

You would benefit from a CGM or a Libre. They will tell you what is going on 24/7 without the stress of waking up to test yourself

 

[Ellenor2000]

Yeah, I'm very annoyed because they are telling me not to test, they wanted me to join a website forum (theirs) which I said I was happy with this one, I told her about it and that I have been a member for yrs and without the help and advice I would not have been able to reverse type 2 or go through last pregnancy without any medication. They told me not to come here for advice and completely bashed it (probably why I got so defensive and really don't trust their advice at all)
I also didn't tell them I was pregnant until 3 wks ago (30wks now) because I just didn't want to deal with them knowing what they are like... I just got to the point I needed baby to be checked and knew I had to put my own feelings aside for her sake.

This is a crazy idea: might they have accidentally given you glucagon instead of insulin? Pharmacy eff-ups have happened before, and switching insulin for glucagon isn't outside of the realm of possible. I don't think that's what is happening, but I'm a conspiracy theorist so I have to consider it.

If I was in your situation right now, I'd be pulling out all the stops to get a CGM so I know if I'm going low then high (happens a lot with short acting insulin on top of long acting food such as meat or some starches) or if the "insulin" (since we're not sure if this is even insulin anymore) is really directly increasing blood sugar.

 

[milesrf]

If you can't get a CGM, a few blood glucose measurements in the middle of the night may help your doctor decide if one would be useful for you. Read about dawn phenomenon to see why:

The Dawn Phenomenon

https://idmprogram.com/dawn-phenomenon-t2d-8/

 

[snufflebabe]

I know nothing at all about being pregnant with diabetes I’m afraid however has anyone even suggested your having too much insulin, not feeling the lows and the highs are a rebound from the unfelt lows?

 

[Jaylee]

Hi @busydiabeticmum ,

If you drive? You should inform DVLA regarding your new medication use. (Insulin.)
Yes, you should test. DVLA legislation requires you to test. (If a driver.)

Ok, where you are injecting your insulin, I don't see any issue. (I use lantus & novo.)

You mentioned you have gotten the insulin from your D team? How have they stored it??

There seems to be a misconception that exogenous insulin only works in the presence of carbs?!

Ideally, you should find a better diabetic health care provider. (From what I can read from your comments.)
It's early days for you starting out on insulin. With the aid of your meter, start at the "foundation" & look at what your basal (lantus) is doing first. Preferably with a fresh batch from the chemist...? https://mysugr.com/basal-rate-testing/

Going back to wondering how your issued temp supply of insulin issued, was stored by your current team.. (till you get a script from a dispensing chemist.) Be carful of your upped dosage if the current pen has gone off...? The newer stuff may be more potent..?

 

[Annb]

I laughed at the diet sheet they gave me, apparently I should eat pizza, pasta, chips, rice, bread, chocolate, rice pudding etc etc etc...
Morning I have 3 desert spoons if full fat natural yoghurt with a spoon of peanut butter and a handful of blueberries.... cup of tea.
Lunch is either a salad or omelette. FYI mayonnaise is OK and low carb.
Dinner can be mushroom soup (home made) or a cauliflower and broccoli cheese bake (I use full cream instead of bichamele sauce as is low carb)... cauliflower pizza was surprisingly good. (The base is made from cauliflower lol) may even have a stir fry of mushroom, peppers, broccoli, spinach/kale, etc...
I cut out root veg as they are higher carb... but I can eat until I feel full.
I hope this helps you... even get a few ideas.
I don't feel so alone now thanks.

I didn't laugh but I did query the diet sheet I was given. It was supposed to help me lose weight as well as control my diabetes. The amount of carbs was crazy and the total calorie content much higher than I have eaten for many years. My diet is similar to yours although I do add the occasional carrot to stews and I don't make cauli rice because my stomach can't cope with it. I don't actually know how much I should eat but the amount I take is much less than it has been in my younger days, when I was able to be active. I was also told that I "probably had gestational diabetes" because both my sons were large babies - but the youngest is 50 this year, so that's an awful long time to have GD.

I was only diagnosed about 12 or so years ago when I finally went and asked a doctor if I had diabetes since no health professionals were picking up on my symptoms. I was put onto Metformin and only put onto insulin when I had to have a 2 day stay in hospital about 10 years ago. It was all under control until then. I never got off insulin after that! Health professionals don't have all the answers and should be challenged when they are clearly not achieving their aim which, after all, is a healthy patient.

My current diet doesn't make me lose weight and fairly large doses of insulin does no more than keep my BG higher than it ought to be but within striking distance of the right range. But it is the best I can do. My BG does drop occasionally but that is only when I have eaten nothing for many hours and also taken no insulin, of course. I hadn't, though, thought that insulin was putting my BG up but even after overnight fasting, with a pretty high dose of Lantus Solostar before bed, my BG is high in the morning.

As others have suggested, perhaps you should check that you are on the right insulin (perhaps I should as well) and that it has been stored correctly. If you are in the UK and you drive you must inform the DVLA that you are insulin dependent and have the ability to check that your BG is high enough before you get into the car - otherwise you are driving illegally and could be prosecuted - and I believe that it would invalidate your insurance - perhaps that would persuade your team that you should be allowed to monitor yourself.

I know it is a struggle to get health professionals to take you seriously and to get them to change their attitudes - I'm finding that myself - but it's worth keeping going and trying to persuade them - there's much more information out there these days to support low carb diets. I'm due an appointment with my hospital soon and will be having another go at them. Unfortunately, the only fact I can show them is that I am relatively stable with almost zero carbs and totally unstable if I have any overt carbs at all.

 

[busydiabeticmum]

I didn't laugh but I did query the diet sheet I was given. It was supposed to help me lose weight as well as control my diabetes. The amount of carbs was crazy and the total calorie content much higher than I have eaten for many years. My diet is similar to yours although I do add the occasional carrot to stews and I don't make cauli rice because my stomach can't cope with it. I don't actually know how much I should eat but the amount I take is much less than it has been in my younger days, when I was able to be active. I was also told that I "probably had gestational diabetes" because both my sons were large babies - but the youngest is 50 this year, so that's an awful long time to have GD.

I was only diagnosed about 12 or so years ago when I finally went and asked a doctor if I had diabetes since no health professionals were picking up on my symptoms. I was put onto Metformin and only put onto insulin when I had to have a 2 day stay in hospital about 10 years ago. It was all under control until then. I never got off insulin after that! Health professionals don't have all the answers and should be challenged when they are clearly not achieving their aim which, after all, is a healthy patient.

My current diet doesn't make me lose weight and fairly large doses of insulin does no more than keep my BG higher than it ought to be but within striking distance of the right range. But it is the best I can do. My BG does drop occasionally but that is only when I have eaten nothing for many hours and also taken no insulin, of course. I hadn't, though, thought that insulin was putting my BG up but even after overnight fasting, with a pretty high dose of Lantus Solostar before bed, my BG is high in the morning.

As others have suggested, perhaps you should check that you are on the right insulin (perhaps I should as well) and that it has been stored correctly. If you are in the UK and you drive you must inform the DVLA that you are insulin dependent and have the ability to check that your BG is high enough before you get into the car - otherwise you are driving illegally and could be prosecuted - and I believe that it would invalidate your insurance - perhaps that would persuade your team that you should be allowed to monitor yourself.

I know it is a struggle to get health professionals to take you seriously and to get them to change their attitudes - I'm finding that myself - but it's worth keeping going and trying to persuade them - there's much more information out there these days to support low carb diets. I'm due an appointment with my hospital soon and will be having another go at them. Unfortunately, the only fact I can show them is that I am relatively stable with almost zero carbs and totally unstable if I have any overt carbs at all.

Yes I'm a driver but dvla only need to be informed of you are on a medication for more than 3 months and I will be on it for less than 2. I only need to inform the insurance company...
I completely agree with everyone here, thank you all for replying, I definitely need to look into everything.

I did look into hyperinsulinaemia. But it doesn't seem to be that but maybe I didn't understand it properly.

It does seem very strange, I know I'm only on it for a short period of time but I do want it sorted for the health of this baby.

I have the new prescription which came to me cold so I know it has been stored in the fridge and I will try using a new pen to see if that sorts it out... I am thinking maybe my body isn't absorbing the insulin properly and so it is a delayed reaction... I don't know.

Thanks if all the responses it has given me loads of information and a lot of questions to ask and hopefully I will get an answer tomorrow from the Dr.