Insulin not lowering BS

Hello @Lord Midas The only times I get this is when either my insulin isn't effective so change your cartridge, or i'm coming down with an infection (dental or possibly cold/illness) and finally down to injection sites so check for lumps. First port of call is to change your insulin cartridge and see if it's this then look at other possibilities, you should be able to work out why eventually though

1. Check insulin is working with a fresh vial/pen from the fridge.

2. Check you took your basal at night or morning. You might want to consider basal testing to check your basal dosage is correct.

3. The rise from 3.9 to 7.9. Did you treat your hypo? If not the rise could be related to dawn phenomenon/ feet on the floor syndrome. It could also be related to the release of adrenaline in response to the low, making you insulin resistant.

4. Rise to 14.5 after a little cheese. Did you bolus for the protein? If you are very low carb your body is probably pretty adept at performing gluconogenis and converting protein in cheese into glucose to cause a blood sugar rise.

Hi @Lord Midas

It's fairly common for different areas on the body where sets are placed, to need a different basal rate due to absorbtion issues but it's also common for basal levels to change anyway due to weather temps changing or bodyweight changing. Try changing back to the other area and then basal test to see what bg levels do that way.

If this were me, along with the suggestions made above, I would work on the assumption I had had a hypo over night (backed up by the reading of 3.9 on waking) and this is now a rebound. I have to monitor my correction doses over the next 18-24 hours and reduce them, as without care, what has happened for me is the correction appear to have no effect, and then I suddenly get a drop creating a yo-yo of hypers and hypos over the 24 hrs.

I'm in agreement with @paulliljeros.

@Lord Midas, if I were in your situation I'd dial back my evening basal dose (or total basal dose if on one injection daily). Waking at 3.9mmol/l is on the low side and I would be guessing that you were probably lower than that during the night, meaning your issue is likely down to rebound hyperglycemia.

I've suffered with very similar issues to you before, and the cause was too much basal.

Regarding your injection sites, you should use your whole abdomen in order to give each side a proper rest. I posted something about sites recently here; it may benefit you:

http://www.diabetes.co.uk/forum/threads/injection-sites.120417/#post-1458083

Site rotation is critical as a T1, so it's in your best interest to set up as good a rotation as possible.

Lord Midas said:

Thanks everyone for your advice. Greatly appreciated. @catapillar you mention basal testing. I test my blood sugar and does with bolus depending on the numbers. Can you explain how to test specifically for basal?

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You don't test for basal, your testing to see if your basal insulin (your long acting insulin) is doing its job. Here's a guide on how to basal test - https://mysugr.com/basal-rate-testing/

Dawn phenomenon / feet on the floor syndrom doesn't have anything to do with compensating for low levels. Dawn phenomenon refers to an early morning rise in blood sugar levels that happens because your body is releasing hormones to wake you up and you liver releases a dose of glucose from its stores to get you going for the day, feet on the floor syndrome is essentially the same thing it's just it doesn't start in some people until they get out of bed.

Lord Midas said:

Hi everyone,

I'm struggling to lower my BS. I've eaten literally no carbs this morning as I'm on a LCHF diet.

• I woke 5:40 am with BS 3.9
• One hour later I was 7.9 (even though I consumed nothing)
• After a little cheese and a bulletproof coffee at 10 am my BS was 14.5
• Took 10 units of Humalog
• Had a few Brazil nuts
• 11:20 am my BS is 14.8

Something other than carbs (because I've had very little carbs) is causing my BS to rise really high, and it's like my insulin is not working.

Does anyone else get this?

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Yes - this happens to me. It happened just last week actually. I will hit a day where it almost seems my insulin is no longer working and my insulin consumption will triple just to keep my levels within a relatively safe zone. What causes it?

For me - it's a pre-cursor to a cold. Almost every time this will happen before I display common cold symptoms. My theory is it's likely my immune system trying to fight something off and poof - BG control is all over the place for at least a day.

So - do you have a cold or some other illness which may be causing your immune system to be overly active thus causing your Blood Sugar Levels to run high? Just a theory based on my own experience - I wonder if it happens to others.

I have type 1 diabetes and have been using Humalog for over 2 decades… I find that over the last year since I started a work from home job where I am sitting stationary for most of the day, my insulin will not work. I will have a modest breakfast (usually toast with eggs or a bagel).

On the weekends however, when I am active, I will have the exact same breakfast and 6 units will work perfectly with my blood sugar remaining between 100 and 200. By lunchtime it will have gradually fallen to the 80s-90s just in time for lunch.

Today for instance I had just a toasted bagel at 8:15 and had 6 units, but my sugar kept rising… at this point I have had another 8 units and I am still running high at 1:00pm. I am very busy at work and cannot afford to run a lap around my block or do some exercise in order to get the Humalog to kick in.

[Also, I take 23 long acting insulin — Tresiba/Levemir and now currently Semglee — and my sugar is fine overnight)

Does anyone have a strategy or a calculation that I can use to adjust my dosage for days where I will not be active?