Levels sky high. Please help!

[Shazia555]

Hi.

I've been on insulin since January 2015 as my bg levels were sky high after being on tablets 17 years.

With the advice of the kind members of this forum I finally got the levels under more control starting in the mornings between 6-8 and similar levels before meals.

Now for some reason this past week (actually a few days after my periods) my levels have gone back to how they were when I was on tablets!

Over the last week my levels start at around 15 in the mornings and after meal and during the night are in their 20s!

In the weeks where they were more controlled I was taking 40 units levenir and between 10-18 noborapid depending on meals.

Now I am taking 55 levemir and 20+ noborapid but no decreasing of levels

My nurse when I rang asked if I could be pregnant but then dismissed it saying I couldn't be so soon after periods (is this possible) I have changed the insulin cartridges in case the warm weather has affected them but still no better results.

I have increased weight since taking insulin so I am adopting the low carb rule so having either no bread or rice most meals but even so my blood glucose is increasing rather than decreasing regardless of what I eat.

If anyone has any inkling on how I can go back to having lower levels please advise

Many thanks in advance

 

[skipworth]

Just a suggestion, you may want to re think your insulin ratio. levermir is a long term insulin and novarapid a quick acting one, as I understand it levermir should represent about 40% of your TDD (total daily insulin). You may not be taking enough rapid acting insulin to counter your meals. If you talk to your nurse she should be able to advise you on the need to adjust your intake. It may be useful to understand your carb ratio as well, if you don't already know it, with that you should be able to determine your quick acting requirements for meals. I have a carb ration of 1:3 that is one unit of insulin for every 3 grams of carbs I eat. It meant I was on a daily dosage of 40 units of Levermir and approx 50 units, dependant upon what I ate of Novarapid.

A quick way of knowing if you are taking sufficient Levermir is to test your BG before bed and then testing in the moring when you wake, if it is within 1 point of the evening raqding then it is pretty much okay to assume your levermir dose is pretty accurate. Carb ratios are bit mor difficult and require some patience with adjusting the amount of insulin until you hit the level that seems to keep your readings stable. Your nurse probably advised you to start at a 1:10 ratio, which seems to be the standard starting point. T"'s tend to be insulin resistant and have a lower carb ratio but everyone may be different dependant upon your resistance level. The downside is that you need to be pretty aware of the carb levels that you are eating, by either cutting out carbs as much as possilbe or by weighing your food to calculate their carb content, google comes in very handy for getting carb weights, and if your diet is pretty regular you can get the information for the majority of food that you currently eat.

I found this site useful in trying to work out my insulin intake, but the ssave to be taken with the rider that they are based on T1, and T2 have to think it may a little out for them, but it gave me a good starting point for getting levels under control.

http://www.diabetesnet.com/diabetes_tools/tools_carb_results.php?toolState=switch

Your Diabetic nurse should be able to help, as long as she doesn't advise you to eat carbs which are a killer. It may be hormonal but not being female I can't help you with advice on that, but taking insulin can be a self defeating cycle, you gain weight which in turn lead to increasing insulin rsistance and insulin doses which leads to further weight gain and more insulin. The trick is to break the cycle.

I have recently tried the Newcastle diet, cut my carb intake to less than 50gms per day, reduced my weight by 19lbs and have stopped my medication, although I have done this without medical support, I would advise wherever possible to get your nurse on board. I can't say that I won't need to go back on insulin, but at the moment I am getting through with no insulin at all. What happens at the end of the ND remains to be seen. I am not saying you should go on it as well bit may be an option for you to discuss with your nurse, and if you look around these forums you will find many others who have gone through it.

Good luck

 

[Totto]

Hi.

I've been on insulin since January 2015 as my bg levels were sky high after being on tablets 17 years.

With the advice of the kind members of this forum I finally got the levels under more control starting in the mornings between 6-8 and similar levels before meals.

Now for some reason this past week (actually a few days after my periods) my levels have gone back to how they were when I was on tablets!

Over the last week my levels start at around 15 in the mornings and after meal and during the night are in their 20s!

In the weeks where they were more controlled I was taking 40 units levenir and between 10-18 noborapid depending on meals.

Now I am taking 55 levemir and 20+ noborapid but no decreasing of levels

My nurse when I rang asked if I could be pregnant but then dismissed it saying I couldn't be so soon after periods (is this possible) I have changed the insulin cartridges in case the warm weather has affected them but still no better results.

I have increased weight since taking insulin so I am adopting the low carb rule so having either no bread or rice most meals but even so my blood glucose is increasing rather than decreasing regardless of what I eat.

If anyone has any inkling on how I can go back to having lower levels please advise

Many thanks in advance

Low carb is a sensible thing to do but you may also want to check for a possible infection. UTI can be very quiet for example.

 

[Shazia555]

Just a suggestion, you may want to re think your insulin ratio. levermir is a long term insulin and novarapid a quick acting one, as I understand it levermir should represent about 40% of your TDD (total daily insulin). You may not be taking enough rapid acting insulin to counter your meals. If you talk to your nurse she should be able to advise you on the need to adjust your intake. It may be useful to understand your carb ratio as well, if you don't already know it, with that you should be able to determine your quick acting requirements for meals. I have a carb ration of 1:3 that is one unit of insulin for every 3 grams of carbs I eat. It meant I was on a daily dosage of 40 units of Levermir and approx 50 units, dependant upon what I ate of Novarapid.

A quick way of knowing if you are taking sufficient Levermir is to test your BG before bed and then testing in the moring when you wake, if it is within 1 point of the evening raqding then it is pretty much okay to assume your levermir dose is pretty accurate. Carb ratios are bit mor difficult and require some patience with adjusting the amount of insulin until you hit the level that seems to keep your readings stable. Your nurse probably advised you to start at a 1:10 ratio, which seems to be the standard starting point. T"'s tend to be insulin resistant and have a lower carb ratio but everyone may be different dependant upon your resistance level. The downside is that you need to be pretty aware of the carb levels that you are eating, by either cutting out carbs as much as possilbe or by weighing your food to calculate their carb content, google comes in very handy for getting carb weights, and if your diet is pretty regular you can get the information for the majority of food that you currently eat.

I found this site useful in trying to work out my insulin intake, but the ssave to be taken with the rider that they are based on T1, and T2 have to think it may a little out for them, but it gave me a good starting point for getting levels under control.

http://www.diabetesnet.com/diabetes_tools/tools_carb_results.php?toolState=switch

Your Diabetic nurse should be able to help, as long as she doesn't advise you to eat carbs which are a killer. It may be hormonal but not being female I can't help you with advice on that, but taking insulin can be a self defeating cycle, you gain weight which in turn lead to increasing insulin rsistance and insulin doses which leads to further weight gain and more insulin. The trick is to break the cycle.

I have recently tried the Newcastle diet, cut my carb intake to less than 50gms per day, reduced my weight by 19lbs and have stopped my medication, although I have done this without medical support, I would advise wherever possible to get your nurse on board. I can't say that I won't need to go back on insulin, but at the moment I am getting through with no insulin at all. What happens at the end of the ND remains to be seen. I am not saying you should go on it as well bit may be an option for you to discuss with your nurse, and if you look around these forums you will find many others who have gone through it.

Good luck

Yes she keeps telling me to eat carbs with every meal but I eat carbs in one meal or sometimes I eat no carbs at all

I spoke to the nurse on Thursday and it was on her advice that I increased the levemir but that hasn't brought down the levels down at all so I'm increasing the noborapid but that isn't helping either The levels were good two weeks ago but all of a sudden they have shot up and nothing in my diet has changed

 

[mekalu2k4]

I am sharing what I saw and remember - this is not an advise.

My sis had this problem of unpredictable spiking, specifically after 10 or 12 days of her periods. Docs pointed towards hormonal imbalance and she followed prescription - that is it; she is fine after that. She is now managing T2D with metformin, now managed to reduce to BMI of 25 (previously 30).

She had been a die-hard fan of french fries and coke for long, a couch potato too. We thought initially that fries and coke causing her BS to spike, but we were wrong. Her husband used to monitor all her diet and literally she had no freedom to consume what she wanted. She completely stopped taking junk food; but her problem remained as it was, until docs fixed it. Not sure what the medication etc; it was about 7 years back. But it was hell of emotions, arguments at home to restrict her diet, after all we all are human and have cravings. At the end, we were sorry for her, and thanks to the GP who fixed it easily.

May be sometimes controlling BS in T2B may get tricky. The key is to get help at the right time, from right source.

 

[dawnmc]

What are you eating Shazia? Whats a days menu like for you?

 

[Shazia555]

Hi thanks for the info

My average days meal consists of the following

Breakfast an ommelate of two or three eggs with cheese.

Lunch. Salad or sushi or something's I go without

Evening meal meat or fish with salad and/or rice

I rarely snack in between but if I do it's an apple

I don't drink tea/coffee. Drink water or Pepsi max. I'm not a fan of chips crisps but occasionally have some chocolate

I've cut out bread completely as I need to lose weight and try to go gym two or three times a week


After reading a few threads one woman that had similar levels was someone who later found out she was pregnant. If I am it could explain the highs but I need to warrior I can test for pregnancy but if I am not pregnant then I am at a loss.

Last night I had a steak with salad and as my levels were 15 before the mean I took 28 units of novorapid. An hour after my levels was 17

At night I increased my levemir to 60. Very high doses I know.

I awoke at 3am and tested. It was 12.4. Woke up at 7 and it was 12.7 so still coming high in the mornings meaning the levemir needs to be increased?

 

[Shazia555]

I am sharing what I saw and remember - this is not an advise.

My sis had this problem of unpredictable spiking, specifically after 10 or 12 days of her periods. Docs pointed towards hormonal imbalance and she followed prescription - that is it; she is fine after that. She is now managing T2D with metformin, now managed to reduce to BMI of 25 (previously 30).

She had been a die-hard fan of french fries and coke for long, a couch potato too. We thought initially that fries and coke causing her BS to spike, but we were wrong. Her husband used to monitor all her diet and literally she had no freedom to consume what she wanted. She completely stopped taking junk food; but her problem remained as it was, until docs fixed it. Not sure what the medication etc; it was about 7 years back. But it was hell of emotions, arguments at home to restrict her diet, after all we all are human and have cravings. At the end, we were sorry for her, and thanks to the GP who fixed it easily.

May be sometimes controlling BS in T2B may get tricky. The key is to get help at the right time, from right source.

Hi thanks for this. Unfortunately my sugars have spiked so much only after my periods this month. Since January I've not found my sugars to spike so much although what you say does make sense as many have stated the levels to increase at this time as the changes in hormone during this time.

 

[Heathenlass]

Quick question - are you rotating your injection sites ?

Signy

 

[Shazia555]

Yes all over thighs and side of my bum x

 

[Heathenlass]

Do you inject in your stomach or arms at all ? The reason why I ask is because by and large the long acting insulin tends to do its job better in the bum and thighs, and the rapid in the tum or arms . It's possible to have a build up of fatty deposits that prevent the insulin from working properly if the site is overused, and a change of sites can help.

Having said that, hormones do play a part in general weirdness and insulin doses, all part of the fun of being a woman

Are you still taking ( Metformin?) tablets alongside your insulin ?

Oh and welcome to the weird and wonderful world of th Diabetes Detective Agency !

Signy

 

[Shazia555]

Do you inject in your stomach or arms at all ? The reason why I ask is because by and large the long acting insulin tends to do its job better in the bum and thighs, and the rapid in the tum or arms . It's possible to have a build up of fatty deposits that prevent the insulin from working properly if the site is overused, and a change of sites can help.

Having said that, hormones do play a part in general weirdness and insulin doses, all part of the fun of being a woman

Are you still taking ( Metformin?) tablets alongside your insulin ?

Oh and welcome to the weird and wonderful world of th Diabetes Detective Agency !

Signy

Thank you

Yes occasionally I inject in the tummy but was advised against the arms. I used to inject in the tummy all the time with novorapid but I found my tummy getting bigger (not sure if directly associated with the injections) so used thighs more and only use the bum for my levemir as there's a lot more of a dose so don't feel the burning when injecting.

I will start injection in the tummy to see if that makes a difference but one would assume that I've gone from a dose of 40 levemir to now 60 and still not much difference and I'm sure that I can't have developed a resistance overnight to the insulin? It's really stressing me out as I know large doses cause weight gain so it's a no win situation

 

[Heathenlass]

It's not the injections per se that could cause your tummy to get bigger, but starting on insulin , especially if carbs aren't controlled at the outset. I fully understand your frustration , though, as it seems like a rapid rise in insulin doses for no apparent reason

In your post above ( number 7) you tested at 3 am and it was 12.4, and at 7am it was 12.7, so that would indicate your Levemir was holding steady. You don't say what your pre bed reading, post Levemir was ? If it was close to that, I would say that you won't need to increase your Levemir any more as its doing its job as it should, dealing with the glucose that the body produces from itself. I'm assuming you are taking one dose per day ? It's possible to split Levemir, as it doesn't last the full 24 hours for some people, and its effectiveness is increased by splitting the dose am/pm . Have a chat with your DSN about this. Once you have the basal sorted out , the bolus ratios can be tweaked where needed.

The following link is an excellent resource for all things diabetic, including basal testing, and tweaking your ratios ( ( do speak with your DSN first though ) http://www.mydiabetesmyway.scot.nhs.uk/Mymedication/Medication_Insulin/default.asp

As for the whys of why insulin doses change, and we have so many ***! moments dealing with this beastie, the reasons are many and varied, and often quite unknown and we roll with the punches. Obviously it's better for our own peace of mind if we can find an answer, but sometimes , there just doesn't seem to be one Explore the options ( as you are ) , fire fight where needed, and usually, along the line, things settle again. For the time being ! You have only been on insulin since January, so it's early days yet, and often those early days are when things go swimmingly, before changing and catching you wrong footed.

Hang in there! There is a solution out there

Signy

 

[Shazia555]

It's not the injections per se that could cause your tummy to get bigger, but starting on insulin , especially if carbs aren't controlled at the outset. I fully understand your frustration , though, as it seems like a rapid rise in insulin doses for no apparent reason

In your post above ( number 7) you tested at 3 am and it was 12.4, and at 7am it was 12.7, so that would indicate your Levemir was holding steady. You don't say what your pre bed reading, post Levemir was ? If it was close to that, I would say that you won't need to increase your Levemir any more as its doing its job as it should, dealing with the glucose that the body produces from itself. I'm assuming you are taking one dose per day ? It's possible to split Levemir, as it doesn't last the full 24 hours for some people, and its effectiveness is increased by splitting the dose am/pm . Have a chat with your DSN about this. Once you have the basal sorted out , the bolus ratios can be tweaked where needed.

The following link is an excellent resource for all things diabetic, including basal testing, and tweaking your ratios ( ( do speak with your DSN first though ) http://www.mydiabetesmyway.scot.nhs.uk/Mymedication/Medication_Insulin/default.asp

As for the whys of why insulin doses change, and we have so many ***! moments dealing with this beastie, the reasons are many and varied, and often quite unknown and we roll with the punches. Obviously it's better for our own peace of mind if we can find an answer, but sometimes , there just doesn't seem to be one Explore the options ( as you are ) , fire fight where needed, and usually, along the line, things settle again. For the time being ! You have only been on insulin since January, so it's early days yet, and often those early days are when things go swimmingly, before changing and catching you wrong footed.

Hang in there! There is a solution out there

Signy

Thank you

My before bed dose was 17 after having 28 units of novorapid. I didn't eat any carbs just had steak with salad so again I didn't understand why I needed so much as normally I would have taken around 10 units. Before meal my level was 15 so I overdosed in the hope it would go down to single figures but it didn't at all.


I am taking metformin twice a day and folic acid

The other day I didn't eat anything for lunchtime had an apple and before evening meal it was 16 again didn't understand this

 

[mekalu2k4]

If you provide info on the below, you will get more answers.
what is your age? weight?
waist size?
what is body fat percentage?

 

[BooJewels]

I wonder if you're just not eating enough - counter-intuitive though that sounds? I find that if I'm really hungry, have a meal delayed, or only eat light meals, my BG actually rises. I think my body panics that I'm going to starve to death if it doesn't take action and dumps glucose into my bloodstream.

For example, if you ate an apple and nothing else for a while, it would give a very quick spike in BG, then it would plummet - especially if you're on insulin. For some people this would arise in a hypo, but maybe you're like me and go the other way. I've only been on insulin myself since March, so I'm very new to that treatment, but I've been diabetic for a long time - and I have had very few hypos.

I'm finding that I get a much more even spread of readings now that I've taken a modified LCHF approach - in that the food I eat is digested and processed more slowly and evenly - eating fat causes much less fluctuation. There doesn't seem to be much fat in your example diet and quite a lot of protein - which can act like a slow-release carb.

ETA: I knew there was something else - I also worry about the effect of diet drinks and how these affect your body's perception of the taste of something sweet and yet getting no glucose and I've also been reading that they change the type of bacteria in the gut which can result in increases in BG.

 

[Shazia555]

I wonder if you're just not eating enough - counter-intuitive though that sounds? I find that if I'm really hungry, have a meal delayed, or only eat light meals, my BG actually rises. I think my body panics that I'm going to starve to death if it doesn't take action and dumps glucose into my bloodstream.

For example, if you ate an apple and nothing else for a while, it would give a very quick spike in BG, then it would plummet - especially if you're on insulin. For some people this would arise in a hypo, but maybe you're like me and go the other way. I've only been on insulin myself since March, so I'm very new to that treatment, but I've been diabetic for a long time - and I have had very few hypos.

I'm finding that I get a much more even spread of readings now that I've taken a modified LCHF approach - in that the food I eat is digested and processed more slowly and evenly - eating fat causes much less fluctuation. There doesn't seem to be much fat in your example diet and quite a lot of protein - which can act like a slow-release carb.

ETA: I knew there was something else - I also worry about the effect of diet drinks and how these affect your body's perception of the taste of something sweet and yet getting no glucose and I've also been reading that they change the type of bacteria in the gut which can result in increases in BG.

Thank you

That sounds interesting. I stopped eating carbs as I wanted to lose weight but maybe I need to eat a little to avoid the highs?

 

[BooJewels]

I'm new to LCHF, so a long way from being knowledgeable, but check out the low carb forum as there are people there way more experienced - and more hard core - than me. I started [my version of] LCHF about the same time as I went on insulin in March and have lost 11lbs - I'm pretty happy each week to not have put any on with the insulin, so losing has been a bonus. I'm gradually reducing my carbs more each week - I decided that if I went at it too severely, I'd simply not stick at it. As my BG and weight comes down, I feel encouraged to tighten it still further.

It's a bit counter-intuitive to eat more fat to lose weight, but there is significant testimony here that it really does work - some people have lost several stone on this regime. The fat both fills you up and slows down the process, so evens out your appetite and BG control.

If you need a snack between meals, something like a handful of pecan nuts, lump of cheese or some full fat yogurt would probably serve you better.

 

[eddie1968]

Sounds to me that you are becoming more insulin resistant and may consider a different insulin regime. Read up on insulin resistance and find tips on how to manage it. Hope this helps.

 

[Enclave]

Have you done a pregnancy test ? The wife never missed a period when she was pregnant !