Need some help, running high...

[Juicyj]

I give up... I tried to ring my new DSN last week to have a chat with her and she left me a message saying she would book me in for an appointment to see me on the 12 th Dec... I don't think I can wait that long

For weeks now I have been running high, on the plus side only one hypo but it's still not good, I thought it might be a bladder infection so last week got antibiotics, I have been steadily increasing my basal both morning and evenings. I eat low carb so try to bolus for protein only and still run high 3-4 hours later so am constantly doing correction doses. I am also putting on weight which has increased by half a stone in the last few months.

I need to talk sense with someone and try and figure out where I am going wrong as yesterday I couldn't even get into single numbers, ran from 10.6 to 14.8... I ate omelette with ham and cheese for breakfast, 3 thin rice crackers for lunch with peanut butter and Greek yoghurt with blueberries, pork stew with cabbage and broccoli for supper, walked the dog twice, took novorapid with each meal and still couldn't get into single figures, it feels like I am insulin resistant.

This is pretty much a daily pattern now so have gradually increased morning basal to 17 units, and evening to 9 units, I now weigh 11 stone and do not want to put on anymore, but it's getting me down now.

Any advice would be gratefully appreciated.

 

[LucySW]

You poor thing.

First thing, I'm no expert, but it sounds as if there's something wrong with your basal. Perhaps you don't get on with it. If it's Lantus, perhaps try Levemir, or porcine or human insulin? Why not repost this on the Diabetes Management/Medication/Insulin forum with details about basal and bolus and see if you find others with this experience. It sounds as if your basal just doesn't agree with you.

Second thing, you're quite right that you can't sustain those levels till December - specially if you're already low-carbing. That sounds like a red flag to me. Try again, armed with what you find from others here? You're in the right and that DSN is in the wrong.

Good luck.

 

[tim2000s]

Hi Juicy,

A few questions for you:

How long have you been diagnosed? 17iu and 9iu are both (in my view) very low levels for Lantus (my aggregate amount is more like 22u and 20u)

How long have you had the Lantus out of the fridge? If you are using a vial and it has been out for more than 28 days, I would get going on a new one.

My experience of it is that the efficacy of Lantus really drops off after about that period. (And I mean to the extent of needing to increase dosage by a significant amount)

Secondly, are you varying your injection sites enough? I have found that staying in one place for too long also causes issues with insulin release due to the fat build up there.

The anomaly in this is that you are putting on weight, which is the opposite of what I would expect with insulin resistance.

 

[noblehead]

I'm thinking that you may still have the bladder infection if your bg levels are running high over the last few weeks but are otherwise fine, I personally would book in for another appointment with your gp and take along a urine sample, in times of illness it's quite normal to run higher bg levels until things improve.

To jog your memory, take a look at the DAFNE Sick Day Rules:

http://www.diabetes-support.org.uk/info/?page_id=141

 

[Juicyj]

Thanks for your responses, have been a type 1 for 3 years now, taking Levemir. My pen is quite new so shouldn't of gone off. I rotate sites a lot too.

I managed to get down to 8.3 this afternoon after no having lunch but a correction dose whilst at 10.3 and lots of walking, at the moment the only way I can get my BG down is by exercise and not insulin by itself as all morning I was running at around 10.6. I know this isn't the way forward so think I will just have to keep increasing my basal dose, am keeping a written diary now, something I haven't done in a while.

Thanks Noblehead will keep upping my doses and see if it reigns it in and view the link, forgot about sick day rules.

 

[AndyOD]

Hi
Basal changes take time to effect you so be very careful.
The Basal change takes about 6-7 days to have a full effect as they build on one another as the Basal insulin doesn't just stop working it phases out.
You may be experiencing hypos while you are asleep which will put up you BG in the mornings.

Also the stress of the high blood sugar can make it higher so (easy to say) but 'try not to panic'.

The Bolus is the way to go with decreasing BG leave the Basal as it will complicate maters as it is harder to control due to the longer timescales.
Another option:-
Have you tried not eating at all, to sort out the Basal ?
Maybe a day just to see what you are ?
That way you can eliminate the food intake as a source of high BG, may be a step too far but it is what I've done in the past.

 

[Juicyj]

Hi Andy, thanks for that. It's so tempting to wade in and try an increase on the basal, but am concerned about the flip side of hypos too. Still am so confused about the weight gain, that doesn't make sense and am concerned about putting on more too, I have eliminated all sugar from my diet and eat very low carb, although enjoy a glass of wine or two at the weekend but that's all.

Anyway going to just leave for a few days now and see how that pans out, by the way this evening before dinner was at 8.3, for me this is quite an achievement, so maybe the adjustment is working now, hope so..