off the monitor scale once again!!

Have you been tested for Adult Onset Type 1 (LADA)?

I hope your doctors are able to sort out your insulin dosing soon. Do you have a way of testing ketones? If you've got both high BG and high ketones, would be a good idea to seek medical advice a.s.a.p.

Sorry - BG is shorthand for blood glucose. Ketones can be tested via urine strips, blood strips or breath analysers. Some glucometers also measure ketones using a different kind of strip. I think the Caresens does. Also the Optiums. Make sure you keep drinking lots of water and remain hydrated.

Hopefully some Type 1s will be online soon to give you more advice re your insulin dosing.

Johnny-45 said:

ive tested again its down to 28.4 and yes am drinking flav: water zero in everything

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Are you checking the labels on the flavoured water? Some of them have a sneaky amount of carbs in then.

Ketostix are cheap and readily available on line.

Not particularly accurate but enough to be an additional warning of the risk of ketoacidosis if your sugars are off the scale.

Johnny-45 said:

my diebetic doctor thinks am between type1 and type 2 ,diagonsed type2 insulin dependent / rapid 36units twice a day & lantos 38 units twice a day // and twice a day rapid 2x 3 units at snack time

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So your total daily dose is 154 units? Doesn't sound like LADA to me, is seems there is quite a bit of insulin resistance going on there.

You're on fixed doses of insulin. Have you been advised how many grams of carbs your bolus (rapid acting insulin) is covering? You can work out what it is currently covering (obviously inadequately) by working out the carbs in what you are eating. Usually a type 1 starting out carb counting will be on a ratio of 1 unit of bolus to 10 grams of carbs, but a type 1 doesn't usually have insulin resistance. Type 2 diabetics are often on much higher doses due to insulin resistance. If your fixed doses aren't working at the moment you need to either ask for your health care team for advice on carb counting and apply that when bolusing to keep BG in range, or reduce your carb intake to a level that your fixed insulin doses can cope with.

You also need to check your basal insulin is doing what it's supposed to do, with a basal test. Again, you should ask for advice from your healthcare team in considering increasing the dose.

Do you know what your correction factor is? That is, how many mmol/l 1 unit would bring you down? If so, you can work out what correction dose you need to bring you down.

If you don't understand corrections and you don't have the ability to test for ketones call 111 for advice or take yourself to a walk in centre.

@Johnny-45 Have you spoken to your doctor about the burning pain in your feet? That is very possibly connected to your high blood sugar.

You need help and support in getting that down and keeping it under control. You might find that helps your skin condition too.

No wonder you're feeling so low @Johnny-45 It must be horrible for you : (

I'm tagging @Mep as she's a Type 2 on insulin.

I'm a Type 1 but I'd say that you should push your doctor and/or diabetes nurse for help in getting your blood sugar down. The nerve damage in your feet might improve a little if your blood sugar was controlled.

Can you give us an idea of what you eat in the average day? What numbers are you seeing for your blood sugar two hours after you've eaten?

My first thought - as ever, is too many carbs - and the flavoured water might not be a good idea - some people react to the stuff that is in it. Perhaps try plain water, to start off with at least, I drink a pint of water in the first hour after waking - it seems to be doing me good so far.
I am not wanting to alarm you, but those sorts of blood glucose levels and the symptoms you describe really are something to act on as soon as possible. The amount of carbohydrate you are eating is overwhelming the insulin you are taking, or your insulin resistance is such that it is not as effective as it should be.

@Johnny-45 - so sorry to hear you've having very high sugar readings. It would sure make you feel awful. The others have pretty much covered what you may need to look at. I will just add that it may be you need to change insulins as maybe the ones you're on aren't as effective. Your doc should be working with you to help you get your sugar levels down. Also going by what you're saying about your other health condition you're in severe pain. I personally find pain wreaks havoc on my blood sugar levels. I'm either higher than I should be or I drop low suddenly for no reason. It could be that your doc needs to work with you to get your pain controlled and this may help you control your diabetes. I noticed you mention you're drinking flavoured water... where I live pretty much all of the flavoured water has sugar in it of some kind. That will no doubt be contributing to your high sugar levels. If you can't stand the taste of water, maybe just adding a slice of lemon or something will help take the edge off? You can buy those infuse bottles now where you can do that. I was going to say tea or coffee but they both have caffeine which would dehydrate you and wouldn't help your sugar levels either. I hope you can get some relief though from your high sugar levels and severe pain you're having. When you mentioned you have puss coming from your toe... is that part of the skin disease or is that an infection? If you have an infection, that would raise your blood sugar too and make it hard to control. I wish you the best.

Here's some links that may help:

Basal testing: http://www.salforddiabetescare.co.uk/index2.php?nav_id=1007

Carb counting (even though it says type 1, it's for all insulin users really: https://www.bertieonline.org.uk/admLogin.asp

I would say you need to ask for a refferal to an endo consuktant at hospital...quickly.
Also a podiatrist.

When your levels are HI are you continuing to eat?

I'd seriously ask to be seen by an endo at hospital.
You should not be having HI's. This needs specialist attention urgently.

@Johnny-45 - I'm not going to comment specifically on your bloods or insulin regime, as plenty have already, but could I ask about the "splinter" in your toe and the redness in your lower legs?

Am I right thinking your nurse is leaving the "splinter" to fee itself from your toe, and it has puss coming from it, if you squeeze around it? The body is usually pretty efficient at ridding itself of things like splinters. I had a piece of ceramic in the middle of my heel pad a couple of years ago (I'll spare you how that came about!), which couldn't be dug out. Within a few days it sort of worked it's way to the surface and could be dealt with by the nurse. Mine was completely uninfected.

Is the redness on both legs the same, or is one very different from the other? Have you been checked out for cellulitis? Although, cellulitis is very uncommon in both legs at the same time, it isn't impossible.

Have you had any recent blood tests done?

Hi @Johnny-45

You really do need to get proper specialist medical attention to sort out a number of your problems. You need to be pretty strict with your current doctor and demand the relevant referrals as @donnellysdogs advised in the earlier post.

Good luck and keep us posted - we all want to see some progress in your situation so please contact your doctor!