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Suddenly high yesterday at lunch and dinner and all through the night

JMoli

Well-Known Member
Messages
250
Location
Edinburgh
Type of diabetes
LADA
Treatment type
Insulin
Hi, I was wondering if anyone could help- I probably need to chat to diabetes nurse but it’s the weekend of course!
I went really high yesterday suddenly at lunch time - took my usual 5 units for 65g lunch which normally gives me a rise after three hours but it shot up immediately and climbed to 18. Took a couple of corrections to get to 12 after an hour and a half then it went down gradually. Checked pen and changed cartridge then had my ‘safe dinner’ that doesn’t typically give any rise but spiked up to 12 and stayed at almost ten all through the night.
Does this seem like a basal issue? I’m on Tresiba and have myself an extra unit (normally 7, today 8) which will probably take a couple of days to kick in.
I really don’t know how to eat today and I’m a bit anxious after yesterday
 
Right.. you cant adjust basal insulin off the back of 1 bad day.. first tresiba takes about 3 days to start working.. and if it was an oddball issue that cause a 1 off you could be buying yourself issues in 3 days

Many things can cause unexpected highs from illness.. I have issues at the start of a cold for example even before I know I have it.

Hay fever causes me issues as does treatment for it

Steroid creams which people assume are ok can cause issues… new meds.. or a day of the week with an ‘A’ in it can all cause issues

So the first thing before adjusting basal is to confirm that it’s lasting. Ie not just that day.. if it was a ‘sudden’ rise it’s more likely something has caused it rather than a change in insulin requirement that is normally gradual

Short term fixes rather than increase in basal would be more frequent very small corrections with your rapid

I get it sometimes and the following day I’m fine
 
Are you still producing insulin? I was warned that during the honeymoon things can suddenly change for no reason. I’ve had times when it just looks like I’m getting zero help from the pancreas & shoot high.

Eat your ‘safe’ options today & see what happens. If it’s still occurring tomorrow you can call your team and/or basal test. Then look at carb ratios.
 

Thanks, yeah panicked about my basal but I’m premenstrual so typically a wee bit higher through the night at this time but not this high. I’ll check with the nurse tomorrow about the basal. Maybe I’m coming down with something. I’ll see what today brings
 

Thanks, I was just so surprised as I’ve never had this happen before but maybe my honeymoon has come to an end or maybe it was a random day or maybe I’ve got some virus brewing. I think I’ll have a lower carb day, just had breakfast so I may have to make a few corrections, as yesterday was so horrible and exhausting
 
Some good advice above (although I probably would not have panicked you about the basal increase so much).
One thing to bear in mind is that we become more insulin resistant when our blood sugars go high so need more bolus to correct. For me, my correction ratio is twice as much over 15 as usual .
Another thing to consider is the weather. Some of us need more insulin as it warms up and some need less so you may end up needing more basal.

Finally, if you require more basal flexibility because, for example, you need more when premenstrual, Tresiba may not be the best for you. It's flat profile is fantastic if every day's needs are the same. But it is a pain in the proverbial if you need more when premenstrual, less when exercising, more on a week day, less on a weekend, etc.
 

Hi, thanks so much. Yes I was wondering how others managed Tresiba during their cycle. I usually just accept that I may be higher (some months very insulin resistant, some months not so it’s hard to make decisions with basal increases)
I guess I’ll see how today works out, it’s the not knowing that’s frustrating - is it the basal, have my carb ratios changed or is it weather, illness etc.
Last Summer I needed less insulin but maybe that’s changed. I’ve noticed with hot baths that I used to have hypos but now I go sky high. So many ‘maybe it’s.....’ today!
 
Strange you should mention this because I had a similar problem yesterday. Though my bloods had been stable over night somewhere between 4 and 6, it was like my Tresiba just gave up. Took a correction before and after Breakfast to get back to normal range. Had a snack fine. Then needed a correction after lunch after eating the usual thing with the usual dose. Ate dinner all was fine for 2-3 hours. But then it was like I had ate another dinner after cause my blood sugar shot to the moon. Took another 9 units spread across 7 hours to bring me back to normal range and bloods only started meaningfully dropping in the last hours. Interestingly my blood sugar’s only came to rest approximately 24 hours after the whole thing began.

Like you’ve already been advised, I’m not going to change my dose off one incident alone unless I start to see the same pattern on three consecutive days (even two I’d say is not enough even though DAFNE educators would disagree with me, but then the DAFNE I did didn’t acknowledge the existence of Tresiba either so *shrug*)

The Tresiba I tool as well was the first dose out of a new pen funnily enough. Examining the pen before my second dose I didn’t see any issues with it.
 

It’s frustrating isn’t it, so are you back to ‘normal’ now or waiting to see what happens today? I gave myself an extra unit of novorapid for breakfast and am keeping an eye on numbers but it’s starting to feel like a random guessing game with how it’s going to go for the rest of the day
 
searley said:
Right.. you cant adjust basal insulin off the back of 1 bad day.. first tresiba takes about 3 days to start working.. and if it was an oddball issue that cause a 1 off you could be buying yourself issues in 3 days
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Hi,

I got turned down for a change to Tresiba by my endo. Pretty much the same reasons you gave above.
I had to concur. My lifestyle wouldn't sit with it.

Lantus for all its faults for me can be adjusted to pre-empt a planned following day.
Even "sick days" (adjustments for.) it's reasonable.
 
I’d agree that Lantus is good for fluctuating basal needs. I have a 2nd autoimmune disease that flares up during my cycle, so I often need to up my basal the week before & during.
 
Too early to say, as of right now yes, but I really need to see what happens once my Breakfast Bolus is absorbed. I find the trickle of Fiasp left after the first two hours pretty insignificant so should have a good idea by the time lunch comes around.

Days like this are definitely the major disadvantage of Fiasp. That said, every Insulin has its disadvantages.
 
TashT1 said:
I’d agree that Lantus is good for fluctuating basal needs. I have a 2nd autoimmune disease that flares up during my cycle, so I often need to up my basal the week before & during.
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That’s interesting, I’m having a bad psoriasis flare up just now during my premenstrual week. I’ll ask about Lantus when I speak to the diabetes team, I’ve been tracking my cycle but there’s no real pattern as to when and if my bloods will be harder to manage x
 

Fingers crossed it’s a good day for you. My Libre is currently doing it’s ‘scan error’ thing which seems to last for hours at a time so I’m finger pricking constantly, so far so good but who knows
 
JMoli said:
Fingers crossed it’s a good day for you. My Libre is currently doing it’s ‘scan error’ thing which seems to last for hours at a time so I’m finger pricking constantly, so far so good but who knows
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When you get that Scan Error thing, does your Sensor start working again afterwords? In my case, if it stops working for about half an hour, it can be almost guaranteed the Sensor's done (even if it does take about two hours for the Sensor to finally give in). I do however find if I have unstable bloods* the Libre sometimes gives up until it settles down, however I'm lucky enough to have that kind of instability for long.

*I'm defining unstable as neither trending Low or High, but bouncing/rollercoastering quickly.
 
JMoli said:
Fingers crossed it’s a good day for you. My Libre is currently doing it’s ‘scan error’ thing which seems to last for hours at a time so I’m finger pricking constantly, so far so good but who knows
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Dehydration can cause this
 

Tresiba did really well for me for some years.. it was only when I started hgv driving with long hours and differing work load I started to struggle
 
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