Suddenly very insulin resistant and experiencing constantly high levels

Have you changed your insulin and pens?
The insulin may not have been kept properly or the pens may be faulty.

pinewood said:

I’ve been experiencing much higher blood sugar levels for the past 2-3 days and I cannot understand why because:

1. No illness and I feel fine;
2. I am stressed, but no more than usual;
3. I have tried changing my insulin vials and pens.

Basically, my bolus requirements have more than tripled – I’m now running at about 1u:5g of carbs whereas before I was around 1u:15g.

I’ve increased my Tresiba from 14U to 20U but, so far, no effect. My levels are especially stubborn over night.

I have been doing slightly less exercise than usual but I went for a long run on Friday and my blood sugars Friday evening and overnight were sky high and it seemed like no amount of bolus would get them down (I must have had nearly 15U of NovoRapid during Friday night – I only got back into range at 8am)

Any advice? Should I be worried?

Maybe it’s the end of my (long) honeymoon; I was dx’d in December 2014 so it has been nearly 5 years now.

I’m really at a loss. I guess I will just keep increasing my Tresiba dose...

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Hello!
With Tresiba, you’ll need to give it 4 days or so for it to settle when changing doses. It is a flat line insulin, so whether I’m running high due to hormones, changing Tresiba didn’t do much so I just correct. However you can consider a basal test to see if you have a correct amount of tresiba on board or too little or just right. This would require you to fast after dinner and wake up at midnight to test and another test at 3am.

Maybe it’s some of the carbs or high fat content foods you are eating that go beyond your novorapid insulin window - some people split dose for it for better coverage.

It could be dawn phenomena in the mornings where your liver does it’s sugar dump.

pinewood said:

Thanks; yes I changed both my bolus and basal.

The only thing that I can think of is that I have a really sore gum and think it may be infected … the timing coincided with my rising levels … have a dentist appointment on Thursday but can't imagine this could have such a profound blood sugar impact?

Click to expand...

Being in pain or having an infection does cause higher readings.

pinewood said:

I’ve been experiencing much higher blood sugar levels for the past 2-3 days and I cannot understand why because:

1. No illness and I feel fine;
2. I am stressed, but no more than usual;
3. I have tried changing my insulin vials and pens.

Basically, my bolus requirements have more than tripled – I’m now running at about 1u:5g of carbs whereas before I was around 1u:15g.

I’ve increased my Tresiba from 14U to 20U but, so far, no effect. My levels are especially stubborn over night.

I have been doing slightly less exercise than usual but I went for a long run on Friday and my blood sugars Friday evening and overnight were sky high and it seemed like no amount of bolus would get them down (I must have had nearly 15U of NovoRapid during Friday night – I only got back into range at 8am)

Any advice? Should I be worried?

Maybe it’s the end of my (long) honeymoon; I was dx’d in December 2014 so it has been nearly 5 years now.

I’m really at a loss. I guess I will just keep increasing my Tresiba dose...

Click to expand...

Hi Pinewood - have you checked your insulin sites? In November, my diabetes specialist consultant had a look at my injection sites and discovered that I had a fair few lumps on my stomach and thighs that I wasn't able to see. I changed my insulin sites and my insulin levels dropped lots. Hope you get sorted soon.

Could be an infection you don't know about or something to do with your tooth!

Also, make sure to use vials from a completely different box as it might be a bad batch potentially!

My ratio is 1u:3g so I absolutely feel your pain. I've been through periods of resistance where I was on 1u:0.5g and ended up simply going minimal-carb until I went back to normal. Awful stuff!!

Keep us updated with any changes, see if we can figure out what it is for future reference!

Hi @pinewood, From past experiences as a TID, not as health professional opinion or advice:
infection can do it every time if severe enough.
Also sometimes our nerves do not always convey the amount of pain we expect from a sore tooth, unless we happen to bite hard enough on the area or it reacts to drink a cool or hot beverage.
In a way high bsls may be the particular signal that us diabetics notice to indicate something is wrong.
The problem with Tresiba is that it is so long acting that it takes a longer while to get with the action of reducing blood sugars than other long-acting insulins.
You really need to be in close contact with your nurse and doctor to talk through what to do about your diabetes management, diet and insulin - in order to prevent a worse situation.
It may be worth measuring your ketones if you have the meter and special strips which allow this to be done. If you do not have this facility, then perhaps also ask your nurse about how to sort this out.
It is also usual to have a sick day plan, which swings into action when these type of situations, which you posted about, occur.
After you have sorted this present situation out with your nurse/doctor/dentist (and the dentist's treatment does the trick)! you will have the opportunity to update or devise a sick day plan so that the next time will be easier to manage.
Best Wishes for a quick resolution to your problem and a return to better bsls !!

Guys, I’m also on tresiba. Started like 3 months and everything was alright at 54 u tresiba daily and 38 u of humalog per day average. Correction was 1u to 10g carbs and bolus 1 to 6.

Since I started with insulin at that time( I was 80 kg with 1.89 m). I started gaining weight and I’m now in 93 kg which is ok.
But my ratios are not the same. I don’t have a clue right now if my ratios my levels are going up even if I don’t eat nothing, which is insane.
Not sure if you experience this: when I woke up could 168 but once I stand up from bed and walk to the toilet and around it starts going up when measured it ya gone up to 216 and ️ without eating absolutely anything for breakfast yet.
Any clues?
Could it be that since my weight came up my needs have gone up too?

Sometimes the first indication of sickness is increase insulin resistance, and it all drops into place when we get ill!

I had exactly the same problem a couple of weeks ago and since I’ve changed injection sites it’s improved completely! Now I keep going into hypo

Well it seems my level of stress