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Sugars won’t go down today

GuidingSenses

Well-Known Member
Messages
117
Type of diabetes
LADA
Treatment type
Insulin
Hi I’m type 1.5 since 2020. Today my sugars won’t go down and I’m not doing anything different. I put a fresh insulin in my novorapid pen yesterday and it’s coming out fine. My sugars on rising were 9 then it went to 15 after my gym session when it usually goes down? I go regularly to the gym. I injected for lunch with a correction dose and it’s stayed about 16 even when tea was ready! I injected again for tea and it’s now 17! Should I change the insulin to another phial? Getting concerned and my carb intake wasn’t excessive only 120 today ( my goal is around 150 carbs)
I’m on novorapid and Tresiba at night.
Thankyou
 
Hi. You mention a phial? Are you using a pump and 'vials' or a normal pen? It's rarely anything to do with 'bad' insulin. I've had similar problems recently and found it's due to lipohypertrophy where there has been overuse of certain injection areas. I've now been using the shoulder and backside and it's making a big difference in the insulin absorption rate. Be aware that once your BS goes into the high teens it can take hours to get it back down regardless of injection amount; it's not linear behaviour. Do consider new injection areas. Google it and there are loads of images. BTW I also inject some Basal as well as Bolus when I have this problem to bring BS down
 
Hi Thankyou so much for replying. This has helped and yes I use my hips and backside mainly as my stomach area bruises too badly. It’s so strange though as usually exercise brings it down rapidly. it’s a novorapid pen with changeable insulin so it’s like a phial of insulin that gets screwed in when it’s run out.
Hope it improves - I just did another correction dose of 1 as it’s gone up to 18. When do I really panic? What’s the panic range? Thankyou again .
 
Sorry, @Daibell but I have had no lipohypertrophy issues after more than 15 years whereas I have experienced insulin problems a few times. So I would not agree with your suggestion.
It seems too much of a coincidence that the problem started when @GuidingSenses changed her insulin cartridge (I assume that is what she is referring to as I have read others call them vials on multi use pens … not that it matters).
I would recommend checking that the insulin is correctly coming out of the pen ( @Jaylee has a picture showing how to measure insulin using a pen cap). Then changing both bolus and basal insulins.
 
Thankyou and yes cartridge is the word
I checked it was coming out and in fact it was shooting out with no air bubbles. It’s something to consider changing again I suppose as this is only the second time it has happened to be constantly high and I feel fit and well and worked a little harder at the gym even. thankyou
 
GuidingSenses said:
and I feel fit and well and worked a little harder at the gym even. thankyou
Click to expand...

Any chance you are coming to the end of a honeymoon period? I know LADAs can go on producing their own insulin for a long time.

Though high bgs can be scary, it's when combined with high ketones that you have to worry (diabetic ketoacidosis). Do you have a meter that tests for ketones or, failing that, you can buy urine testing strips from the chemist that test for ketones and would probably tell you if you were running high. (Low ketones aren't an issue.)
 
OMG I’m now scared as I took the cartridge out of my Novorapid and realised it was Tresiba night time cartridge! I’ve been injecting Tresiba all day!!!!!
What will happen. ? I usually only have 5 x Tresiba at night and I’ve injected 20 throughout the day but NO Novorapid!!!! Omg I’m so stupid what shall I do!? Obviously I need novorapid now but should I not have Tresiba at night now?
 
GuidingSenses said:
OMG I’m now scared as I took the cartridge out of my Novorapid and realised it was Tresiba night time cartridge! I’ve been injecting Tresiba all day!!!!!
Click to expand...

Well, the good news is you now have an explanation for your bg behaviour. (And honestly, most of us have done the switch between basal and bolus at one time or another.)

In your position, I certainly would skip today's night time dose, which means you've got 3 times the normal tresiba hitting your system for the next, maybe 2 days? If you are panicking you could ring 111 for advice but in my opinion it's a question of doing enough testing to make sure that you don't creep into hypo territory, particularly at night. Do you have someone at home with you as back up?

I'm not experienced with tresiba so my advice may not be the most useful. (My mix ups have been injecting bolus instead of basal, which required massive amounts of carbs to stop the crash, but was fine once the bolus had worn off.)
Here's a thread from 6 years ago
Double dose on Tresiba | Diabetes Forum • The Global Diabetes Community

Tagging @Juicyj whose thread that was.

(Edited to change "basal had worn off" to "bolus had worn off ", why oh why do I find it so easy to mix the two words up?)
 
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You've had a lot more Tresiba than you usually have, so I wouldn't be too eager correcting your high bg before bed.

The Tresiba will stay in your system for 2 to 3 days, so you might find you'll need less Novorapid in the next few days.

What about setting an alarm every couple of hours tonight to test?

You might find your lows are more stubborn than usual, and you might find you'll need some more carbs than you usually have throughout the day.

Keep testing a lot until things stabilise again!
Do you live alone or do you have someone around?
 
I’ve rang Nhs direct and may be a long wait for a call. Yes my husband is here. My bs is 17 so that’s why I rang Nhs as it’s high still but yes I’ve had far too much Tresiba. I will test in night and will see if I get a call back - Thankyou everyone
 
Glad you've rung NHS 111, and hope you hear back soon.Take care, and let us know how you're doing.
 
This sounds like the best way to go, very sensible approach!
Hope you and your husband will get some sleep despite the testing, and your BG will stay in or just above range!
 
Seems I missed the call as it never even rang, just my phone lit up and then a voicemail so a bit disappointed - sugars now 16 and not going to take any insulin whatsoever tonight x
 
Well, if you inject Novorapid, whe!n you should have injected Tresiba, that could be dangerous!
 
Yes I suppose I at least did the right mistake if that’s a thing lol
 
Update
Ambulance turned up 5 am as I’d missed the 3rd call from 111. I’ve had two hypos in the night and feel rough. My husband has made me breakfast (porridge) but darent take any insulin until I hear from my diabetes team at hospital.
What a night
 
Keep testing and make sure you have whatever you use for hypos close at hand. The test results will be useful for the hospital people when you hear from them.
 
In Response said:
@Jaylee has a picture showing how to measure insulin using a pen cap). Then changing both bolus and basal insulins.
Click to expand...

Yep, sort of...


Hi,
@GuidingSenses ,


If you feel your pen maybe faulty? You could try after an airshot, firing 20 units into an empty needle cap & see if it fills to the line in the picture below?
Not very scientific. But it may give an idea on what's happening with your pen delivery system..

 
How have you been doing since?
I really hope it has settled a bit by now.
 
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