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Help with high BS - no idea why!

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benunited

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Relationship to Diabetes
Type 1
Hi folks!

I have been T1 for 15 years and my BS control has varied over that time.

As part of my new year health kick I decided to get back to watching what I eat and exercising.

Normally, I would take around 20-30 units of Novorapid on an average day and about 21-22 units of the background insulin, which I've always taken at night before bed.

When I am on a normal/reasonably high carb diet (cereals, sandwiches, potatoes etc) I can usually get my BS levels spot on before bed - but then find they are in double figures in the morning.

For the past 10 days I have cut my carbs - and therefore my Novorapid - in half, so around 10 units a day. Also I've been doing a lot of running which means l need less bolus and basal. This has also meant cutting my overnight background insulin.

Now, I thought I was getting this spot on as my morning BS levels (which are often an issue) have been perfect, exactly where I want them to be.

But I'm now getting high BS later in the day!

So, this morning my BS level was 6.1. Result!

Breakfast was a slice of wholemeal toast (18g carbs) and a banana (20g carbs) so 38g in total. I work on a roughly 10:1 ratio so took 4 units of insulin.

I know bananas have a lowish GI index so expect there may be a small spike in BS late morning - but BS was fine.

Before lunch it was 9.1. Okay...

Lunch was low in carbs - chicken breast, cucumber, pickles and some spicey sauce. My Fitness Pal app said this was around 9g of carbs so I took 1 unit of Novorapid.

So here's the thing...

2pm: BS were 16 - took 2 units to bring this down
3pm: BS were 13 - took another 2 units to bring this down (still not eaten anything since lunch)
6pm: BS were STILL 13

I'm at a loss on this one. One thing I'm wondering is if cutting my background insulin is the problem and I just don't have enough? But if I'd taken any more than I have been I know I would have had a hypo overnight.

I'm going to ask at the diabetes clinic but wondered if anyone has any ideas on why this is happening - it's been happening almost every day for the past week.

Thanks if you've been able to read this!

Ben
 
Welcome to the forum, Benunited.
Sauces can be surprisingly high in sugar, but without knowing type you're eating, it's difficult to be sure. Also, always worth checking there's no sugary residue on your fingers.
If neither apply, then perhaps you reduced your basal dose too much? Which basal insulin are you using? How many doses per day?
 
Copepod said:
Welcome to the forum, Benunited.
Sauces can be surprisingly high in sugar, but without knowing type you're eating, it's difficult to be sure. Also, always worth checking there's no sugary residue on your fingers.
If neither apply, then perhaps you reduced your basal dose too much? Which basal insulin are you using? How many doses per day?
Click to expand...

Thanks for the reply!

The sauce? Was just a tiny amount - My Fitness Pal said it was 1g of sugar.

Many times in the past I've miscalculated food/a meal. What I don't get about this is I kept taking more insulin and it didn't have any real impact!

I'm using Lantus basal - but I'm thinking if I'd taken say 10-15 units of this I'd have had a hypo overnight. One dose per day, before bed
 
I'm wondering, if you've reduced your carbs, whether you've increased the amount of protein you're having. I find if I have a low carb high protein meal, I have to Bolus for the protein. Protein also takes longer to get into the system, so can affect BGs several hours after you would expect carb to have been digested and used up. Somewhere on here, ( sorry, can't remember where) someone has posted a chart showing how much protein and fat your body converts to glucose in the absence of useable carb, I think it's about 50% of the protein, and 10% of the fat.
 
Hi Ben. Can't help but hello
 
Hello to everyone and thanks for the welcomes! 🙂

Robin - thanks. Yes, my protein has gone up a fair bit. Like today's lunch was chicken breast, cucumber, gherkins and just a little spicy sauce. So just 1 unit of insulin. I had thought if I had taken 3 or more units I would hypo due to lack of carbs!?
 
Hi Ben

You mention that you take your Lantus at night. Have you considered switching your background to Levemir. I found it helped as I was then able to split the dose, to a morning and night time one. That way I had more control over the amount of basal insulin active, so I could reduce the night time amount if I was hyping at night, and adjust day time based on how active I was going to be.

You also mention that when you were high the insulin did not seem to bring you down as you expected. I find that the higher my BG the more resistant to insulin my body is. So I increase a correction dose if I am above 10 and even more if above 14. Again talk to your DSN and see what he/she thinks.
 
Thanks SB2015!

I'll be moving onto an omnipod (my first ever pump!) soon so guess that may help controlling the basal.

Re the protein and insulin - I understand I may need to take insulin if my body is going to turn protein into carbs in the absence of carbs - but... last night my dinner was fish, chicken and veg and I only took 1 unit of insulin and had no problems with BS.
 
benunited said:
Thanks SB2015!.

Re the protein and insulin - I understand I may need to take insulin if my body is going to turn protein into carbs in the absence of carbs - but... last night my dinner was fish, chicken and veg and I only took 1 unit of insulin and had no problems with BS.
Click to expand...
That's Diabetes for you!
 
I'd be willing to bet that your Lantus at the lower level, is not sufficient to cover your needs in the afternoon. Like SB2015 - I'd say immediately - get your basal changed to Levemir 2x daily - but it will all be up in the air anyway shortly when you get your pump.

If it's within the next couple of weeks - just firefight meanwhile. Otherwise - get the basal changed. Seriously - they can now actually prescribe Flexpens (the disposable pens) of Novorapid and Levemir in ONES, not the boxes of 5 they usually prescribe on repeat - I know this cos I have one at a time, to keep in the fridge, in case MY pump goes base over apex - cos you still have to have back up, for emergencies. Pump cos are excellent with helplines open at weekends and 24 hours - however - even courier services don't deliver that quick! LOL
 
Hi. I think you need to review your total daily carbs and keep them below a sensible level e.g. below 150'ish gms to help remove any insulin resistance. You then first need to get the Basal right. There are various ways to do this but if you are on one Basal injection day just check your morning fasting level is between 5 - 7 mmol. There is a more accurate way using more controlled fasting. Once the Basal is right then you need to get the right Bolus ratio. If the Basal is right then your blood sugar should stay stable when not eating anything for a few hours
 
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