BP, blood sugars, crazy readings

[Junglegirl]

Hi,
I was put on Candesartan which I take at night as instructed 8 weeks ago, I have a history of very high BP. As previously mentioned I don’t tolerate BP meds at all well and think maybe I am now reacting badly again. However, I have now started suffering regular night hypo’s (usually a rarity) and my daytime sugar levels have started to rocket. Using the old system usually around 6.9 this morning a staggering 23.3. I took extra insulin to try and reduce this quickly, hardly any effect. My BP is currently 153/5 but was 121/61 about 3 hours ago. Can’t say as I feel great.
Any ideas anyone?

 

[rebrascora]

Have you considered that your insulin may have become compromised or didn't inject?

Did you remember to do an air shot before injecting your basal insulin yesterday? The reason I ask is that I have had some needles (BD Viva) which have been blocked and if I hadn't done the air shot I would not have known.
... Or perhaps you are on a pump?

If your BG is high then it is likely that your BP will also go high as your body will be under stress. I assume that figure of 153/5 is a typo though?

If you are on MDI, which basal do you use and when do you administer it?

If you have been on the new medicine for 8 weeks it is unlikely to be responsible for this problem, so I would be looking for a possible insulin issue initially.

 

[Madeline]

I’ve had some blocked Tri Care needles too.

 

[Pumper_Sue]

However, I have now started suffering regular night hypo’s (usually a rarity) and my daytime sugar levels have started to rocket. Using the old system usually around 6.9 this morning a staggering 23.3.

It sounds to me as f you need to test your basal and adjust it accordingly. As a matter of interest what are you treating your hypo with and how low are you going?
It could just be a simple thing like a rebound high.

 

[Junglegirl]

Have you considered that your insulin may have become compromised or didn't inject?

Did you remember to do an air shot before injecting your basal insulin yesterday? The reason I ask is that I have had some needles (BD Viva) which have been blocked and if I hadn't done the air shot I would not have known.
... Or perhaps you are on a pump?

If your BG is high then it is likely that your BP will also go high as your body will be under stress. I assume that figure of 153/5 is a typo though?

If you are on MDI, which basal do you use and when do you administer it?

If you have been on the new medicine for 8 weeks it is unlikely to be responsible for this problem, so I would be looking for a possible insulin issue initially.

Hi,
Yes to typo bottom figure should be 50

It sounds to me as f you need to test your basal and adjust it accordingly. As a matter of interest what are you treating your hypo with and how low are you going?
It could just be a simple thing like a rebound high.

It sounds to me as f you need to test your basal and adjust it accordingly. As a matter of interest what are you treating your hypo with and how low are you going?
It could just be a simple thing like a rebound high.

It sounds to me as f you need to test your basal and adjust it accordingly. As a matter of interest what are you treating your hypo with and how low are you going?
It could just be a simple thing like a rebound high.

Hi,
Thank you for your response and forgive me for not really giving enough information.
I am currently what I would call old school, as in I take two injections a day one in the morning and one around 6pm these are mixed animal insulin, soluable and isophane . I did wonder about compromised insulin as I had just started a new batch so dumped that earlier today and have started yet another new batch tonight, fingers crossed that this is more the cause than anything else.
Rebound high would have been a comfort but I didn’t hypo last night so had no rectifying treatment. Depending on the severity of the hypo’s and these have been severe, the glucose gel is the quickest reviver for me as I can’t eat, I am usually rendered almost paralysed by the hypo’s only being able to breath really, totally unable to move, swallow etc. I have suffered this type of hypo since diagnosis back in the 70’s. Just a tube of the gel usually does the trick, though throughout my diabetic history well over 40 years I have fitted many times. Thankfully my other half is well versed in sorting me out.
I can go very very low around 1.5 before my symptoms become noticeable to other people, usually I self recognise around 2, however when asleep I tend not to wake, when on human insulin I had no warning signs whatsoever and ran my blood sugars high for 20 years to cope.
I always have to ensure that any syringes I use have any excess air removed so always draw up more than needed and air expel, I have also had some blocked needles but usually when drawing up the insulin.
As my BP has been running in the 200’s for 30 years....I was wondering whether the bodily re-set at 4am, coupled with what is extremely low BP for me around the 120/80 or less, and the insulin working away in the background, is confusing my whole system. Again I’m thinking a couple of units reduction in basal I only take 20 units but maybe this is now too much.
Apologies for the length of this reply.
Thank you for your help

 

[rebrascora]

Hi again.

Thanks for all that extra info. Those hypos sound very scary.
Can I ask what you use to inject. It doesn't sound like a disposable pen. The reason I ask is that there was a lady on my DAFNE course who had been diabetic for 50 years and she was still using what looked like the skeleton of a gun. It was metal and had a spring loaded trigger. Like you she was suffering severe night time hypos on a regular basis and then in the teens during the day despite using only tiny amounts of insulin. It turned out that one of the problems was that her injector gun was no longer giving accurate amounts of insulin and since she was already on very small doses, the inaccuracy was causing major fluctuations.
I am guessing your issues with modern insulins prevent you from having a pump. Afraid I know nothing about animal insulins or mixing them so I will leave any further comment to those who are more experienced.

I really do hope you get it sorted both for your own welfare and that of your partner, as it can't be easy to sleep well with that sort of worry on a regular basis.

 

[Pumper_Sue]

I used bovine insulin for over 50 years and it worked very well for me, unfortunately this has been discontinued so have changed over to using Fiasp which is fine for me. I use this in a pump. I also used bovine in a pump for many years.
Have you considered a pump as your porcine can be used in a pump this will give you a lot better control?
From what you are saying I can not work out if you use a mixed insulin as all in one vial or you have the two which you can adjust yourself in the same syringe?
If not separate then perhaps consider asking for them to be as you can then have a lot better control and adjust as you need too.
From the hypos you are having I would look into trying some of the newer analogue insulins as you should not be hypoing in the way you do.

I would would also be asking/demanding a CGM so you can see your levels and can also set it to alarm way before hypo land hits.

 

[DaveB]

Hi. As a T1, NICE recommends MDI (Basal/Bolus) and not mixed insulin so I would ask your GP to make the change. Also syringes as you probably realise are very 'old hat' unless using a pump and you should find more modern pens much easier. In your post you also mention a Basal so I'm a bit confused on what you do inject? Is it mixed and/or just Basal?

 

[Pumper_Sue]

Hi. As a T1, NICE recommends MDI (Basal/Bolus) and not mixed insulin so I would ask your GP to make the change. Also syringes as you probably realise are very 'old hat' unless using a pump and you should find more modern pens much easier. In your post you also mention a Basal so I'm a bit confused on what you do inject? Is it mixed and/or just Basal?

Syringes are better than pens because if Jungle girl is using separate basal (Isophane) bolus (neutral) then she can put them in the same syringe and cut down the amount of injections needed per day.
Pens are just an excuse by the insulin manufactures to milk even more money from the NHS as far as I am concerned.
@Junglegirl another suggestion for you to think about, Have you done a basal test as in no food and just taking your basal insulin and then testing every two hours during the night and seeing exactly what is happening?
This way you can determine whether you need to adjust the timing of your Isophane or whether you need to decrease it. I know when I used Isophane I had to have supper to stop any lows so basically feeding the Isophane. This all stopped when I went on a pump as only neutral used.

 

[Junglegirl]

Hi everyone,
Thank you for your responses, all much appreciated.
I have separate insulin isophane and soluble so I can individually adjust each amount I take, I use just one syringe so mix the insulin myself.

I can’t have a continuous glucose monitor I don’t meet the criteria to qualify.

As regards an insulin pump, I trailed one of the first pumps back in the day (now in a museum I think ...lol). I had an awful time with it, it was very restrictive, cumbersome, made a hell of a racket too, life became very difficult to live. I was so glad to see the back of it ..think it scared me for life.

Analogue insulins would be a very last resort for me, if ever.

Things have calmed down a little today, I’m not out of the woods yet I know, the basal test will be my next port of call, will have to order more test strips, another trip to eBay. I do get a considerable amount from my GP but when I increase testing it’s never enough. At least I get some though.