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Skelly77

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Type 1
My daughter is type 1 diebetic and over last few months her sugars and keytones are going out of control. Rising very high and keytones jumping up Quickly. We are working with diebetics clinic raising insulin correct diet and also exercise but it's not working well. We are trying to find if any underlyng conditions can cause this problem?
 
Skelly77 said:
My daughter is type 1 diebetic and over last few months her sugars and keytones are going out of control. Rising very high and keytones jumping up Quickly. We are working with diebetics clinic raising insulin correct diet and also exercise but it's not working well. We are trying to find if any underlyng conditions can cause this problem?
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How old is your daughter?
 
Could it be puberty or a growth spurt @Skelly77 ? If you tell us a little more then you’ll get more tailored suggestions. Does your daughter use a pump or is she on injections?
 
Is she under stress at work or personally?
 
Skelly77 said:
My daughter is 44yrs old and is on Injections
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Has she been ill recently with any lingering effects? Or stressed? Has anything changed for her personally or professionally? Has she had her injection sites checked to make sure she’s absorbing the insulin properly?
 
Checking her sites was what I was going to suggest until @Inka beat me to it.
I have read of some people finding they become resistant to their insulin and benefited from a change to a different type, especially if they can change to a different manufacturer. For example, if they are on NovoRapid, change to Humalog (or vice versa).
 
Skelly77 said:
My daughter is 44yrs old and is on Injections
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It could be something as simple as the menopause many people with type1 diabetes go through the change earlier than non diabetics.
Realistically though we can not give any help as there is so little information given 🙂.
 
Sorry to hear about your daughter’s raised levels and ketones @Skelly77

Does she carb count her meals and match the insulin doses to the food she is eating, or just take the same doses each day?

Has she ever been on a course like DAFNE that teaches about balancing insulin with food and other stuff life throws at you?
 
Hi people. She is being referred for both Dietician and Daphnia course but still waiting. Her nurse has advised on how to adjust her insulin but it's crazy this morning her breakfast boiled egg with slice of o added sugar wholemeal n cup of tea with sweetener. Sugars were 6.2
Just before then shot up to 13.9 hour n 20 mins later. She did correction dose We were then out shoppinv and they still rose to 15 while we walking about shopping. It's really strange as if the insulin doesn't touch her blood
 
Skelly77 said:
Hi people. She is being referred for both Dietician and Daphnia course but still waiting. Her nurse has advised on how to adjust her insulin but it's crazy this morning her breakfast boiled egg with slice of o added sugar wholemeal n cup of tea with sweetener. Sugars were 6.2
Just before then shot up to 13.9 hour n 20 mins later. She did correction dose We were then out shoppinv and they still rose to 15 while we walking about shopping. It's really strange as if the insulin doesn't touch her blood
Click to expand...
Although I can't help, it would be useful for people who can to know what insulins and dosing regime your daughter is on. It could be that the aftermath of being unwell is affecting things.
 
Skelly77 said:
Hi people. She is being referred for both Dietician and Daphnia course but still waiting. Her nurse has advised on how to adjust her insulin but it's crazy this morning her breakfast boiled egg with slice of o added sugar wholemeal n cup of tea with sweetener. Sugars were 6.2
Just before then shot up to 13.9 hour n 20 mins later. She did correction dose We were then out shoppinv and they still rose to 15 while we walking about shopping. It's really strange as if the insulin doesn't touch her blood
Click to expand...
Did she take insulin before eating her food? And how long in advance did she take it. Why did she test and correct only 20 minutes later? Insulin takes time to start working so it is normal for glucose to go up after eating. Taking it further in advance of eating can help reduce the spikes.
 
Skelly77 said:
Hi people. She is being referred for both Dietician and Daphnia course but still waiting. Her nurse has advised on how to adjust her insulin but it's crazy this morning her breakfast boiled egg with slice of o added sugar wholemeal n cup of tea with sweetener. Sugars were 6.2
Just before then shot up to 13.9 hour n 20 mins later. She did correction dose We were then out shoppinv and they still rose to 15 while we walking about shopping. It's really strange as if the insulin doesn't touch her blood
Click to expand...
Bread is notorious for spiking my blood sugar. Also it's not just the sugar in the bread, it's the total carbohydrate count she needs to look at. Especially at breakfast time when often insulin resistance can be higher. I need more insulin at that time of day per grams of carbohydrate than I do later in the day. As Lucy says, an hour and 20 minutes is a bit early to start doing corrections as you are then "stacking" doses which can lead to a sharp drop later.

As Lucy also points out, taking her insulin earlier will help. Insulin takes about 45 minutes to kick in before it's effective (depending on which insulin she is using), so basically the carbs your daughter eats will hit her blood sugar before it really starts working. Tell her to try bolussing 10 - 15 minutes ahead of eating... if that's not effective then try another 5 minutes the next day etc. until she is matching the insulin action to the time the carbohydrates kick in.
 
It sounds like it may be a combination of her basal insulin dose not being enough to hold her steady and not injecting her bolus (quick acting food insulin) far enough in advance of eating her breakfast. I know the guidance is to inject 15-20 mins in advance of a meal but at breakfast time I personally need over an hour for NovoRapid and 45mins for Fiasp which I am now on.
It is important to adjust this timing carefully and just increase it by 5 mins every day or two to find the optimum timing for your individual body. At other times of the day I just need 15-20 mins but morning time is always difficult and takes much longer. How far before her breakfast does your daughter currently inject her insulin? And which insulins is she using?
 
@rebrascorer After I posted my message above I did think that perhaps the lady's basal needs have changed, which often happens with a change in the weather and perhaps she needs to increase the basal a little bit. It is really difficult though to make suggestions as we don't know what insulins she is on.
 
Menopause and injecting too close to eating both sound like likely causes, so I'd agree with the advice that your daughter should try injecting a bit earlier/eating a bit later after injecting. Just one other point though - if your daughter has developed any food intolerances, these can cause spikes in blood sugar. Intolerances are not like allergies, there may be no other symptoms, or just a bit of nausea. I say this because you mention eggs - I have a slight intolerance to eggs, and if I ate an egg my blood sugar would very soon be 18, despite eggs not having any carbs, and no matter how much insulin I injected.
 
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