Blood doesn’t come down after two hours and almost always goes above 10 even after low carbs ??

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Upset Racoon

Upset Racoon

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Type 1
Hi ,

I was diagnosed under two years ago now with type 1 diabetes. I am not convinced it’s not type 2 to be honest . I was tested for GAD antibodies which I was positive for .

I was straight away put on novorapid and lantus .

I have noticed that whatever I eat ( i don’t carb count , i just randomly put a lot of units in , eg 11 most times to cover about 40g / 50g / 60g of carbs .

I hear other people having only 1 or two units per meal … can’t imagine doing that . I am clearly not insulin sensitive as they are .

yet it always goes above 10?? and doesn’t seem to come down without more insulin ?? and I know the rough guideline is about 1 unit to lower blood glucose around 2+ mmol ( this is clearly not the case for me , when I ‘ correct’ it , with eg two units , it barely lowers by 2 mmol.

Hate this so so much . it takes the joy out of eating , it’s dreadful , I hate it so so much !!

I ate 5 oatcakes with hummus on . each oatcake wad around 5.8g of carbs . and a bunch of almonds just before hand . 2 hours later ( after injecting 8 units ) its 10.8 and not coming down ( it’s now another 2 hours later and still the same result .) help ??
 
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Is this something new that is happening?
I wonder if you are trying to apply the criteria that would apply to somebody who is Type 2 as injected insulin will behave differently to naturally produced insulin.
Hopefully some Type 1 folk will be along to try to assist you and make some suggestions about your regime.
 
I’ve noticed it more last few days but it’s more or less like this all the time unfortunately:(

Thank you for replying 🙂
 
You need to go right back to basics and do a basal test.
Sort your basal out and things will then slot into place.
Have a look on line for the Bertie carb counting course as well.
 
Hi I was only diagnosed 8 months ago myself so not sure how helpful ill be. But if it's staying high and not coming down after 4 hours(somthing been myself recently) or it sunsets the insulin isn't enough for the amount of carbs or background isn't enough(why corections mignt not be workinggg(again sonetimes had similar problems) Can I ask why you don't carb count is this something you haven't been taught by you're team? Only asking because if your taught to carb count it might make things easier.
 
Hope you get sorted with your query. Don't stop eating!

I luvs your user name. That's cheered me up to no end. How did you decide on it? 🙂
 
Pumper_Sue said:
You need to go right back to basics and do a basal test.
Sort your basal out and things will then slot into place.
Have a look on line for the Bertie carb counting course as well.
Click to expand...

Also the NHS site https://mytype1diabetes.nhs.uk has carb counting advice. (I have to confess I've not looked at either, but BERTIE online was mentioned on the course I went to a few years ago.)
 
it is possible for a type 1 to be insulin resistant. Type 1 means the cells which produce insulin are dying/have died and it is thought to be an autoimmune condition. Type 2 means your body is still producing plenty of insulin but your body doesn't use it properly. Forget about how much insulin other people need, everyone is different. Do a basal test first and make sure your dose of that is correct. if that is wrong nothing else works properly. Then you can start to look at how much rapid acting you need with meals.
 
@Upset Racoon I hope you have some suggestions that will help. One thing I have learned by reading the posts here is there are many reasons for a persons insulin requirement to change due to all sorts of factors and people have to learn how to make adjustments by getting the knowledge and confidence themselves or with the help of their DSN who should be able to give you advise.
 
Sally71 said:
it is possible for a type 1 to be insulin resistant. Type 1 means the cells which produce insulin are dying/have died and it is thought to be an autoimmune condition. Type 2 means your body is still producing plenty of insulin but your body doesn't use it properly. Forget about how much insulin other people need, everyone is different. Do a basal test first and make sure your dose of that is correct. if that is wrong nothing else works properly. Then you can start to look at how much rapid acting you need with meals.
Click to expand...

It's not true that type 2's produce plenty of insulin, especially if the hba1c is high - this generally means there's more dysfunction in the pancreas due to beta cells no longer working or beta cell apoptosis, ie, a reduction in mass of beta cells due to cell death (When cells die, the body cleans out the remains!). This is why it's better to catch it early before this happens, in the pre-diabetic stage. I've seen research that shows a hba1c of 10% can mean a 60% loss of insulin production and it may be worth treating these patients with insulin to give some relief to what is left!

The work in Newcastle appears to show that in a number of cases, catching type 2 within 6 years and reversing the causes of insulin resistance can lead to the 'dormant' cells slowly working again after a few years, but even so, the response is still slower than non-diabetics, and there's no easy way to bring back beta cell mass at the moment apart from a few experiments.

From what I've heard from a GP friend of mine, most T2 patients just take pills, carry on eating the same diet, and it just gets progressively worse which I guess is because the pancreas is giving up. It seems that need not be the case - although if genetic factors are involved, nothing will overcome them.
 
Some harsh words:
1. If you have had a +ve GAD test then you are T1.
2. The ONLY treatment for T! is insulin.
3. The best way to give it is with two types of insulin, in the way that your HCT intended.
4. You can NOT treat T1 by shooting up random amounts of insulin and eating anything that comes along.
5. You claim that change to your base insulin made no difference. How so you know this, you have no record of insulin to carbs.
6. When you change the base dose wait several days for the results to take place before make another cjange. Changes should only be made after a base test. DO THIS TEST. Unless the base is right nothing else will work as it should.
7. You MUST record the amount of carbs taken, insulin, BG and perhaps exercise, to allow your HCT to advise.
The HCT should be able to provide some factors to enable you to estimate the dose required before each meal.

Your insulin requitemanr will change over time. If the base is too low you will need very large doses pre-meal to maintain even poor unstable control.
 
Hear Hear @leonS.

Type 1 Diabetes is serious - it can actually be literally, DEADLY serious. Once we have it - it is up to US to control it well enough so it isn't deadly - all anyone else can do is try and advise us the best was to keep it that way and provide the tools that will help us - ie first and foremost - insulin - which is then up to us to keep refrigerated as necessary and then inject ourselves with it in sufficient and regular enough amounts to control our blood glucose.

Initial doses are a matter of informed guesswork by the docs and nurses - but then, we have to work out for ourselves exactly when and how much will do the job decently. 'They' can't do this for us and none of us here, can do it for you either.

Start at the beginning and plod your way through the various stages. Step 1 is to do a full 24hr basal insulin test in your own time, cos the easiest way is to divide the 24 hours up into segments of however many hours at a time, you can manage - so it takes at least, several days to complete this if not longer. It's not quick so we have to resign ourselves to that.

Once you get the basal insulin dose(s) adjusted to keep your BG tests as stable as you can for the full 24hrs, only then can you move on to Stage 2 and consider how much of the faster acting insulin per 10g of carbohydrate eaten is effective for you.
 
Take control @Upset Racoon Although Type 1 is a pain and perfection is impossible, you can get good results if you get the thing under your thumb a bit.

As said above, you need to get your basal right first. Then you need to carb count. Don’t worry about how many units other people have, have what’s right for you.

It sounds like you might appreciate some support and information. Here are two two great books about Type 1:

Think Like a Pancreas’ by Gary Scheiner.

And Type 1 Diabetes in Children Adolescents and Young People by Ragnar Hanas (ignore the title - it’s great for adults too)
 
How do you do a basal test?
Do you fast and just see what your levels are on just the background insulin?
Thank for Any advice 🙂
 
Here is a guide to basal testing. Do not try to do it all in one day. Spread it out over several days... breakfast on one, lunch a couple of days later etc.
 

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@Upset Racoon I remembered your name and that you seem to be finding it hard to accept your Type 1 diagnosis. Remember that Type 1 is an auto-immune condition and not your fault. It’s no judgement on you at all. Remember too that some Type 2s take insulin. I think you thought you were LADA? That’s just a form of Type 1 and, for example, my consultant doesn’t really use that term. I would put your concerns about your diagnosis out of your head as I feel they’re stressing you.

It looks like your control is good from your previous threads. All you need to do is do a basal test to ensure that’s at the right dose, then work out your ratios for each meal. They do NOT have to be 1:10. They might be 1:6, 1:20, 1:5 or whatever. Different meals (ie breakfast, lunch, etc) often have a different ratio. Correction factors vary too. Remember that it’s perfectly possible to be Type 1 and have an element of insulin resistance, especially if your BMI is at the higher end of normal, or you’re overweight.

Another thing to consider is the amount of time in advance that you bolus for a meal. Getting that right (once you’ve checked your basal) helps massively. You’ll find some meals will need an earlier bolus eg I have to bolus 30mins in advance of breakfast.
 
Plus - nobody expects a Type 1's BG to revert to pre meal level 2 hours after eating - only before the NEXT meal. It's a guide to judge whether a Type 2's meal is OK for them since they don't get the assistance of injected insulin so instead have to try and help their body not become overwhelmed by eating too much carbohydrate at a time.
 
Forget how much others inject for meals as it means nothing to you, or shouldn't do, what you need is what you need.
 
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