Blood sugar 'stuck' - any suggestions

[DeusXM]

Ok, having a bit of trouble tonight.

For dinner at 7pm I had pasta - calculated around 80g of carbs. My pre-meal BG was 5.2. I took my insulin in a 1:5 ratio so that's 16u but I took 18u just to be on the safe side.

At 9pm, I did a postprandial test and found I was at 11.8, so that's basically a complete failure to manage that meal. I then took another 10u as a deep intramuscular shot.

At 10pm I did another test. Only to find that my BG has gone UP to 13.8! I know Novorapid takes a while to work but I just can't see how my BG could go up by so much when there's supposed to be nearly 30u of active insulin on board - plus my basal. So in other words, I have nearly 60u of circulating insulin but a rising BG.

Any suggestions? I don't think the cart has gone bad but it just seems like there's nothing I can do to actually solve this.

 

[everydayupsanddowns]

Missed this last night. Hope your levels came down ok. Did you retest any if those unexpected BGs? Any chance you hit a lipo/scar?

My guess would be a combo of late-breaking pasta push and novoturgid holding the initial rise despite your best efforts.

80g might also be over your std ratio limit. Above a certain load I seem to need about an extra 30% on a bolus!

Did you have to snack much later?

 

[DeusXM]

Yeah I think I blew my standard ratio - which is pretty depressing given it's already 1:5. Still don't get quite why this is. I am probably about 10lbs overweight and ideally I'd like to lose 16lbs, but I can't get quite why I'm so insulin resistant, particularly as I try to get in at least 3 cardio gym sessions in a week (although interestingly, they also put my BG up).

I took another 10u at 10.30pm and went to bed - I know it sounds a lot but in my experience, when I get in a situation like this I need to take a LOT of insulin just to have an impact. Woke up at 4am with a hypo so I corrected for that, although interesting my Novorapid should have been done by that point so it seems more like I'd got back to a normal BG and my Lantus just tipped me over.

Woke up this morning with a 7.4 which is far from ideal but I suspect a case of over-correcting the hypo + my significant dawn phenomenon - I usually need to take 5u of Novorapid on waking just to stay level in the morning. I know that's not ideal but it's very hard for me to either increase my Lantus or split the dose appropriately so this is the next best solution.

 

[Vix]

Glad you managed to get them down a bit this morning, despite the hypo. I'd get scared of doing 2 extra units before bed nevermind 10... When do you do your lantus?

I had the same problem yesterday - I did 2 units yesterday with no carb mid afternoon at 14.8 and I was still 14.7 2 hours later (usually do 1u to correct 3mmol/L) so I then did 7 units for 24g carb at dinner (my usual dose is 1:7.5 so would have been 3 units) at 12.7 and it on'y came down to 10.8!! Woke up this morning and it's down to 6.2 but imagine it will go up this afternoon as it usually does...

Seems like a guessing game sometimes doesn't it??

Xx

 

[Phil65]

Deux, when I was on MDI I could only achieve in-range post prandials after eating pasta,pizza and rice meals by splitting my injections, usually 60/40, the 40% would be taken about an hour after eating. Also my ratio would need to be upped considerably. Thanks to my pump the problem has reduced massively! 🙂

 

[DeusXM]

I take my Lantus at 6pm so my background should have been covered.

I think to be honest, I sorta knew this was going to happen. I find it much easier to manage my pasta-post-prandials(!) if I'm using dried wholemeal pasta, whereas this stuff was the fresh stuff in a packet that you boil for about 4 minutes and is stuffed with meat and cheese.

I did do a whole dilemma thing before cooking because the nutritional info suggests you're supposed to eat half a pack, but in the pot it looked like a tiny portion. And rather than have maybe 2/3 of the pack, instead I thought I'd chuck the whole thing in.

In retrospect I'm not hugely surprised then that I had a problem but I am a bit concerned that I can inject so much insulin and for it to barely touch the sides. Does anyone have any advice on how to reverse insulin resistance? I'm already exercising regularly but my Lantus dose is about double what the official calculator says I should have for my weight and it's getting to the point that my insulin ratio is sometimes swinging quite near 1:3, rather than the more usual 1:10-1:15. I don't think it can be healthy for me to have so much circulating insulin (although I know there are T2s out there taking 100u of Lantus a day).

 

[Phil65]

I take my Lantus at 6pm so my background should have been covered.

I think to be honest, I sorta knew this was going to happen. I find it much easier to manage my pasta-post-prandials(!) if I'm using dried wholemeal pasta, whereas this stuff was the fresh stuff in a packet that you boil for about 4 minutes and is stuffed with meat and cheese.

I did do a whole dilemma thing before cooking because the nutritional info suggests you're supposed to eat half a pack, but in the pot it looked like a tiny portion. And rather than have maybe 2/3 of the pack, instead I thought I'd chuck the whole thing in.

In retrospect I'm not hugely surprised then that I had a problem but I am a bit concerned that I can inject so much insulin and for it to barely touch the sides. Does anyone have any advice on how to reverse insulin resistance? I'm already exercising regularly but my Lantus dose is about double what the official calculator says I should have for my weight and it's getting to the point that my insulin ratio is sometimes swinging quite near 1:3, rather than the more usual 1:10-1:15. I don't think it can be healthy for me to have so much circulating insulin (although I know there are T2s out there taking 100u of Lantus a day).

If you find out please let me know! I was put on metformin to help.....it hasn't made much, if any difference! I seem to take huge amounts of insulin, even though I became a pumper 2 years ago, 2.7 units per 10g carb at breakfast, 2 units per 10 at lunch and 2.5 per 10 for dinner, despite a basal of 46 units! I am a big guy but I do get worried about the amount of insulin I need to take.