Getting just a bit worried.....

[rebrascora]

My body is suddenly not responding to insulin.....

I unusually woke up to a nice flat relatively horizontal line overnight on my graph this morning on 7.6 after months of persistent nocturnal hypos, even with no evening Levemir, although I took 1.5 units last night and went to bed with a minor correction on board as well, as levels had started to rise towards bedtime with no appreciable carbs on board. I congratulated myself on my flat line and thought maybe I have cracked the problem and was feeling really good. I jabbed my 20 units of Levemir and 2 units of Fiasp to cover FOTF before I got out of bed as usual and got up, had a cup of coffee with cream and 10g carbs (unbolused) and scarpered up the hill to feed and muck out my GGs, which, with the 2u of Fiasp, I expected to hold me steady or perhaps drop me a bit. Dashed back home to get a shower and defrost the car to get to a breast screening appointment for 9.14am. Got out of the shower to find my reading was a shocking 15.3! I know I was a bit stressed about getting to the appointment on time, but surely not that stressed! I jabbed 5 units which I thought was generous and headed off for the appointment. 16.3 when I got in the car 10 mins later to drive. Got to the appointment and all done then went shopping, keeping a close eye on levels as I fully expected a sudden drop with that big a correction. I got back home at 11.24am on 12.9 and a level arrow after 2 hours of shopping, an activity which normally drops me, let alone without a 5u correction on board!

At this point I was getting concerned and jabbed another 7units of FIasp hoping I might get some breakfast out of it.... I admit I ate a few nuts as I was a bit hungry and had more coffee with cream as I was starting to feel really tired. High BG really affects me like that. An hour later it had gone up a little so I jabbed another 5u. Fiasp can be a wimp at high levels like this and sometimes needs stacked corrections for me but this was a bit of a rage bolus in desperation as I had been mid teens for 5 hours. Half an hour later and I had gone up another mmol so hit it with another 4u. I also checked my Levemir pen to make sure I really had done my morning dose and, yes I had and checked pen/needle was dispensing properly.

I was absolutely shattered despite 3 coffees, so having tried exercise, a hot shower and shopping for lowering my levels I climbed into bed to see if sleep would do it. Have had 3 hours kip with all that stacked insulin on board and still in the teens and heart thumping as it does with levels this high, so I have just hit it with another 5u, but starting to get really worried now! Don't think I can be at risk of ketones as I have had plenty of insulin but will check with Ketostix next visit to the little room. Even if my Fiasp was somehow compromised, I haven't had enough carbs to be this high, but obviously trying a new cartridge is the next option as I just changed to a new one last night.

The last time this happened I came down with Covid a day and a half later, but on that occasion I only used 21 stacked units of Fiasp and I kept it below the teens.... and I had had half a piece of very sweet birthday cake. I have now had 28u of Fiasp today and just 30g carbs including the carbs in the nuts, so something is very wrong!

Heading out to do evening stables so maybe some more exercise will bring me down a bit, but taking insulin with me just in case I need more.... as well as lots of JBs of course! Really hope I am not coming down with something but in some respects it will be a relief if I do, so that I know why my levels have gone so haywire.... Trying not to panic about it but it is a struggle.

Here is my graph for today as compared to the 2 previous days when ....

 

[helli]

Sorry to read about your “watery insulin”.
Have you tried changing your cartridges for your pen to check your insulin as not gone on strike?

 

[Inka]

I know how stressful and unpleasant it is to stay high like that @rebrascora A few thoughts:

- have you changed both your insulin cartridges as a precaution (even if you think the insulin is ok)?

- could it be a lack of food/carbs making your body pump out glucose? My body does that as I think I’ve mentioned to you (?) before. I find eating and bolusing even if I’m 11 or 12 gets my blood sugar dropping whereas if I avoid food because I’m high, I’ll stay high for hours despite corrections.

 

[Robin]

My first thought was, try changing the cartridge, then I read you’d just started a new one, Do you think you might have got a duff one? Try a change.
Edit, an afterthought, if it was a new box, suspect the whole box and try one from a different box if youve got one.

 

[JonathanGi]

I thought it was just me that these strange things happen to. It's a strange condition. I hope you are now feeling ok. This is probably not a lot of help but. ...

 

[Lucyr]

Maybe you’re coming down with a cold?

 

[rebrascora]

@Inka I started the day with 10g carbs (unusually for me it was a dark chocolate ginger biscuit, so a small carby item) and things went upwards from there but as I always eat low carb, I know that isn't the issue. I am not starving and have eaten during the day but mostly normal low carb things like cheese and olives, so as not to make things worse. Carbs are definitely not a magical cure for high BG in my case.

@Robin and @helli I am pretty certain that it isn't the insulin. It was the third cartridge from the box, but as luck would have it I have a part used Fiasp Flexpen in the fridge left over from when I couldn't get the cartridge refills the prescription before and I have used that a few times so I know it works, so my next correction is from that but I find it impossible to believe that one cartridge from a box of 5 can be so ineffective when the first 2 were fine, so I really don't believe that is it. On a production line it would be impossible for one cartridge to be filled with water or near water, and to see so little impact, it would have to be incredibly dilute.

@JonathanGi Nice to know it happens to others.... not that I wish it on anyone as it is worrying. I always feel a bit guilty posting about stacking corrections which is very much against guidance I know and 2 large corrections within half an hour is really naughty, but I monitor my levels closely both when things work well and when they don't and I know that if Libre goes up instead of down half an hour later, even if it is just a few decimal places, I need more. I also think it is important for people to know that this sort of thing happens occasionally and sometimes you just have to fight it as best you can and if necessary flout the guidance as long as you risk assess it and have a plan to cover the risks.

@Lucyr That is my gut feeling, that I am coming down with something but no symptoms of anything yet. I guess I will know in a day or two unless my body manages to fight it off completely before symptoms appear.

I feel a little less worried now as I don't feel I am having to fight it quite so hard compared to earlier and I am at least keeping it steady, it's just too high. I think my main difficulty tonight is trying to decide how much evening Levemir to take. It has been zero for several weeks and often still having nocturnal hypos which I believe is partly down to the Amitriptyline but I increased it to 1.5 last night because I hadn't been as active yesterday. My levels rose a bit overnight but then absolutely took off this morning, so I am guessing I am going to need more rather than continue to firefight with Fiasp through the night. I am holding steady between 13 and 14 at the moment but been persistently above range for over 12 hours and the last correction was 4 hours ago so going to stick another one in (from the Flexpen) and then decide in a couple of hours on the Levemir dose when I see how that is panning out.

Thanks to all of you for your kind input and "Care" emojis. It is reassuring just to be able to share it with people who understand. I think it is times like this when you get a sense of how isolating diabetes can be, so being able to reach out to others who understand, can be a real comfort.

 

[rebrascora]

Well, 3 units from the Flexpen when I was on 13.0 and 2 hours later I am 13.4, so at least still maintaining things near enough where they were. Think I am going with 4 units of Levemir rather than stick another correction in and may increase my morning dose too if there is no significant improvement when I wake up.

@helli Just so you know I have also changed my socks just in case they were the issue, being the wrong shade of black or something. 😉 The new ones have a butterfly motif. Maybe the diabetes fairy can hitch a ride on one of them and bog off to visit someone else!

 

[Elenka_HM]

I know this is not the point of the thread but I just realised I also have butterflies in my socks and thought it was a funny coincidence 😉 (wanted to add a picture but my phone is not cooperative).

Hope you are not coming down with anything and your levels come back to normal soon. I get is frustrating. I would be scared to stack corrections like that but you know your system and it works for you.

 

[nonethewiser]

Thoughts are your going to come down with something @rebrascora as you've already done the precautionary things.

This can happen to myself days before, maybe not as stubborn & need same amount of insulin you used yesterday but can get some form of insulin resistance going on day or two before a bad cold for example.

Anyway wishing you well & hope today is a better day my friend.

 

[rebrascora]

Well I achieved a pretty horizontal line during the night undulating mostly between 13 and 14 despite a 3 unit correction from the flexpen and 4 units of Levemir and then a bit later I decided to try @Inka's suggestion and jabbed myself another 7 units of Fiasp and ate 25g carbs. I never went below 12 or above 15. I couldn't keep that steady if I was trying really hard, so it seems odd, almost like my liver is topping me up to a predetermined level. I have even walked up and fed and mucked out the horses and have come back for breakfast, so jabbed another 8 units of Fiasp, Oh... and I increased my Levemir this morning by 2 more units so 10% on top of the increase last night which was 2.5units, so a total daily increase of about 20%. Sitting looking at my breakfast yoghurt and impatiently scanning my Libre every few mins in the hope it will drop below 10 with those measures I have taken, so that I can actually eat it without another stacked correction.

 

[rebrascora]

Got to 10.3 and decided I couldn't wait any longer and it was close enough, so I have eaten my yoghurt and berries and on the way back up again now without quite dropping below 10 😡 Still it is the best reading I have had in 24 hours, so I just need to be a bit heavier handed still I guess. Going to jab another 4u and that is my last intervention for a few hours.

 

[JonathanGi]

Hope you're ok.

 

[Lucyr]

Got to 10.3 and decided I couldn't wait any longer and it was close enough, so I have eaten my yoghurt and berries and on the way back up again now without quite dropping below 10 😡 Still it is the best reading I have had in 24 hours, so I just need to be a bit heavier handed still I guess. Going to jab another 4u and that is my last intervention for a few hours.

Try not to stress about it. I know it’s higher than you’re used to but a few days of 10s won’t kill you. Stressing about it will just make you higher.

 

[eggyg]

Just catching up Barbara. Wow! What a conundrum. What about your injection sites? What do they call it? Lumpydumpy something or other. I’ve just managed to find the right word by Googling lumpy skin! Lipohypertrophy! Nowt like lumpydumpy! What do I know? That’s my only offering as I see you’ve had lots of suggestions. Hope you get sorted very soon and if you are coming down with something it’s not too nasty. Big hugs. X

 

[rebrascora]

Delighted to report that those last 4 units plus the increased Levemir of course, did the trick and I very briefly dropped to a 5..WOOHOO!!, but having bolused double what I normally would and eaten lunch, I am now 8.1 with a vertical upward arrow. Still it has encouraged me to keep on being heavy handed and it will eventually come down and hopefully stay down and return to normal in due course. There is no way I would have dared inject so much insulin like that if I hadn't had Libre so really do appreciate how wonderful it is at times like this.

@eggyg Not worried about Lumpydumpy as a cause thanks. Too many injections in too many different places all with little or no response for it to be that and nothing looks or feels out of the ordinary, so pretty confident to rule that out, but appreciate the thought and it has definitely put a smile on my face, which is worth a lot!

 

[Jade]

The frustrations of diabetes when get highs for unknown reasons. I have taken insulin for over 25 years, but not used fiasp or levemir, so haven’t experienced how they work. But have had times when insulin feels like water and you keep taking corrections and nothing really works. Be careful with your levels when your body decides to use the insulin and causes your blood glucose to crash down and to keep dropping low for next few days.
Cgm’s are good for lows, constantly knowing what bg is and showing patterns but so frustrating when showing all the highs. Sometimes better not knowing.
Hopefully your bgs will sort themselves out soon. Do you have contact with diabetes nurse to get help?

 

[Inka]

Do you feel at all unwell @rebrascora ? I had an extremely mild cold of which the main symptom by far was blood sugar between 12 and 15 for a day or so despite increased basal and corrections. It was very strange as it was the mildest cold I’ve ever had with hardly any symptoms at all apart from that.

Glad things are getting back to normal. It’s such a relief, isn’t it?

 

[rebrascora]

@Inka I have been a little bit shivery, but nothing else at all and of course it has been frosty the last couple of nights, so that could easily account for being shivery. Nose is dry, so nothing else to indicate a cold/virus.... yet. I guess there is still time as this is certainly happened a day and a half before I came down with Covid in October.

Delighted to report that I didn't need a correction after lunch and levels came back down from the 8s with the insulin I had injected, so looks like normal service is resuming albeit with increased basal and double bolus, but keeping an eye on things and will reduce those as soon as I can. I do find that Fiasp is an absolute wimp once levels get above 10 which is why I work hard to keep below 10 and usually proactively correct at 8, plus I find that my Levemir units are a lot more powerful than my Fiasp. ie. I can firefight and need say 10 units of Fiasp to keep a lid on things but an increase of just 2 units of Levemir will do the same job as those 10u of Fiasp. ie a 2unit increase in basal will put things right when a combination of corrections amounting to 10 units of Fiasp over the day was struggling. Not sure if that makes sense.

 

[Inka]

My mild cold started with feeling cold when it wasn’t particularly. I didn’t feel feverish just colder than normal and needing to wrap up and have an extra blanket in bed. Then I sneezed a few times but didn’t have a runny nose. My head just felt a bit funny and my ears and throat ever so slightly dry/lumpy (bad description but I can’t think of how to describe it!) For a couple of days I was pretty tired too - and that was it! No coughing, no runny nose, just a general feeling of malaise.

I’m pleased things seem to be working ok now 🙂