High BG for a few months, but no ketones?

[Bumblebuzz]

I was diagnosed in January 2018, I’ve had pretty tight control on my BG up until the past few months. I’ve had a few good days but most of the time it has been at least 8.0-16.0 but every time I’ve tested ketones, they’ve been below 0.2. I‘m 14 so could it be to do with the p word?(I feel uncomfortable saying it ) My cat (also my best friend) died 2 months ago as well, so could it be grief? I’m getting really worried now and that’s obviously no good for my BG so if anyone has advice pleaseeee give it.

 

[Kaylz]

Are you on injections? If so what? Have you tried increasing your basal? Yes hormones can effect BG but not for months, generally just before and during (can't say I have experience as I don't have them being on the contraceptive injection) have you spoken to your team? Done a basal test? xx

 

[rebrascora]

Hi and welcome.

It is good that you don't have ketones (well done for testing) but what have you been doing to reduce your BG levels? Do you know how to make corrections with bolus insulin to bring them down and back into range or are are you doing that and your levels are drifting back up again?
Do you have Freestyle Libre sensors so that you can see what your BG levels are doing without having to prick your fingers too often?
I agree with @Kaylz that it may well be that your basal insulin needs adjusting. If you haven't been taught how to do this, contact your team. Whilst we can give general suggestions of what to try, we are not allowed to give dosing advice so speaking to a DSN at your clinic would be best. Many of us experience a change in basal needs with the colder, darker days of autumn/winter, so this may be what you are experiencing.

So sorry to hear that you lost your cat. Certainly stress and grief can cause your levels to be higher, but whatever the cause, you need to find a way to get them back in range with the help of your health care professionals.

Good luck and let us know how you get on?

 

[Sally71]

My daughter is 14 so I know life is tough at the moment if you’re that age. Ketones below 0.2 is exactly where you want them to be so don’t stress about that!
Are you on injections or a pump? It sounds like your doses probably need a tweak, are you able to get in touch with your hospital team? Possibly you need to increase your basal a bit but we can’t tell you how much by, everyone is different.
Stress can certainly mess about with your blood sugars, as can hormones. I don’t know if you are male or female, if by the “p” word you mean female monthly cycles then yes that can mess about with things but probably only for a few days at a time. If you mean puberty then that plays absolute havoc with it and can do so for 2-3 years (my daughter's insulin requirements at least doubled during that time and that is perfectly normal according to our consultant). We had to increase her basal by about 30% all at once and it's never really gone down again. We’ve had to change her carb ratios by quite a lot over the years too. Diabetes never stays the same for long and you will probably find that you have to adjust things from time to time all through your life. Good luck 🙂

 

[Bumblebuzz]

I am on 7 lantus and my ICR is 1:12 (my mum contacted the team and they changed the ratio and lantus was changed from 6 units to 8, but I was having lows after tea on 8 units so I took it down to 7). I feel like it could be to do with puberty and the change from summer to winter, I was going on walks + gardening during the summer, but now I’m going outside for a maximum of half an hour per day. My parents are thinking about investing into a freestyle Libre because it would be helpful.

 

[rebrascora]

It sounds like you are managing things pretty well and have a good understanding of how to adjust things.
It may be that your ratio for tea was too high and lowering that but leaving the Lantus at 8 might have been better or it could be to do with what you had for tea.... Things like pasta and pizza can be slow to release the glucose which means the insulin takes effect and drops your levels before the food is digested and your BG levels spike later at night. Some people split the dose of bolus insulin and take half before eating and half afterwards to deal with meals like that.

It would be worth you discussing Freestyle Libre with your team as it is possible to get it on prescription if you fulfil certain criteria, but self funding is an option if you can't get it through your medical team, if you (your parents) can afford it. I used my birthday money to self fund it and I loved it so much I couldn't think of a better present anyone could have given me!... Perhaps that makes me a bit of a saddo! 🙄 Thankfully I now get it on prescription.

 

[Sally71]

@rebrascora beat me to it - I was going to say that another thing to think about is that you might need a different carb ratio later in the day, my daughter's at the moment are 1:7 at breakfast time, 1:8 at lunch and 1:10 at tea time. A Libre would certainly help you to find out where the peaks and troughs are and whether there are any patterns, then it's easier to work out whether it's your basal or your boluses which need adjusting.
Oh and if you are less active at the moment than you used to be then that might well be a factor!

 

[rebrascora]

PS. I think you are very perceptive to realise that your reduced outdoor activity may well be part of the problem. Gardening and walking are both great activities for lowering your BG levels, but obviously opportunities are restricted at this time of year. Can you do some physical activity in the house... maybe a workout every evening or put on your favourite music on and have a good dance for half an hour in your room. The dancing will help to lift your mood as well as being good exercise.

 

[trophywench]

Or offer to do the ironing - apart from pleasing your mum anyway (a welcome side effect possibly?) I always found that lowered my BG, as always does vacuuming 'properly' which involves moving furniture. Sorry to be boring! Want to come and clean the wall tiles in my bathroom for practice?

 

[everydayupsanddowns]

Welcome to the forum @Bumblebuzz

Good to hear that you and your Mum are in contact with your clinic to get advice.

But yes, stress/grief can certainly affect BG levels, as can changes in activity, and also changes in the seasons. Many members here expect their insulin needs to vary up and down a little as the year rolls around. Perhaps it’s a combination of everything that is building up to have an effect for you.

Hope you can work with your clinic, and do your own cautious experiments, to slightly tweak your doses and ratios to keep your BGs a bit more in range.

Are you feeling a bit grim with those higher levels? I tend to feel a bit grumpy and generally frustrated with life when my BGs are high and won’t behave!