High blood sugar all day

[MaryPlain]

What would you do if this happened to you:

This morning on waking my blood sugar was a nice healthy 5.0.

I ate two low carb pitta breads with scrambled egg and had 1 unit of insulin to cover them. 1 unit is slightly more than I would normally have for 8g carbs but I have had increases from eggs before.

At the two hour mark by blood sugar had risen to 13.8 so I took a correction of 2 units, allowing for the half unit which was still active. Normally 1 unit drops me by 4, but with a blood sugar that high I figured 2 units might be a bit conservative.

Two hours later I was at 16.8! I used a pen to give myself 3 units.

Two hours later and it was back to 13.8 so I changed my complete infusion set and used a fresh vial of insulin. I realised that the insulin in the pump had probably been out of the fridge for about 5 weeks, but I'm not convinced this is the cause because a) it was working just fine until before breakfast, and b) the pen correction didn't seem to do much either.

Since then it's been stubborn at around 12 -13 even with a further correction. I didn't eat lunch because of the highs but around 5 was feeling hungry so ate some cheese and a handful of pecans. I had dinner about an hour and a half ago and injected the normal amount of insulin to cover it plus a further correction.

I tested for ketones before eating the cheese and pecans and had small ketones - probably not surprising given that I hadn't eaten anything since breakfast. I don't feel any worse than I normally would with high blood sugar, ie not brilliant, but not good either!

I have a big exam tomorrow, otherwise I would stay up and keep monitoring but I really need to get some sleep.

What would you do in my position?

 

[Pumper_Sue]

Hi Mary,
a bit late with my reply. Hope your exam goes well.
I'm wondering if it's stress due to your exam that's causing the unexpected highs?
If that's the case I would run a temp basal.

 

[Copepod]

Was going to ask if you'd forgotten your long acting dose, when I realised that you use an insluin pump.

So, like Sue, I think stress about exam is the most likely explanation. Hope you got a good night's sleep - under the circumstances, I would have prioritised sleep over monitoring, had I experienced unusually high levels when doing my MSc exams some 14 years ago, on MDI like now.

 

[MaryPlain]

Thanks Sue and Copepod. It did occur to me that it might be stress, but I have had so much stress over the years, and never experienced this before. It's also not my first exam, and it was only a mock.

I went to bed and set my alarm for when the last correction dose would run out, and by then my levels had come down to 10 so I did a small correction (just enough to bring me down to 8) and woke up this morning to a 4.2.

I've experienced high levels again today after breakfast - very strange. Not as high as yesterday - a more normal breakfast (for me) of Lizi's granola with muesli and flax seed. Because I was at 4 I corrected by taking a slightly smaller dose than I normally would (2.1 instead of 2.5) and was 11 again at the two hour mark, staying level thereafter until I corrected again. Something weird going on!

The exam was horrible, but thanks for asking! The funniest thing was because of the diabetes, college sat me in a room on my own. Evidently this was a room which someone had become accustomed to using as a prayer room, because she interrupted me twice to ask me if I was studying, then to ask whether the exam I was doing was important! 😱

 

[Copepod]

Sounds like you need to take a sign to stick to outside of door if you use the room again. Invigilator should have noted times of interuptions and give nyou extra time at end to compensate.

I invigilate exams at a historic university, popular with tourists, so sometimes have to go outside and ask them to be quiet as students are sitting exams inside. As invigilators have to wear academic robes, they usually stare at me, but do obey and shut up or walk away. My sister did her degree at the same place, and had one exam interupted by American tourists, who had ignored "Silence Exams" sign and to be asked to leave.

 

[MaryPlain]

Sounds like you need to take a sign to stick to outside of door if you use the room again. Invigilator should have noted times of interuptions and give nyou extra time at end to compensate.

I invigilate exams at a historic university, popular with tourists, so sometimes have to go outside and ask them to be quiet as students are sitting exams inside. As invigilators have to wear academic robes, they usually stare at me, but do obey and shut up or walk away. My sister did her degree at the same place, and had one exam interupted by American tourists, who had ignored "Silence Exams" sign and to be asked to leave.

I did suggest the sign to the receptionist when I complained about the interruption. As it was a mock exam, I had to invigilate myself, so I did give myself an extra minute!

I used to be a school teacher and it's amazing how many people will actually open a door and come through it, despite "exam, do not enter" signs pinned clearly on the door.

Everything seems back to normal today, so it looks like it might well have been stress. Isn't it just bizarre that the body can suddenly change the way it reacts to things.