High blood sugars

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I could not ever, possibly, not allow my BG to get over 10 OR just not eat if BG isn't low enough - I always worked in an office so one hour for lunch and all paperwork so couldn't keep eating, or indeed drinking, coffee and teabreaks at specific times end of story. Everything done to specific times whether it's office hours, buses or trains - in retirement husband's body clock insists lunch about 1, dinner about 6 to 6.30. If it's the insulin you use that causes having to mess about well try another one instead. How about Apidra? Patti used that OK for years, (she might still, not sure now) before that on MDI she used Humalog and found it worked quicker than the H, which has a sting in its tail for most people, which I've never ever found for Novorapid.

I agree when sh*t happens you just have to deal with it BUT I do know that if I stack boluses with Novorapid, it will only have exactly the same effect of injecting the whole lot at once and hence would never normally stack, and never share it when I do anyway since it's so very unwise to ever do it until you know yourself 100% what's going to happen. At least that's where my BG meter/pump handset comes its own, because it knows instantly exactly how much IOB I have and how much longer that's going to be active for, I fingerprick and press the 'calculate bolus' button, and it calculates whether I need any more or not. If so obviously I have it, then I just carry on with my life anyway. I don't usually test or indeed scan between meals unless there's a specific reason eg I need to drive somewhere in the next half hour. Libre is only a vague representation of BG for me anyway, nowhere near accurate enough to base insulin dosage on - annoyingly at the D clinic last week it was only 0.3 different to my fingerprick immediately before scan but since then despite giving the replacement 24 hrs to bed in before starting it. This one's miles out. That first one hadn't actually finished but had fallen off my arm in the night the day after my appointment. I had actually thought one edge had got a bit loose but being me hadn't asked Pete to stick a bit of micropore tape over it just cos I was too bloody lazy to bother, cos I am too bloody lazy to do a lot of things these days frankly, so its only me that pays the price.

My mom's comment about you celebrating what the D clinic said to you, then that mega hypo, had it been me would have been "Well, they always did say that pride comes before a fall, Jen, didn't they!"

😉
 
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trophywench said:
My mom's comment about you celebrating what the D clinic said to you, then that mega hypo, had it been me would have been "Well, they always did say that pride comes before a fall, Jen, didn't they!"
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But I didn't have a mega hypo or even any hypo last night. The lowest I came down to was 7.6 before it headed upwards again and Fiasp works really well for me most of the time, otherwise I would not be able to achieve the results I do with it, but I do have to be very proactive with it. And I calculate my own IOB in my head from my Libre log where I document every injection, so I can see the time I took it and how much etc. I don't need a machine to tell me that.
My gut feeling is that my liver was triggered into pumping out glucose like there was no tomorrow for some reason probably the huge sugar rush from the cake as I did have a wave of nausea just after I gave up on it or my Fiasp was not working last night, but it has not degraded, because it is working this morning and I injected those corrections into lots of different sites, so it is not like it got trapped somewhere and didn't release which could of course happen with one single large dose. My past experience has shown me that Fiasp needs to be stacked for me once I get over 10.

It took me 2 x 3 months of intense frustration to get the hang of Fiasp and all it's quirks. I don't love it but I like the fact that for me it is spent in 3 hours and I can usually see if it is having the desired affect in half an hour after injecting. My consultant is of the opinion that other "quick" insulins would be no better for me and considering how long it took to get the hang of Fiasp I would be extremely dubious of changing again, to something that may well be no better, plus I would have to unlearn all the strategies I currently use which can be a lot harder than learning new ones, because a lot of it becomes instinctive.

I posted about it so that people can see that there are circumstances where you need to break the "rules" for whatever reason and as long as you monitor your levels closely with CGM, it is not dangerous and certainly less dangerous than letting BG levels keep climbing to very serious levels and be too frightened to do anything about it, for fear of breaking the "rules". The important thing is to keep yourself safe, know the risks and offset them by monitoring closely with fast acting carbs to hand if need be.
 
Personally I find that having any TIR in the mid to high 90s is pretty much a guarantee for something to mess it all up 🙄 Diabetes has lots of little rules like that: great TIR, highs approaching; important meeting, temporary cure where you struggle to keep your blood sugar above 4; blood test at the GP, you randomly wake up with a 12mmol, etc, etc.

@rebrascora I know you said you didn’t want to try another bolus insulin, but for many people Humalog works better than Novorapid. In fact, Dr Bernstein rates it as ‘stronger’ even though on paper it’s not. As a not infrequent cake consumer, I know that my Humalog would sort out any cake miscalculations and get any high down in 1 and 1/2 to 3 hrs. But generally I find cake fairly ‘friendly’ so don’t go too high. It sounds like you had a super-sweet one and sometimes they can cause a bigger than expected rise.

I see both your points @trophywench and @rebrascora so I’m adding to them, not contradicting anyone, but the only time I worry about stacking is with corrections. I’m very cautious about adding extra insulin. Sometimes when you’re high, the insulin takes a while to have an effect but when it does, it can have a massive and very unpleasant effect. Think being hit with a sledgehammer or falling over a cliff. Not even CGMs can stop every hypo because if you have a quantity of insulin there and it’s suddenly working at full speed, there’s not a glucose tablet/glucose drink that can stop it in time. You can eat/drink them but they won’t work in time to stop hypo seizures (which are terrifying) and possibly unconsciousness.

I know that modern insulin regimes, modern insulins, and modern tech have reduced the number of severe hypos, but they’re always there as a possibility and it takes one bit of bad luck or over-enthusiasm with the insulin for them to hit you like a brick wall. Once you’ve had one, you don’t forget. Insulin is our life-saving friend but it can turn on us in an instance. Always err on the side of caution - which is something I write a lot, but something I follow religiously.
 
Inka said:
I see both your points @trophywench and @rebrascora so I’m adding to them, not contradicting anyone, but the only time I worry about stacking is with corrections. I’m very cautious about adding extra insulin. Sometimes when you’re high, the insulin takes a while to have an effect but when it does, it can have a massive and very unpleasant effect. Not even CGMs can stop every hypo because if you have a quantity of insulin there and it’s suddenly working at full speed, there’s not a glucose tablet/glucose drink that can stop it in time. You can eat/drink them but they won’t work in time to stop hypo seizures (which are terrifying) and possibly unconsciousness.
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It is interesting, but I find stacked corrections much less risky than a rage bolus which I was sometimes want to do before, and it is really something that developed as a result of using Fiasp because it was the only way to make it work for my body. The peaks of activity are spread over a period of time with stacking, so I don't get a massive drop and in fact despite all of that stacked insulin yesterday, every single scan showed an horizontal arrow on my Libre after those 6 stacked corrections and I scanned lots, not even a downward sloping arrow once!!
I appreciate what you are saying and I do think a lot of it is the nature of Fiasp, but for the odd occasion when this happens it simply is not worth changing to another insulin. I have been using Fiasp for 3 years now and a lot of these strategies are ingrained and it could potentially be dangerous changing if other insulins act significantly differently and I automatically use them in the same way. I will stick with the devil I know thanks. The cake really wasn't worth a repeat experiment. I used to love sweet stuff and I see such things on occasions like that, looking all gorgeous in the display cabinet and think I still do like them, but in reality I don't and my body definitely doesn't!
 
Just coming back to this thread because the following day (last Thursday) I had a bit of a tight throat and by Friday it was clear I was coming down with a cold, I spent the weekend flattened by what I thought was a really heavy cold but today I did a lateral flow test and it was VERY positive for Covid..... so maybe it wasn't the cake responsible for my levels going high and refusing to come down and needing ridiculous amounts of insulin, but my body gearing up to fight an infection. I am currently up 7 units of Levemir and about double my Fiasp but managing to keep in range most of the time with those adjustments.
 
Oh noooooo!

Hope it passes speedily with no follow-on nastiness and your BGs settle back down again really soon. Always such an upheaval isn’t it :(
 
everydayupsanddowns said:
Oh noooooo!

Hope it passes speedily with no follow-on nastiness and your BGs settle back down again really soon. Always such an upheaval isn’t it :(
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Had a couple of minor hypos today so time to start reducing the Levemir again it seems. Unfortunately I lost my sense of smell completely 2 days ago, just as I was starting to feel I was over the worst and my taste isn't right either but at least I do still have some, so I'm thankful for small mercies, but you don't realise how much you rely on your sense of smell. Oddly I feel a bit vulnerable without it.
 
rebrascora said:
Had a couple of minor hypos today so time to start reducing the Levemir again it seems. Unfortunately I lost my sense of smell completely 2 days ago, just as I was starting to feel I was over the worst and my taste isn't right either but at least I do still have some, so I'm thankful for small mercies, but you don't realise how much you rely on your sense of smell. Oddly I feel a bit vulnerable without it.
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Hope the drop in Lev requirements you are on the mend. Get well soon.
 
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