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High despite insulin onboard

J

jessd1

New Member
Relationship to Diabetes
Type 1
Pronouns
She/Her
Bit of advice needed please
So numbers been much better
Today had day off - had usual breakfast - I have a bit more insulin (as in work day very busy/lots of walking) within an hours I was out of range & & stuck there for an hour
Did a light bit of exercise which brought it down

Then had a decent walk before lunch
Came back & had lunch & 2 cups of tea- gave correct dose for thid

Also I notice I have insulin on board but still going high??

Such a nice day - sat out side for a bit
Number rose again within half an hour
2pm- 4pm been out of range

This is doing my head in, now my TIR is ruined for the day

What can I do?
 

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your pump gives you an option for having different profiles. If you are having a problem staying in rang consider setting up a day off profile.
 
@jessd1 When things go badly, don’t look at the TIR. You know it’s going to be messed up and you know you didn’t do anything wrong to make it so. Looking at it is pointless and depressing.

I had similar - 3 lovely days of 100% TIR then the highs started Still don’t know why. I suspect a pump site issue because that’s a very common reason. The sites and cannulas are the absolute weak point of pumps. So,I’d change your cannula and your insulin too, just to be sure. I’d also do any further corrections with a pen until you know your new site is working.
 
Inka said:
@jessd1 When things go badly, don’t look at the TIR. You know it’s going to be messed up and you know you didn’t do anything wrong to make it so. Looking at it is pointless and depressing.

I had similar - 3 lovely days of 100% TIR then the highs started Still don’t know why. I suspect a pump site issue because that’s a very common reason. The sites and cannulas are the absolute weak point of pumps. So,I’d change your cannula and your insulin too, just to be sure. I’d also do any further corrections with a pen until you know your new site is working.
Click to expand...
I only changed my site yesterday-
Yes feel I need slightly more background insulin - trouble is my days off vary a bit- did have a quiet ish day today - but still sitting at 13- so maybe I will change my site - thanks
 
jessd1 said:
I only changed my site yesterday-
Yes feel I need slightly more background insulin - trouble is my days off vary a bit- did have a quiet ish day today - but still sitting at 13- so maybe I will change my site - thanks
Click to expand...

Sensible to change it @jessd1 Sometimes sites will stop working properly having previously worked fine. This can be nothing to do with the length of time they’ve been in. I had a site that worked perfectly - like the best site ever! I stayed between 4.8 and 6.3 all day and night. No post-meal spikes, just perfect. Then my blood sugar suddenly started rising and didn’t stop 🙄

I hope you get it sorted whatever the cause. It’s very frustrating fighting high sugars.
 
last night 10pm numbers back to normal - 5.9 & steady through the night - numbers on pump were saying 6.7 with arrow up this am (did bm-4.7) had usual breakfast & went to work- within an hour numbers out of range again (I let the pump do its thing) for an hour I was out of range??
Then came back down
What is frustrating is I have insulin on board - yesterday as well when I mentioned these high numbers
Don’t understand
 

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jessd1 said:
last night 10pm numbers back to normal - 5.9 & steady through the night - numbers on pump were saying 6.7 with arrow up this am (did bm-4.7) had usual breakfast & went to work- within an hour numbers out of range again (I let the pump do its thing) for an hour I was out of range??
Then came back down
What is frustrating is I have insulin on board - yesterday as well when I mentioned these high numbers
Don’t understand
Click to expand...
This was yesterday
 
Which pump are you using?

Edited at add - it’s the Medtronic from looking back at your earlier posts? From what you’ve said, it sounds like your settings might be wrong. Rather than talking to your team first, can you try to work out changes that might help, then maybe run them past your team if you feel you need to?
 
Inka said:
Which pump are you using?

Edited at add - it’s the Medtronic from looking back at your earlier posts? From what you’ve said, it sounds like your settings might be wrong. Rather than talking to your team first, can you try to work out changes that might help, then maybe run them past your team if you feel you need to?
Click to expand...
Hi, my team made changes a couple of weeks ago, I was slightly reluctant (but was going a bit low in the am) so they reduced my insulin to carb ration by 1
 
jessd1 said:
Hi, my team made changes a couple of weeks ago, I was slightly reluctant (but was going a bit low in the am) so they reduced my insulin to carb ration by 1
Click to expand...
Hi Jess
Sorry you are still having problems with your levels. I definitely agree with @Inka about not looking at TIR when you know it is an off day. These days happen and often for absolutely no obvious reason.

You mention that you are letting the pump do its things. Are you looping. Apologies if you have already said. Either way you noticed that you went out of range after your breakfast, which I will do too. This very much depends on two things:
  • The timing of my bolus before a meal. I find that I need to inject about 30 minutes before I have breakfast, and about 20 minutes at other meals. This varies for each of us and it is a case of trial and improvement and gradually adjusting the time to see what works for you. This gives time for the insulin to get active (and make it into our blood stream) and match the conversion of the carbs into glucose inside us
  • The carbs I have chosen to eat for a meal. Some of them are ‘spikier’ than others. I find any bought cereal will be spikey some make my own using quinoa rather than oats (which just don’t work for me)
Once we have gone high I find that the corrections take a bit longer to bring me down. I am looping so once I have done a pre bolus and eaten breakfast I don’t bother to look at my pump (unless I am about to drive) as I know that it will get me back in range.

I try to pre-bolus for all my meals, which is easy to do at home but I don’t do this if eating out (although there are a couple of local places that are happy to bring my meal at a set time and I know what I am getting so know the carbs) or eating at friends. Yesterday I was told when we were going to be eating but as there was a big group of us I decided to err on the side of caution and allowed just a 10 min pre bolus. A good job as there was a bit of a delay.

It is good to remember that any TIR of over 70% is really good. Having said that I still have bad days where I dip below that but I know why and count as part having T1.

It is great that your team are helping you to make adjustments and it will be worth you asking them to help you to make these changes yourself when you are ready to do so.
 
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