High glucose reading

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Debby11

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My glucose reading has been high since yesterday 16 to 17 and I can’t seem to get it down no one available to ask at my doctors I wonder if anyone could help. I am fairly new to diabetes after having my pancreas removed.
 
Debby11 said:
My glucose reading has been high since yesterday 16 to 17 and I can’t seem to get it down no one available to ask at my doctors I wonder if anyone could help. I am fairly new to diabetes after having my pancreas removed.
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We have a few people with Type 3c which is what you will be if you have no pancreas. I would contact your diabetic clinic as your GP is unlikely to have the experience of your Type of diabetes.
However some more information about what medications you are taking will help people to help with some suggestions.

Apologies I didn't read your previous posts.
 
I take insulin 4 times a day …2 different types in morning Toujeo and Novo rapid and Novo rapid before each meal. My diabetic nurse at Doctors surgery had never come across T3 before and I am still waiting to be referred to hospital diabetes team.
 
Debby11 said:
I take insulin 4 times a day …2 different types in morning Toujeo and Novo rapid and Novo rapid before each meal. My diabetic nurse at Doctors surgery had never come across T3 before and I am still waiting to be referred to hospital diabetes team.
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Even if your nurse hasn't heard of type3c she should be treating you as type1 anyway. If your levels are high when you wake and still high at bed time then it's your long acting insulin you need to increase.

Only do a couple of units at a time and wait a couple of days before you increase again if needed.
Once your background is ok (long acting) then look at your meal bolus. Don't try changing everything at once because it will cause you a lot of confusion (and everyone else) as you wont know what worked and what didn't.
 
Leadinglights said:
We have a few people with Type 3c which is what you will be if you have no pancreas. I would contact your diabetic clinic as your GP is unlikely to have the experience of your Type of diabetes.
However some more information about what medications you are taking will help people to help with some suggestions.

Apologies I didn't read your previous posts.
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Silly question? but wouldn't the NHS have mentioned it to the GP when someone had had surgery undertaken to remove a pancreas?...
 
Debby11 said:
My glucose reading has been high since yesterday 16 to 17 and I can’t seem to get it down no one available to ask at my doctors I wonder if anyone could help. I am fairly new to diabetes after having my pancreas removed.
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First thing - change your insulin pens/cartridges. Occasionally, insulin degrades and becomes less effective. Has anything changed that might be causing the highs, eg are you ill, stressed, etc? Have you changed your diet? Are you counting carbs and adjusting your mealtime insulin? Do you know how to do correction doses? When did you start on insulin?

Lots of questions there @Debby11 but all that information will help.
 
Debby11 said:
I take insulin 4 times a day …2 different types in morning Toujeo and Novo rapid and Novo rapid before each meal. My diabetic nurse at Doctors surgery had never come across T3 before and I am still waiting to be referred to hospital diabetes team.
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Good that you are on insulins already, as without a pancreas this is essential.

Your Tujeo is your background insulin which is dealing with the glucose that your liver is dribbling out all the time to keep your body ticking over. The Novorapid is a quick acting insulin which deals with the glucose that comes from the carbohydrates that you eat.

If this has suddenly happened, it maybe that you need to change your insulin cartridge/pen. If it been excessively hot, or out of the fridge for more than 28 days it could have degraded. That is always a good first step. Otherwise your insulin doses need changing and you need to be advised on how to do this safely. Your body needs more than you are injecting. As others have said you need to adjust this slowly and wait a couple of days to see the impact a change each time.

Your nurse at the Practice needs to treat you as if you are T1, as this is the closest diabetes match for your 3C, whilst there will be other digestive issues to take account of too. you are best supported by the soecilaia team at the start as the Practice team are rarely familiar with the nuances of T1, so you need an urgent referral. With your high levels this cannot wait.
 
When you say "can't seen to get [BG] down" what have you done?

I can not advise on treatnent but I would inject sn extra 4 units of novorapid at every meal until lt did come down, Then set about getting the treatment right as suggested
 
Also, have you a means to test for ketones?
 
leonS said:
When you say "can't seen to get [BG] down" what have you done?

I can not advise on treatnent but I would inject sn extra 4 units of novorapid at every meal until lt did come down, Then set about getting the treatment right as suggested
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That is not a good idea is it? We have no idea what the correction factor is for OP, with some people that extra insulin would drop them by 12 points but for me it would be 24 points as I have a 1unit drops me by 6.
 
Inka said:
First thing - change your insulin pens/cartridges. Occasionally, insulin degrades and becomes less effective. Has anything changed that might be causing the highs, eg are you ill, stressed, etc? Have you changed your diet? Are you counting carbs and adjusting your mealtime insulin? Do you know how to do correction doses? When did you start on insulin?

Lots of questions there @Debby11 but all that information will help.
Click to expand...
Inka said:
First thing - change your insulin pens/cartridges. Occasionally, insulin degrades and becomes less effective. Has anything changed that might be causing the highs, eg are you ill, stressed, etc? Have you changed your diet? Are you counting carbs and adjusting your mealtime insulin? Do you know how to do correction doses? When did you start on insulin?

Lots of questions there @Debby11 but all that information will help.
Click to expand...
I will try changing my pen . My diet has not changed not eating much at the moment and not really counting carbs . I have increased my meal time insulin by 1 unit today and not sure on correction doses . When I rang the Doctors they advised ringing 111 which I haven’t done yet now reading 12 this evening after a day of highs . Thanks for reply.
 
Pumper_Sue said:
That is not a good idea is it? We have no idea what the correction factor is for OP, with some people that extra insulin would drop them by 12 points but for me it would be 24 points as I have a 1unit drops me by 6.
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Exactly so. This is why the post reads "I can not advise you on treatment..."
 
leonS said:
Exactly so. This is why the post reads "I can not advise you on treatment..."
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So why did you go on to say inject 4 extra units per meal?
 
Debby11 said:
No I don’t…think I have a lot to learn
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If blood sugars are high you can develop ketones, which is a bad thing and can be a medical emergency. Now you are down to 12 it should be fine, but it may be worth looking at 'the sick day rules' for next time you are persistantly in the 15s, and asking for some way to ketones from the clinic.
 
Debby11 said:
I will try changing my pen . My diet has not changed not eating much at the moment and not really counting carbs . I have increased my meal time insulin by 1 unit today and not sure on correction doses . When I rang the Doctors they advised ringing 111 which I haven’t done yet now reading 12 this evening after a day of highs . Thanks for reply.
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It could be that your basal (Toujeo) insulin dose is too low. Did you say how long you’ve been diagnosed? If you’ve been referred to a hospital team but haven’t yet been seen, you could try giving them a ring, asking to speak to the diabetes dept and a DSN. They might be able to give you some basic initial advice.

When you say that you’re “not really counting carbs”, what do you mean? Carb counting is crucial. The amount of Novorapid you take per meal should be appropriate for the carbs you’re about to eat. This amount will vary depending on the individual. The doses you’ve been given are just estimates and starting points. You should eventually have meal ratios that you use. These might be different for each meal (breakfast, lunch, etc). Meal ratios are how many grams of carbs one unit of insulin covers.
 
Inka said:
It could be that your basal (Toujeo) insulin dose is too low. Did you say how long you’ve been diagnosed? If you’ve been referred to a hospital team but haven’t yet been seen, you could try giving them a ring, asking to speak to the diabetes dept and a DSN. They might be able to give you some basic initial advice.

When you say that you’re “not really counting carbs”, what do you mean? Carb counting is crucial. The amount of Novorapid you take per meal should be appropriate for the carbs you’re about to eat. This amount will vary depending on the individual. The doses you’ve been given are just estimates and starting points. You should eventually have meal ratios that you use. These might be different for each meal (breakfast, lunch, etc). Meal ratios are how many grams of carbs one unit of insulin covers.
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@Debby11 first posted in Aug 2022 and talked about possibly needing her pancreas removed but I can't see if that actually happened.
 
Inka said:
It could be that your basal (Toujeo) insulin dose is too low. Did you say how long you’ve been diagnosed? If you’ve been referred to a hospital team but haven’t yet been seen, you could try giving them a ring, asking to speak to the diabetes dept and a DSN. They might be able to give you some basic initial advice.

When you say that you’re “not really counting carbs”, what do you mean? Carb counting is crucial. The amount of Novorapid you take per meal should be appropriate for the carbs you’re about to eat. This amount will vary depending on the individual. The doses you’ve been given are just estimates and starting points. You should eventually have meal ratios that you use. These might be different for each meal (breakfast, lunch, etc). Meal ratios are how many grams of carbs one unit of insulin covers.
Click to expand...
Hi had my operation in March this year so still learning. I do know about carb counting only through the internet but nobody has explained to me yet what to do when I have counted them ! My referral to the hospital team seems to be taking an age…I got a text to say as was on the waiting list to see them. I would like to take the DAFNE course I hear it is very helpful.
 
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