High levels on pain meds

[Mr Lee]

Hi, i am on pain medication for diabetic neuropathy which is greatly affecting my daily routine. Sleep, Eating, Exercise and the use of many pain killers have all recently changed. So have my blood readings, I normally hover around the 14 to 20 figures during the day, but my levels have not been below 22 for nearly a week, average is 25 to 33. Strangely increasing insulin to double amounts has very little effect?

Is it possible that being in great pain can actually cause the body to increase levels? or is it more likely that the pain killers are causing it to rise? or can pain relief meds lower the strength of the insulin?

Thanx.

 

[Kaylz]

Hi and welcome to the forum

Those are pretty high levels to begin with, are you working with your team to lower those as 14-20 is double the target range and more

Yes pain can significantly increase BG levels as can stress, illness and many other factors

May I ask have you tried using fresh insulin? You don't say whether your MDI or pump but with this recent warm weather there is a chance that your insulin has gone bad so that's worth a shot
xx

 

[Inka]

I agree - first thing is to change your insulin pen/cartridge (if you haven’t already). Personally, I’d change both insulins if you’re on MDI.

As well as pain, stress and illness, I also find that poor sleep can mess up my blood sugar eg if I get up during the night or am awake for any significant amount of time. So it could be a combination of factors affecting you.

Those high levels must be making you feel like rubbish so I hope you can get it sorted quickly. With levels in the 20s, I’d be speaking to my team for advice and testing for ketones frequently. Never think you’re bothering anyone if you have to call for support. They’re there to help.

 

[Mr Lee]

Hi.. thank you both for your reply's.

Strange that you should mention the insulin date, My insulin i was using is 2 years old this month. Doc's have given me fresh ones but the amount they has told me to take is way to low in my opinion. (12 units of slow release per day) . i did 45 units per day for the previous 2 days with no effect.

I phoned this websites help line a few days ago and the lovely i spoke to was surprised i was only on lantus slow release. I have spoke to docs about this and they said that they will call me yesterday with some urgency... guess what ...no call.
So i guess its down to me to lower my levels somehow?

 

[Kaylz]

Sorry 2 years old? You've had it 2 years or it expired 2 years ago? What IS the expiry date on it?

How long have you been Type 1 for?

Are you in the UK?
xx

 

[Mr Lee]

hiya.

expiry date is august 2020. but as from Thursday i have new ones, But taking the advised 12 units does very little.. well saying that i am currently 15 when i tested 5 mins ago, i am not too sure what type i am , nobody has said ? but i have been on insulin on and off for 15 years.

 

[Kaylz]

Are you on any oral meds for diabetes as well?

I find it highly odd that nobody has told you which Type of diabetes you have

Saying that the helpline were shocked that you were only on a basal insulin I assume they may have presumed you were Type 1, many Type 2's on oral meds often require insulin treatment and that can be just in the form of a basal

What are you eating on a day to day basis? xx

 

[Thebearcametoo]

Regardless of what type of diabetes you have with readings as high as 33 you should go to hospital*. Do you have a way to measure your ketones? Any reading over 16 and you should be testing your ketones too. With levels that high for that long you are in serious danger of DKA and basal or indeed fast acting insulin would struggle to get your glucose levels down as they would be firefighting ketones as a priority. Please don’t wait for your GP.


*if your diabetes was usually under control and you knew your ketones and how to treat them then you may not need hospital even at 33 but given what you have said that doesn’t seem to apply and if you have no fast acting insulin then you need to be in hospital.

 

[Mr Lee]

hello again .
my diabetic meds are Insulin, metformin, gliclazide, linagliptin and atorvastin. i have just measured keytones as recently got test strips, and my reading just says LO, which i assume is low. (last night is did read HI)
My diet is pants at the moment, due to pain,, but i am just trying to stay away from sugar.

a complicated factor is that my body has sort of adapted to running high with little effect on the way i feel.. except for the background nerve damage that i could not see.
Stupidly i was banned from insulin for a while by Crisis team because i let depression get the better of me. so i was just on oral and allowed to run high.

 

[Mr Lee]

i guess i am paying for my stupidity now tho.. lesson learnt ...

 

[Kaylz]

Are you sure it's a ketone meter your using? They generally don't give hi or lo as a reading and in fact just give a number as far as I'm aware

So it seems that you may be a Type 2

You say you are trying to stay away from sugar but I hope you are aware that total carbohydrate is the problem so if you are still eating carbs on already high BG then it's no surprise you are registering levels like that

I'd highly suggest calling 111 and asking for their advice as it's highly dangerous to be running levels so high
xx

 

[DaveB]

Can I ask what your BMI is and weather you have reduced the carbs in your diet? There is a view that T1s can eat a normal diet which means a lot of carbs. Many of us can't and you can gain weight thru the carbs (not the insulin). BTW it's not normal to have or continue to have Gliclazide when on insulin as they do the same job; do discuss that with the GP. Do take great care with those very high BS levels and keep any carbs way down; go to A&E if you need to.

 

[Mr Lee]

Its a glucoman lx plus, no numbers given , and have no idea what BMI is?
i had 2 slices of bread yesterday , nothing on it, i am starving but just cannot eat , i have called the docs and all they said was to take 12 units and they will can me back yesterday, they also told me to stop taking the pain killers and to increase other meds instead, tried calling them today but they are closed.

Kaylz, i am scared to call 111, i think antidepressants made me worse a few years ago, i just noticed that i think the pain killers are antidepressants as well?

I am a 50 year old man, but i am sitting here in tears, not from the pain. i am reaching out... i Dont want crisis team involved,,
Ime scared...

 

[Inka]

@Mr Lee Please phone someone. It’s heartbreaking to read that you’re in tears and scared. Please know there are lots of people here who can support you and who care that you’re ok. X

Do you have anyone ‘in real life’ you can speak to? Could you call the Care Line at Diabetes UK again?

I’m going to tag a few people as they might have good suggestions @everydayupsanddowns @LucyDUK @Josh DUK @SB2015

It does sound like your original insulin wasn’t working. Now you have the new insulin hopefully things will improve. Do not have more insulin than you’ve been told to. Remember this new insulin will work and you definitely don’t want a hypo. I’m concerned you had a LO reading. You really are best off getting some medical input. They won’t judge you. Tell them about your high sugars, the old insulin, etc. Say your sugars have been very high for some days and you can’t eat.

 

[Mr Lee]

Thank you Inka.
My son just got home from night shift, he knows very little, he still believes i was in IC from a hypo a while back , (it was insulin overdose) Thank you for the links, as soon as he goes out again i will talk to one of them , I cannot go out as my legs are so painful i cannot walk.

Do you think that upping my insulin just a small minuscule tiny bit until i speak to docs on monday is a good idea? because 12 units is a bit of a small dose right? i would be careful and monitor every hour . ?

 

[Kaylz]

@Mr Lee if you don't know what your doing then don't adjust your insulin without talking to a medical professional, every case is so individual we are not allowed to give advice on insulin dosing, I still advise calling 111 and asking to speak to a GP on their end

No it's not particularly a small dose, I lived 2 years of Type 1 on only 1 unit of basal insulin and it varies for each individual
xx

 

[Inka]

I’m just a person with Type 1 diabetes, Mr Lee, so I can’t and shouldn’t give medical advice. All I can say is what I’d do.

My concerns are:

a) your previous old insulin wasn’t effective so you were able to give large doses with no ill effects (because it didn’t work to lower your blood sugar) but your new insulin should work well, so you might find your blood sugar dropping a lot.
b) you say you got a LO on a meter. That sounds like a hypo so, again, I wouldn’t increase your insulin
c) it’s always better to err on the side of caution - better a little high than risk a hypo
d) you need to see how this new insulin works over a few days before making any changes or assessments
e) if, as you say, your body has got used to running high, then it’s better to bring your levels down slowly so you don’t feel ill or cause damage

You’ve mentioned depression. Please don’t feel ashamed of this in any way. It’s an illness like any other. You don’t have to tell your son the full story. You could just say you’re having problems with high sugars.

The people I tagged above are experienced forum members and the ‘tag’ just alerts them to this thread. It’s quiet here now because it’s Saturday. I didn’t want you to miss out on good advice from people like them.

So, no, don’t take more insulin but do test your blood sugar regularly, and talk to your son. I understand you’re scared about the crisis team being involved, but people with depression are ‘allowed’ to have purely physical health problems, and you do need help with your diabetes at the moment.

 

[Deleted member 27171]

Hello,

I’m sorry to read how tough things are for you right now and that you feel you don’t want to worry your son with how you are feeling. With your levels running as high as they are and with little support from your nurse over the weekend, it is important you get some medical help.

The risk with levels running high is that you could quite quickly develop ketones and become very unwell needing emergency treatment. Do you have any way of testing your ketones? If you don’t then it is all the more important you take yourself to a medical centre or at least call 111 for some advice.

What is it that concerns you about the involvement of the crisis team? Is that because you don’t feel you need them at the moment or that you just don’t want things escalated in that way? If you attend hospital or call 111 about your physical health and elevated bgl, there is no reason to assume they will automatically refer you to the crisis team because of that, unless it is felt you need their input. @Inka has made some really good points above, you can seek medical support without needing to mention your mental health condition to your son, if you are worried about sharing that with your son.

The Diabetes UK Helpline aren’t around over the weekend but you can call the Samaritans about anything that is causing you distress so do think about speaking with them in the meantime by calling 116 123 at any time of day or night.

 

[Mr Lee]

Thank you all for your advice,, I am taking it in , although struggling, 🙂

I think i was extremely embarrassed about the past and i think if i involved the crisis team... the first thing they will do is confiscate all my insulin. I feel stronger than before but i do fear that in a face to face situation that i would break down,

Thank you for recommending Samaritans, i think thats a good option for me at the moment, as not face to face and i can remain anonymous ... good thinking 🙂

I am not to sure if i am doing something wrong with my machine. i have just done a blood test (14.8) and then i just did another test but with a ketone strip in it.. the result just showed LO.. no numbers?

I do feel trapped in a loop between me lowering my levels, needing help but not involving the system to much, in need of my usual pain killers, but have to take head drugs instead ( which effect me mentally) and my levels.

All your inputs have helped me today.. more than you know.. and for that i thank you all again.

 

[silentsquirrel]

Thank you all for your advice,, I am taking it in , although struggling, 🙂

I think i was extremely embarrassed about the past and i think if i involved the crisis team... the first thing they will do is confiscate all my insulin. I feel stronger than before but i do fear that in a face to face situation that i would break down,

Thank you for recommending Samaritans, i think thats a good option for me at the moment, as not face to face and i can remain anonymous ... good thinking 🙂

I am not to sure if i am doing something wrong with my machine. i have just done a blood test (14.8) and then i just did another test but with a ketone strip in it.. the result just showed LO.. no numbers?

I do feel trapped in a loop between me lowering my levels, needing help but not involving the system to much, in need of my usual pain killers, but have to take head drugs instead ( which effect me mentally) and my levels.

All your inputs have helped me today.. more than you know.. and for that i thank you all again.

https://www.glucomen.co.uk/wp-content/themes/glucomen/assets/pdfs/LX%20PLUS%20Manual.pdf

Good news on the ketones front, which is a relief! The manual for your meter, link above if you have mislaid your copy, section 7.3, says LO is displayed if the reading is less than 0.1.