High numbers

[CoventryTrev]

Evening everyone.
My numbers have been very good for weeks until the last few days.
The last few days my numbers have been between 12 and 20. I haven't changed anything, still carb counting and a ratio of 1:9 of Flasp and 20 units of Lantus at night. Tested my ketones yesterday and today, both days 0.4
I have been doing correction units and they have no effect.
It seems like the insulin (flasp) is no longer working.
Any advise would be much appreciated.

Thank you

 

[AndBreathe]

Evening everyone.
My numbers have been very good for weeks until the last few days.
The last few days my numbers have been between 12 and 20. I haven't changed anything, still carb counting and a ratio of 1:9 of Flasp and 20 units of Lantus at night. Tested my ketones yesterday and today, both days 0.4
I have been doing correction units and they have no effect.
It seems like the insulin (flasp) is no longer working.
Any advise would be much appreciated.

Thank you

Are you under the weather at all? I have observed folks reporting that as raising their numbers and increasing their insulin resistance.

Alternatively, do you have another vial or pen you could try, to check your insulin hasn't been compromised in some way?

Hopefully, someone with more of a clue will be along to be more helpful shortly.

 

[Thebearcametoo]

Once you’re high it may take more insulin to bring you down even without ketones. If you’re starting with one of the bugs that’s going around that may explain it but whatever the cause you need to treat the numbers as they appear. Try a different vial just to be sure your insulin isn’t compromised and then try a bigger correction.

 

[rebrascora]

I have been doing correction units and they have no effect.
It seems like the insulin (flasp) is no longer working.

This is something that I often find and so far it hasn't been down to the Fiasp going off but just that it becomes a "wimp" when faced with high BG levels. I find I have to be really heavy handed with Fiasp once my levels get into double figures. The important thing is to keep an eye on your levels after a larger correction and be prepared with a JB or 2 if necessary to stop yourself dropping too low. I usually have a JB if I get to mid 5s with a vertical downward arrow and then watch it closely and check with a finger prick after that to see if it needs any further carb adjustment.
I hit a BG of 14 with 5 units the other night (6am) and I think I needed 1 jelly baby to level it out at 5 after about 3 hours. I don't eat until my levels come down into range otherwise, I will never get them down, so the correction is not attached to a bolus or meal but an independent correction just to get things back under control. This is just an example of what works for me, but I think you may need to look at basal insulin to keep it down once you get it into range. Perhaps a good time to do some basal testing once you have brought it down or consider increasing your Lantus if your levels are consistently high across the board.... assuming you have double checked your CGM with finger pricks to confirm you are high. I can't remember if you had a complete pancreas removal or not but if not, it could be that more of your beta cells have died off, if the increase in levels isn't down to a virus or other illness.
Good luck!

 

[SB2015]

Once I am above 10 I need about 10% extra and above 14 I added an extra 20%. We are all different but it always seem to need a bit more the higher I am. Now looping and it appears to agree with me looking at the frequency of corrections when I am higher after a bigger meal and/or forgetting to pre-bolus

 

[Ian T]

Hi - first time I have been on the forum for quite a while but I am going through a prolonged phase where my BG control seems to be falling apart, even though I'm not seemingly doing anything different...
These are interesting posts for me as I am also finding that the higher my BG goes, the more Fiasp I need to take in order to make an effective correction. At the moment I have been taking a correction dose, finding it doesn't do the job and therefore taking another a couple of hours later, but in the meantime I remain out of range. I hadn't realised that this might actually be a characteristic of Fiasp for some users. The only exception I find is if I am woken by dear Libre during the early hours of the night with a high BG alarm - I then find that my body is extra sensitive to Fiasp and I need only a small correction dose to have a big impact over the next 3 or 4 hours.

 

[nonethewiser]

Don't know what type you are or if you take a basal insulin also, if you do then that could be reason why your going high & fiasp is less effective during day, so basal test to rule it out.

Goes without saying that all of us need more bolus when bg goes high, I use fiasp in pump but it was same before using novorapid & actrapid before that.

 

[Ian T]

Thanks - I'm Type 1 LADA. My point about needing more was about increasing the ratio of Fiasp to Carb when BG is already high - I might need to use double the normal ratio etc. My Basal (Treciba) seems about right. I'm pretty fed up with it all to be honest but a case of just going back to basics and treating each day as a new start (so I keep telling myself)....

 

[rebrascora]

Thanks - I'm Type 1 LADA. My point about needing more was about increasing the ratio of Fiasp to Carb when BG is already high - I might need to use double the normal ratio etc. My Basal (Treciba) seems about right. I'm pretty fed up with it all to be honest but a case of just going back to basics and treating each day as a new start (so I keep telling myself)....

I find it best simply not to eat if my levels are above 8. I inject a correction and wait for it to come down otherwise it will remain high because we tend to become more insulin resistant the higher our BG, so putting more carbs in when levels are high will just make it worse.
My carb:insulin ratio doesn't change but my correction factor changes as my BG gets higher. The correction is the extra insulin injected to bring your levels back down into range and is different from your carb:insulin ratio. So you might have a correction factor of 3 where 1 unit of insulin drops you 3mmols. But that might only apply below 10. Between 10 and 14 you might find you need a correction factor of 2.... ie 1 unit of insulin drops you 2 mmols.... and above 14, you might need an even stronger correction factor of 1 or 1.5. If you were adding a bolus on top of the correction, then that would usually be at your normal ratio for that meal. It is only the correction factor which changes. At least that is my understanding.

 

[Pumper_Sue]

Evening everyone.
My numbers have been very good for weeks until the last few days.
The last few days my numbers have been between 12 and 20. I haven't changed anything, still carb counting and a ratio of 1:9 of Flasp and 20 units of Lantus at night. Tested my ketones yesterday and today, both days 0.4
I have been doing correction units and they have no effect.
It seems like the insulin (flasp) is no longer working.
Any advise would be much appreciated.

Thank you

It's probably some quite simple like needing more basal. Fiasp can not and does not do the job of basal and bolus if you are on MDI.
So easiest thing to do is check your basal. Instructions can be found in the pump forum. 9/10 times it's the basal causing problems not the bolus. 🙂

 

[Ian T]

Thanks both - helpful observations and, as always, it's good to share the frustration when things go off the rails a bit!

 

[void]

Evening everyone.
My numbers have been very good for weeks until the last few days.
The last few days my numbers have been between 12 and 20. I haven't changed anything, still carb counting and a ratio of 1:9 of Flasp and 20 units of Lantus at night. Tested my ketones yesterday and today, both days 0.4
I have been doing correction units and they have no effect.
It seems like the insulin (flasp) is no longer working.
Any advise would be much appreciated.

Thank you

Hi,

When in the day are you initially recording these high readings?

I've had inexplicably high readings before I started on a CGM (libre2) What was happening was that I'd get high readings when waking up. "liver effect" so i thought. And with a headache.

The libre2 showed that what was happening in the early hrs was that bg was going far too low, causing a massive liver dump and therefore subsequent high glucose. This proved I was taking too much basal (going low overnight), and also eating (and therefore bolusing) way too late. Adjustments here normalised things.