Hi just wandered if any body had any advise for me that would be helpful. Have phoned 111 but not really much help. I came out of hospital sat 7pm after a shoulder op. Since I've come home my noporapid is basically not working (aswell as before) I know my bodies under stress and inflammation but wanted some advise. Normally my readings are 4-7 99% of time with amount of daily novorapid 10-16 units per day. Yesterday I did 110 unit and can't get below 10 bloods. Today I have already done 32 units and I'm 16.1 bloods still. What action should I take. My surgery opens tomorrow but wandered if any one had any experience from insulin taking no effect or little effect after theri op. Tia
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Insulin after shouder op or local anesthetic
- Thread starter BenC101
- Start date
Did you increase your basal insulin?
When I had an op on my elbow, i needed 50% more basal.
The other thing to remember is that we become insulin resistant as our BG goes higher
Have you changed your insulin - both NovoRapid and your basal?
It maybe coincidence that your insulin has gone "off" at the same time as you had your op.
Finally, if your BG has been high for some time, do you have the ability to check your ketones? We need to be aware of the possibility of DKA are prolonged high BG. If you feel unwell, get to A&E.
When I had an op on my elbow, i needed 50% more basal.
The other thing to remember is that we become insulin resistant as our BG goes higher
Have you changed your insulin - both NovoRapid and your basal?
It maybe coincidence that your insulin has gone "off" at the same time as you had your op.
Finally, if your BG has been high for some time, do you have the ability to check your ketones? We need to be aware of the possibility of DKA are prolonged high BG. If you feel unwell, get to A&E.
Inka
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Normally my readings are 4-7 99% of time with amount of daily novorapid 10-16 units per day. Yesterday I did 110 unit and can't get below 10 bloods
Welcome @BenC101 🙂 Is that a typo or did you really have 110 units of Novorapid yesterday? Being between 4 - 7 mmol 99% of the time is very unusual. The target is that you aim for 70% between 3.9 and 10 and that counts as excellent control. When were you diagnosed?
Welcome @BenC101 🙂 Is that a typo or did you really have 110 units of Novorapid yesterday? Being between 4 - 7 mmol 99% of the time is very unusual. The target is that you aim for 70% between 3.9 and 10 and that counts as excellent control. When were you diagnosed?
Unfortunately I can't find my keytones testing strips , mainly down to being so used to using my libre 2 plus on the app. My diabetes is so well managed compared to previously. I haven't increased my toujeo. How long was you affected after your op. I will ring my surgery as soon as they open tomorrow and talk to the diabetic nurse. I just didn't anticipate how much glucose the stress on my body would be producing. Sorry also no haven't changed any of my insulin types. I am just hoping my body starts reacting more to insulin sooner rather than later.
Inka
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@BenC101 Changing your insulins to new cartridges is always the first step in case the insulin has degraded slightly. It doesn’t matter whether you recently got them from the pharmacy. Very occasionally insulin can be affected by temperature during its journey across Europe.
However, as you suggest, it’s most likely that your shoulder op is the cause. Did you have any meds or a general anaesthetic, etc, or any meds you’ve started after the op, eg antibiotics? It could just be stress and inflammation, of course, but that’s a massive change in your dose. I agree with @helli that you might need an increase in basal temporarily.
I've tried 3 seperate pens from the fridge. I have been given stronger painkillers since op and paracetamol and broken. Like I feel okay in myself just worried about dka and this affecting the healing process. I have been eating bad food where im in pain and less capable of prepping my normal healthy lifestyle but I still feel my insulin is not responding. I think it will start leveling out as op date gets further away I was just after some advise where im worrying abit. Thanks you everyone for the replies
Inka
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You haven’t said when you were diagnosed. I ask because if you’re still in the honeymoon period, the stress of the OP could have caused your remaining insulin production to reduce.
Another thought - are you carb-counting and adjusting your mealtime insulin accordingly? If not, that could be contributing.
You can buy Ketostix over the counter for around £5. They’re urine dipsticks that test for ketones. Ketones generally only appear around 13-16mmol, but it’s always wise to have some means of testing. You might also be able to get them from Amazon or similar if you can’t get out.
All you can do is watch things closely. Hopefully this is a temporary blip due to the OP, and will resolve itself within a day or two, or at least improve.
Yes sorry where on my phone missed a few points . I have had diabetes 17 years. I'm 40 now. It's only the last 2 years I've really got it completely under control. Mainly since had the arm patch it's been a game changer for me. That's perfect I will go buy the dipsticks as a back up. Although I am colour blind luckily my 7 year old loves to help. And yes I was put to sleep for 3 hours for the op for the other person that asks. Lovely to have an outlet to ask advise. Very thankful
rebrascora
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I find that if my basal insulin needs increasing I need to fire fight with a lot more bolus insulin than the number of units of the basal increase that is required. So for instance I might need 8 or 10 correction units in a day but if I increase my basal insulin by 2 units everything goes back to normal. It lead me to believe that my basal was stronger than my bolus but in fact it is down to the increased basal keeping me in range and when I get above range I become more insulin resistant and therefore need a lot more units of bolus insulin to bring me down.
I believe Toujeo is triple strength Glargine so do be a bit careful with your increases. Generally it is suggested that you try a 10% increase in basal, give it 3 days and then increase again if necessary. Good luck and hope your shoulder heals well.
I believe Toujeo is triple strength Glargine so do be a bit careful with your increases. Generally it is suggested that you try a 10% increase in basal, give it 3 days and then increase again if necessary. Good luck and hope your shoulder heals well.
Flower
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Hi @BenC101
Do you know if steroids were injected during your shoulder surgery as they can wreak havoc and cause sustained high blood glucose.
When I had shoulder surgery the first couple of times steroids were injected without me knowing and I struggled for a few days to get my glucose down.
Just a thought to maybe explain your high glucose that’s not reducing with normal insulin corrections.
Do you know if steroids were injected during your shoulder surgery as they can wreak havoc and cause sustained high blood glucose.
When I had shoulder surgery the first couple of times steroids were injected without me knowing and I struggled for a few days to get my glucose down.
Just a thought to maybe explain your high glucose that’s not reducing with normal insulin corrections.
Hi thanks for the message. I just know I got put to sleep and had few injections in the neck to stop the pain getting through to my brain. Never heard anything mentioned of steroids though. Think I'm definitely going to up my background insulin tonight see if that helps. I've done 74 units today just to get down to 10-14 bloods