Insulin or temperature the reason?

[pippaandben]

Over the past 7-10 days my correction dose has doubled - I am now using one unit for each full blood glucose point and even that is barely controlling things. I am sure I also need to increase my carb ratio which is 1:9 and has been for about a year.
I am loathe to increase basal as I had been getting night hypos and a single unit reduction has stopped this so currently 12 units am and 11 units mid evening.
I have thrown away my earliest Levemir and Humalog in case they have been compromised by caravanning over the summer months and changing between sites although fridge has never defrosted.
Any other ideas please - I am back to testing c 7 times a day and sometimes have had readings in high teens for no apparent reason.

 

[Northerner]

I find things often change significantly for me at this time of year. Things have been thrown into chaos a bit, I think due to the adaptation of my body clock resetting to the shorter, colder days. During the summer I was on 15-20 units novorapid per day, then a couple of weeks ago it shot up to 35 units, and just lately it has dropped back down to 20! Hopefully, that will be it settled for a while 🙂

What sort of waking levels are you getting? Might it be worth trying a basal test? Is it possible that you are less active, or perhaps need to adjust the timing of your Humalog rather than the amount? How often are you getting the highs? I think I would be tempted to get some brand new, fresh insulin and see how things go with that - if you still have the problems then it would mean you could still use the stuff you are using now, but if it works better then you will know to discard the older stuff 🙂 Also, are you less active, perhaps? Are your pens functioning correctly (do you use cartridges or disposable pens)? There are so many avenues we need to explore when things like this occur!

 

[pippaandben]

Thanks Northerner. This morning 12.9 where the ... did that come from? Every time I tested yesterday pm it was high teens and just before dinner 14.3. No reason - did not eat when out getting MOT done. This is what is complicating things for me as I do a correction dose of 9 units but as it is so high am leary about doing the "proper dose" for my meal on top so change of meal plan and had a full can of soup which was only 8g carbs and did no dose for it. Usual basal at 9pm. and night reading of 12.6. Been told not to correct if in 12s at bedtime in case of night hypo. Will change to last batch of humalog which I only got 4 weeks ago and see if that is the problem. My pens are both cartridge pens giving half units - one by Lilley and the other NovoNordisk. Usually I test and inject as my food is in front of me - would you suggest bringing the injection forward say half an hour before eating?
Neuropathy and subsequent balance issues have led to lack of confidence in going out alone and much less active than I used to be. The neuropathy is partially due to my back operation last year leading to foot drop and lack of sensation knee to toe on the left but now I am at a proper foot clinic which is the centre for diabetic care in the area discovered have also got lack of sensation in right foot as well which is more likely to be diabetes related - but no pain.

 

[Northerner]

Thanks Northerner. This morning 12.9 where the ... did that come from? Every time I tested yesterday pm it was high teens and just before dinner 14.3. No reason - did not eat when out getting MOT done. This is what is complicating things for me as I do a correction dose of 9 units but as it is so high am leary about doing the "proper dose" for my meal on top so change of meal plan and had a full can of soup which was only 8g carbs and did no dose for it. Usual basal at 9pm. and night reading of 12.6. Been told not to correct if in 12s at bedtime in case of night hypo. Will change to last batch of humalog which I only got 4 weeks ago and see if that is the problem. My pens are both cartridge pens giving half units - one by Lilley and the other NovoNordisk. Usually I test and inject as my food is in front of me - would you suggest bringing the injection forward say half an hour before eating?
Neuropathy and subsequent balance issues have led to lack of confidence in going out alone and much less active than I used to be. The neuropathy is partially due to my back operation last year leading to foot drop and lack of sensation knee to toe on the left but now I am at a proper foot clinic which is the centre for diabetic care in the area discovered have also got lack of sensation in right foot as well which is more likely to be diabetes related - but no pain.

Adjusting timing of insulin doses can help, but it can also be very much down to the individual as to how long prior to eating. There was general advice a few years ago that it should be a minimum of 15 minutes, so that may be a good time to start with 🙂 For me, it can also vary according to the time of day - before breakfast I can adjust as much as a hour before eating, about 40 mins before for lunch and 30 mins before for evening meal. I think this is because I tend to become more insulin-sensitive as the day progresses (most people do). It also depends on your levels before injecting - if I am on the low side e.g. 4s rather than 6s, then I may inject closer to when I eat. And, of course, the timing may depend on what you intend to eat - if I inject too early before eating pasta then the insulin will be peaking before the meal does, and I have had one or two mid-meal hypos 😱 Not nice when you have to pop in a few jelly babies in the middle of your savoury meal! 😱

A complicated business, but with patience, experience and plenty of testing eventually you can get it right most of the time 🙂

I hope that the new humalog solves the problem for you - if it doesn't, it may jsut be that your ratios have changed with the onset of the colder, darker days.