Ketones and high sugar levels

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ILikeSugar :|

ILikeSugar :|

Well-Known Member
Relationship to Diabetes
Type 1
So I havent been able to keep my sugar levels stable for about 4 or 5 days now theyve been constantly been going high after every meal and dont seem to go down too much either I've just checked my ketones and they're at 0.5 I was just wondering if theres anything i should be doing?
 
How high is your blood sugar going @ILikeSugar :| ? Have you swapped to new cartridges of both your insulins? Could you be ill?
 
It goes up to like 15 sometimes but it rarely goes under 11 and I have recently been ill but that was a few days ago now and no my insulin has stayed the same
 
Swap your insulin to new cartridges/pens @ILikeSugar :| That’s the first thing to do when you’re running unexpectedly high. Occasionally insulin degrades and becomes less effective.

If you’re able to, eating will help too. Drink plenty of water to help flush the ketones out. Do you know how to use your fast-acting insulin to give correction doses?
 
Inka said:
Swap your insulin to new cartridges/pens @ILikeSugar :| That’s the first thing to do when you’re running unexpectedly high. Occasionally insulin degrades and becomes less effective.

If you’re able to, eating will help too. Drink plenty of water to help flush the ketones out. Do you know how to use your fast-acting insulin to give correction doses?
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What do you mean by swapping cartridges or pens just like getting a new one out of the box? And oh alright I will make sure to drink lots of water and not really I've only corrected once before I did 2 units on my pen without eating and it didnt bring it down loads
 
And also for lunch today I did 3 units over what I should have but I've still gone high
 
ILikeSugar :| said:
What do you mean by swapping cartridges or pens just like getting a new one out of the box? And oh alright I will make sure to drink lots of water and not really I've only corrected once before I did 2 units on my pen without eating and it didnt bring it down loads
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Yes, just get fresh cartridges/pens out of the box.
 
ILikeSugar :| said:
And also for lunch today I did 3 units over what I should have but I've still gone high
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If you’re not confident/experienced with giving correction doses, it would be best to speak to your team for advice. You should be given a basic correction figure eg 1 unit of insulin will drop you 3mmol (just an example). However, when your blood sugar is high (somewhere above 11 usually) you become more resistant to insulin so usually have to add on a little extra insulin to your calculation.
 
So I tried using a fresh pen yesterday and is still did nothing I went up to 15 after dinner and am at 12 after waking theyve been high for like 4 or 5 days now and have been 0% in range on my libre app for like 2 or 3 days now so I dont know what to really do even if I do a correction dose I dont think it will help much as I just go loads higher then I should after every meal
 
Ok, well you did the sensible thing changing the insulin. That’s always a good thing to do to rule out ‘bad’ insulin.

We’re not allowed to give dosage advice, but correction doses should help. You don’t need to do them at meal times, and you will need more insulin if you’re above 11 or so as you become quite resistant to it. I’ve had to have double correction doses before and I’ve almost felt the insulin resistance as I’ve pushed my blood sugar down with insulin. But I’m confident doing that because I’ve had Type 1 a long time.

My guess is that you need more insulin. It might be that you need a temporary basal increase, it might be that your recent illness is still affecting you, or it might be your honeymoon period is coming to an end and all your doses and ratios need looking at. Because I can’t make dose suggestions, I think you should phone your DSN. Before you call them, write down some example blood sugar results and correction amounts, what you ate, what were your results, etc, so they can quickly get a picture of the issues. They should then be able to give you advice about getting your blood sugar back in range.
 
Inka said:
Ok, well you did the sensible thing changing the insulin. That’s always a good thing to do to rule out ‘bad’ insulin.

We’re not allowed to give dosage advice, but correction doses should help. You don’t need to do them at meal times, and you will need more insulin if you’re above 11 or so as you become quite resistant to it. I’ve had to have double correction doses before and I’ve almost felt the insulin resistance as I’ve pushed my blood sugar down with insulin. But I’m confident doing that because I’ve had Type 1 a long time.

My guess is that you need more insulin. It might be that you need a temporary basal increase, it might be that your recent illness is still affecting you, or it might be your honeymoon period is coming to an end and all your doses and ratios need looking at. Because I can’t make dose suggestions, I think you should phone your DSN. Before you call them, write down some example blood sugar results and correction amounts, what you ate, what were your results, etc, so they can quickly get a picture of the issues. They should then be able to give you advice about getting your blood sugar back in range.
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Alright thank you for the advice I will do that sadly I only have my 1st appointment good with them some point this month so I guess I'll have to wait for that but I will be speaking with my gp tomorrow so I'll see if the diabetic nurse there has any advice too
 
It can take a while for your body to return to normal after illness (your body has the symptoms under control but is still fighting the illness) so it may be that in a few days you will go back to your normal insulin needs but until then a correction dose as Inka says is useful. If it persists then it may be that your bolus ratios or your basal need a change but as you know you’ve just been ill presume it’s temporary at the moment. Ketones under 1 aren’t too concerning but when you have ketones the insulin goes to treat those first before glucose levels (in simple terms) so it can take more insulin to get your levels down than it usually would. Don’t worry about what your levels go up to after food just look at where they come back down to after 4 hours (once the insulin has done a full cycle) and that will give you an idea of how well your insulin is working. One thing our paediatric team have said about covid is that people have been getting ketones even when their BG hasn’t been much more than 10 or 11.
 
ILikeSugar :| said:
Alright thank you for the advice I will do that sadly I only have my 1st appointment good with them some point this month so I guess I'll have to wait for that but I will be speaking with my gp tomorrow so I'll see if the diabetic nurse there has any advice too
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You should have a contact number for the DSNs. These nurses know far more than a non-specialist nurse at a GP surgery who usually deal with Type 2s not Type 1s.

If you phone the Diabetes Dept at the hospital your team are based at, you should be able to ask to speak to a DSN for advice. Mine are excellent. If they can’t speak to me at the time, they always call me back very quickly.
 
Thebearcametoo said:
It can take a while for your body to return to normal after illness (your body has the symptoms under control but is still fighting the illness) so it may be that in a few days you will go back to your normal insulin needs but until then a correction dose as Inka says is useful. If it persists then it may be that your bolus ratios or your basal need a change but as you know you’ve just been ill presume it’s temporary at the moment. Ketones under 1 aren’t too concerning but when you have ketones the insulin goes to treat those first before glucose levels (in simple terms) so it can take more insulin to get your levels down than it usually would. Don’t worry about what your levels go up to after food just look at where they come back down to after 4 hours (once the insulin has done a full cycle) and that will give you an idea of how well your insulin is working. One thing our paediatric team have said about covid is that people have been getting ketones even when their BG hasn’t been much more than 10 or 11.
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Well I took a correction does this morning to try get my sugar levels a bit lower this morning I did 2 units on my pen and even though my sugar levels were only on about 11 they only came down to like 10 a few hours later should I double the amount of insulin I need compared to carbs for dinner to see if that helps like say if my dinner has 50g of carbs should I try taking 10 units on my pen? It's just confusing at the moment hopefully it goes back to normal soon as i dont wanna have any problems with it as theyve been quite high for 4 or 5 days now and unstable for even longer due to being ill
 
Inka said:
You should have a contact number for the DSNs. These nurses know far more than a non-specialist nurse at a GP surgery who usually deal with Type 2s not Type 1s.

If you phone the Diabetes Dept at the hospital your team are based at, you should be able to ask to speak to a DSN for advice. Mine are excellent. If they can’t speak to me at the time, they always call me back very quickly.
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Oh right I dont think I have a team to be honest I dont have anyone contacting me or anything the only number I really have is for the dietetic nurse and the only person who's really been checking on me is the practice nurse from the GP
 
They're still a bit high today my sugar levels still havent been in range at all do you think 111 would be good to call or should I leave it a couple more days to see if it keeps up
 
MMM - well 'more insulin needed' is certainly my assessment - but please, please don't double it 'just to see' - cos that's far too drastic an increase for non medically qualified folk like you and I to whack in without expert advice. A max. of 10% a time is the usual advice, so try 5.5u or if you don't have a half-unit pen - tentatively try 6u.

But now I've seen your latest post - yes! Ring 111!
 
I think it is highly likely that your basal needs have increased if your levels across the board have risen. Once you get your basal insulin dose right, even if it is only a temporary increase for illness, or a more permanent increase due to Beta cell die off, everything else will make much more sense and levels should be more stable.


ILikeSugar :| said:
the only number I really have is for the dietetic nurse
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If you have a contact number for a diabetes nurse I would contact her and explain about the problem and discuss a possible basal dose increase.
 
trophywench said:
MMM - well 'more insulin needed' is certainly my assessment - but please, please don't double it 'just to see' - cos that's far too drastic an increase for non medically qualified folk like you and I to whack in without expert advice. A max. of 10% a time is the usual advice, so try 5.5u or if you don't have a half-unit pen - tentatively try 6u.

But now I've seen your latest post - yes! Ring 111!
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Alright thanks for the info
 
rebrascora said:
I think it is highly likely that your basal needs have increased if your levels across the board have risen. Once you get your basal insulin dose right, even if it is only a temporary increase for illness, or a more permanent increase due to Beta cell die off, everything else will make much more sense and levels should be more stable.



If you have a contact number for a diabetes nurse I would contact her and explain about the problem and discuss a possible basal dose increase.
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Thanks yeah I think I might ring 111 to see what they think and I'll have to speak to the GP practice nurse tomorrow anyway so I'll see what she thinks too
 
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