Sugar levels are always high

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Hello @Laura0194,
can you give us the amount of carbs you would be eating for your B/fast so we can get some idea about ratios. You say you go high after injecting, are you injecting before you are eating. I inject 15 to 20 mins before food to stay in range but if I inject with food I will go out of range [HI] and have to make adjustments which you are saying you do frequently.
A God send for me was a pump, if it will suit you I would go for one, talk to your team. it got rid of the need to do multiple daily injections so reduced the tissue scarring which does effect how insulin is absorbed into your body. Are you rotating your injection sites?
Please put up your Dexcom graph when you can as they will be useful to view.

Regards
 
Inka said:
I totally get why you’re stressed now @Laura0194 Those are large doses and it must be very frustrating that your blood sugar is still high.

Are you under a hospital team? Has an insulin pump ever been mentioned? I wonder if it could help.
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I’m under the QE and the pump was mentioned but they said there would be no point because of the doses I’m on I’d have to change the pump every day
 
mark king said:
Hello @Laura0194,
can you give us the amount of carbs you would be eating for your B/fast so we can get some idea about ratios. You say you go high after injecting, are you injecting before you are eating. I inject 15 to 20 mins before food to stay in range but if I inject with food I will go out of range [HI] and have to make adjustments which you are saying you do frequently.
A God send for me was a pump, if it will suit you I would go for one, talk to your team. it got rid of the need to do multiple daily injections so reduced the tissue scarring which does effect how insulin is absorbed into your body. Are you rotating your injection sites?
Please put up your Dexcom graph when you can as they will be useful to view.

Regards
Click to expand...
My breakfast ratio was 30/40 carbs and I inject before food I rotate my injection sites as my skin is very sore and they mentioned the pump but because of the dosage I’m on they said it would be pointless as I’m on high doses
 
rebrascora said:
Thanks for that @Inka, that is really interesting.

@Laura0194 It certainly sounds like the Ozempic is not helping you and just making you feel even more rubbish, so I would ask about stopping that. Life is tough enough without feeling sick half the time for no benefit.

I hope you are able to get some higher strength insulin prescribed, but if we can see your graph when you have time to post it, there might be other practical things that we can suggest to help. For me, I don't eat unless my levels are below 8. If that means injecting my insulin and waiting an hour or two before I eat, that is what I do, but I closely monitor my levels using by CGM (Libre/Dexcom) during that time, until they come down into range and then I eat. Once our BG is high, we become more insulin resistant and then it needs more insulin to do the same job, so the insulin is usually much more efficient at dealing with the carbs in our food when we are in range. That may not be practical for you if you need to take other medication or are relying on others for food, but just one possible tip.
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Thank you I appreciate that I’ve tried to contact them today but no answer
 
Laura0194 said:
I’m under the QE and the pump was mentioned but they said there would be no point because of the doses I’m on I’d have to change the pump every day
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You could possibly use a pump with one of the concentrated forms of insulin (eg the U200 ones would be twice the strength so half the amount).

Did a quick Google. Here’s one of a number of studies:

https://www.sciencedirect.com/science/article/pii/S2376060520301668

Time in range increased from 19% to 43% with a pump and U200 insulin (ie twice the strength)
 
Laura0194 said:
My breakfast ratio was 30/40 carbs and I inject before food I rotate my injection sites as my skin is very sore and they mentioned the pump but because of the dosage I’m on they said it would be pointless as I’m on high doses
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How long before eating do you inject your insulin Laura? At breakfast time, after careful experimentation and gradually increasing the prebolus time, I found that firstly, it was important to inject my breakfast insulin before I got out of bed, so that it was dealing with my Foot On The Floor syndrome which is when the liver releases glucose into the blood stream to give us energy for the day ahead. I then need a pretty consistent 45mins before I eat breakfast. If I wake up in the low 4s, I might need a bit less and if I wake up above 7 I will need longer as well as more insulin, but that timing works for me at breakfast time with my body and my insulin. If you don't prebolus your insulin (inject in advance of eating) at the moment, then experiment with one meal at a time and gradually increase the timing by 5 mins each day until you find the timing that works for you. I only need 15-20 mins for lunch and evening meal, but breakfast is when I am particularly insulin resistant and my liver chucks out a lot of glucose, so I need much more time then. You may be different, so you have to carefully experiment and find what works for you for each meal time.
 
I don’t understand the bit where you said your breakfast ratio was “30/40 carbs”. Ratios are normally something like 1:5g - ie one unit of insulin for every 5g carbs in your meal.
 
Inka said:
I don’t understand the bit where you said your breakfast ratio was “30/40 carbs”. Ratios are normally something like 1:5g - ie one unit of insulin for every 5g carbs in your meal.
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I ment 30/40 g sorry
 
Laura0194 said:
I ment 30/40 g sorry
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So you take 30 units of insulin for 40g of carbs? Have you been given recommended carb amounts for each meal? I mean a max amount of carbs for each meal, that is? I wonder if any particular diet might help you reduce the insulin resistance. I don’t mean a weight loss diet, just a way of eating that helps.
 
Sorry you are having such a tricky time @Laura0194

It does sound like a stronger insulin, which would mean a smaller volume, might be worth asking about?

And in the mealtime, if your levels remain high after carb counted meals, and it would be uncomfortable to inject a greater volume, perhaps you could consider either reducing the carbohydrate count of the meal, or splitting your dose across two or more injection sites?
 
Inka said:
Ok, so if they’re ok in the morning but shoot up when you eat, then it looks like a problem with your Novorapid dose/timing.

Do you inject in advance of eating? You don’t mention Metformin - that can help with insulin resistance. Also, if you’re taking large doses of Novorapid then splitting the dose and injecting in two places can help absorption too (half the dose in each place).

Apologies for asking, but what’s your BMI?
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I’ve told them I don’t think the novo rapid is working they just keeping upping the dose all the time I was on metformin before but made me really I’ll and my BMI I’m not sure to be honest
 
Inka said:
So you take 30 units of insulin for 40g of carbs? Have you been given recommended carb amounts for each meal? I mean a max amount of carbs for each meal, that is? I wonder if any particular diet might help you reduce the insulin resistance. I don’t mean a weight loss diet, just a way of eating that helps.
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Yeah I was given a table I’d follow with the units and carbs was doing it for months but nothing was changing, and I don’t know to be honest starting to give up
 
everydayupsanddowns said:
Sorry you are having such a tricky time @Laura0194

It does sound like a stronger insulin, which would mean a smaller volume, might be worth asking about?

And in the mealtime, if your levels remain high after carb counted meals, and it would be uncomfortable to inject a greater volume, perhaps you could consider either reducing the carbohydrate count of the meal, or splitting your dose across two or more injection sites?
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I watch what carbs I eat in general and when I was doing the carb diet and my dosage of insulin nothing seemed to work didn’t matter what I ate
 
Laura0194 said:
Yeah I was given a table I’d follow with the units and carbs was doing it for months but nothing was changing, and I don’t know to be honest starting to give up
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Don’t give up @Laura0194 There’ll be something out there that helps. It’s just a question of finding it. I know how stressful it must be for you and I feel sorry that your skin is so sore from all the insulin. I really think a concentrated insulin is worth trying. You could try that fairly easily, I’d think. There are various strengths so you could see which suits you. The reduction in insulin would surely help.

That’s step 1. Then I’d think that trying to reduce your insulin resistance would be Step 2. You’ve got options 🙂

I mentioned diet above. Obviously you’d have to introduce any changes carefully and gradually, but there are various diets you could try, including low carb and very low fat. Both those might help and you could still eat nice meals.
 
Inka said:
Don’t give up @Laura0194 There’ll be something out there that helps. It’s just a question of finding it. I know how stressful it must be for you and I feel sorry that your skin is so sore from all the insulin. I really think a concentrated insulin is worth trying. You could try that fairly easily, I’d think. There are various strengths so you could see which suits you. The reduction in insulin would surely help.

That’s step 1. Then I’d think that trying to reduce your insulin resistance would be Step 2. You’ve got options 🙂

I mentioned diet above. Obviously you’d have to introduce any changes carefully and gradually, but there are various diets you could try, including low carb and very low fat. Both those might help and you could still eat nice meals.
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I might ask about a concentrated insulin then see what they suggest, I’ve tried everything I can I’ve followed everything I’ve been told to do and nothing seems to work I’m not taking the ozempic anymore I stopped it yesterday so hopefully I’ll feel a little better after not having that
 
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