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What do you do on a day when your body isn't responding to insulin

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This thread is now closed. Please contact Anna DUK, Ieva DUK or everydayupsanddowns if you would like it re-opened.
AJLang

AJLang

Well-Known Member
Relationship to Diabetes
Type 1
I haven't eaten anything since 8pm yesterday
6.15am BG 14.0 - had 3 units of Humalog
7am Levemir
9.15 BG 16.4 - another 3 units of Humalog
11.15 15.9!! another 3 units of Humalog
an hour later it is still 15.9
not sure what to do as I'm at work - if anything BG normally stays stable or lowers a little in the morning - so can't understand why it is not responding at all to the Humalog. Any advice would be gratefully appreciated as I'm worried in case it goes too high. It's the same insulin that I've been using for the past few days without any problems
 
Is there any chance you are coming down with an infection? Although it may seem that the humalog isn't working, it may be that it is working and keeping your levels from climbing higher as they seem reasonable stable (although too high, obviously!). Either that, or is there a possibility the insulin has been compromised in any way in the past 24 hours? I'd be tempted to try a different cartridge for my next correction attempt. It might also be an absorbtion issue of course, in which case be very careful in case there is a 'surge' from the stacking. Hope things come down to more reasonable levels soon! 🙂
 
Where are you injecting? Have you taken all of those corrections in the same place and
do you have any lumps in that area? It sounds like an absorption problem to me. To be honest, not having breakfast wont help. It could be that your liver is trying to give you energy but it doesn't know when to stop. If you take your lunch time insulin in a different place to your earlier ones and have your lunch, it might help.
 
AJLang said:
I haven't eaten anything since 8pm yesterday
6.15am BG 14.0 - had 3 units of Humalog
7am Levemir
9.15 BG 16.4 - another 3 units of Humalog
11.15 15.9!! another 3 units of Humalog
an hour later it is still 15.9
not sure what to do as I'm at work - if anything BG normally stays stable or lowers a little in the morning - so can't understand why it is not responding at all to the Humalog. Any advice would be gratefully appreciated as I'm worried in case it goes too high. It's the same insulin that I've been using for the past few days without any problems
Click to expand...

I was just wondering if the pen is new and your fridge is on the fritz? One of Luke's pens got too cold in the fridge a few months ago and the insulin did little to nothing until we realised why! This could also be the case with an older pen if it's been subjected to extreme conditions. Has your Humalog been too hot or cold?
 
Is your pen delivering the insulin ok?
Or as Alan has asked has the insulin been compromised in any way?
Perhaps if you ate something as well your liver wouldn't think you were starving and keep dumping glucose to make up for it.
Also are you adding extra insulin to your correction bolus to make up for the high numbers and resistence?
 
Pen has been on a shelf in the living room all night until I used it this morning and then in my handbag under my desk so not near too much heat or cold - and it has been kept like that for several days. Also using different parts of my tummy for each jab so it shouldn't be an absorpting problem. Never eat any breakfast in the morning because of the gastroparesis and usually have a nutrigrain bar at about 11am but have absolutely no appetite at all - have been surviving on diet drinks - not health but all I can manage. I did have unusual stomach pain at around 9am and don't feel quite right so maybe I am coming down with something?? Hope not but it would be an explanation............
 
Have you tested for ketones? It could be that not eating is actually making things worse - your liver might keep chucking out glucose, and your body can start to break down fats for energy which can lead to starvation ketones, which leads to insulin resistance and a high BG that won't come down!

We were told on DAFNE that sometimes in this case a small amount of carbs with insulin can help a huge amount.
 
Also are you adding extra insulin to your correction bolus to make up for the high numbers and resistence?[/QUOTE]
the 6am 3 units would normally bring it down to 5 but so far this morning I've had nine units of bolus with nothing reducing the BG at all
 
Sometimes it's hard to tell whether the lack of appetite is de to illness or because your levels are high - or both :( (Thank you Diabetes Fairy!). I know when I have been ill I've been surprised at how much extra insulin I need to keep levels reasonable, so you may not be making much of a dent if it is illness. Any chance that it might be the levemir that's not working?
 
randomange said:
Have you tested for ketones? It could be that not eating is actually making things worse - your liver might keep chucking out glucose, and your body can start to break down fats for energy which can lead to starvation ketones, which leads to insulin resistance and a high BG that won't come down!

We were told on DAFNE that sometimes in this case a small amount of carbs with insulin can help a huge amount.
Click to expand...

Thanks for this. Unfortunately I haven't got any ketones testing sticks but I will go home in a few minutes and get myself to eat something (with insulin) to see if this helps. I hadn't realised that my liver might keep chucking out glucose
 
If I couldn't understand why I was getting unexpected readings, and none of my actions were working, I'd phone DSN. If I didn't have their number handy (or didn't have one at all), I'd phone NHS Direct on 0845 4647, if I were in England or Wales.
 
What was it you ate last night AJ ?

Rob
 
Hi Rob
Steak, oven chips, onions and mushrooms. BG was 9.7 going to bed and 14 at 6.15am (which often happens because of the gastroparesis) I just haven't had problems that have continued this far into the morning when I've done so many bolus jabs. Copeod you're reading my mind......however DSN number keeps being engaged!
 
I know that a fair % of protein with my meals (low GI) lowers the GI so much that I can be spiking after 4 or 5 hours and it can carry over to the next morning from teatime.

I can see steak doing this, especially with the gastroparesis, but if you've not noticed it this long before then it can't be (entirely) that.

In combo with the stomach pain and off colour feeling, I can imagine it could easily keep you up in double figures. I hope, whatever it is, that it settles down very soon and lets you get back to normal. In the meantime, I suppsoe it's test, test, test and correct, correct, oops, not too many corrections 😱 😉

Rob🙂
 
Have you tried a new cartridge of insulin?
Another thought is, any chance you have forgotten to take your basal insulin?
 
AJLang said:
Hi Rob
Steak, oven chips, onions and mushrooms. BG was 9.7 going to bed and 14 at 6.15am (which often happens because of the gastroparesis) I just haven't had problems that have continued this far into the morning when I've done so many bolus jabs. Copeod you're reading my mind......however DSN number keeps being engaged!
Click to expand...

Wish I could help with solving problems about engaged phone numbers 🙂
 
Walk to and from bus stop (together with all the corrections) only brought it down to 14. thankfully I can work at home now so have wacked in another 5 units of humalog from a different pen and had two crackers with cheese spread.....so now going to test every 30 minutes and will be over joyed if it goes low enough for me to need lucozade.......it's particularly strange that it is doing this today because yesterday it stayed around 5.2 all day yesterday. Fortunately I've been able to test at home and there aren't any ketones
 
Diabetes Fairy although my BG is now improving to 11.5 why is it so high when I've had so much extra insulin today I just don't understand. I'm now starving so had anoth two crackers with cheese spread.....I would normally give myself a unit of insulin, plus correction particularly as I'm 11.5 but I don't know what to today as I've had so many extra doses of humalog......don't want to risk an evening/bedtime hypo from the insulin stacking up but so far today body hasn't been anywhere near responsive to the insulin as it should be.....no point in checking with DSN because she wouldnt have approved of me having all of the humalog jabs that already I've had so far today (she thinks that there should be a four hour gap between each injection) and she also doesn't think that you should have a correction of more than three units at anytime
 
I wonder if the improvement is due to the different pen? Maybe the Diabetes Fairy has struck a deal with the tooth fairy, and the tooth fairy swapped your other humalog for saline? 😱 Let's hope today is a one-off and things get back to (diabetes) normal tomorrow! 🙂

I can see your DSN's point about corrections, but I don't personally have much experience of doing them. I'm lucky that my levels rarely require them because I do get paranoid about stacking insulin, particularly if I'm going to be asleep whilst it works its way through.
 
Totally agree about the paranoia.....the worse I had was nearly years' ago when I'd eaten my dinner but then BGs crashed and I needed two bottles of lucozade over the space of an hour to get back to "normal" I reached the point where my stomach was on the point of not being able to cope with any Lucozade survived the hypo........but ended up in hospital two days later with sickness......although in hindsight this was probably the start of the gastroparesis. BG is now donw to 9.0 - hooray - I think both tooth fairy and diabetes fairy are very naughty!😡
 
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