I'll lead this off by saying this is only one sampling, as I don't have my logs in front of me right now. So I realize I need to do more testing, as well as probably test more than just 4 hours later, but I was tied up yesterday and didn't think to check my sugar a few extra times. Given that, I had a high (very high) of 572 yesterday at 11:58 am. I gave 1 unit of Humalog and waited to see how much it moved me. 4 hours later, at 3:58 I was 409. A change of 163. This sounds like too much of a change for so little insulin to me. Granted I haven't been calc'ing correction doses for some time, but the last time I was, 1 unit would drop me by 50. I was a teen then, and suppose hormones could have been playing with that as well. I guess my question while I test this some more is, does anyone else take such a small dose and move so much? Or would you all venture to guess this was more a fluke or that the 572 wasn't really 572? (it sure felt like it was.) Thanks, Ryan
It is quite unlikely that you are that sensitive to insulin. I would bet your basal rates might be too high and could explain a lot of the drop in your BG?
my correction factor is like 120 but i am honeymooning. i:c rate is 1:30, sometimes higher.
When your blood sugar is very high as yours has been, all bets are off with respect to correction factors. You often get very insulin resistant and your actual blood sugar level is affected wildly by a range of things.
I looked through your previous posts. You are really struggling and I know you have anxiety over low blood sugars. But you also in your heart know that you are so far from a low blood sugar that this is not an issue. I suspect that you have consistently been taking too little insulin. You said you basal was four units? Do you really think that is enough? And you also said you undercount carbs. Again, too little insulin for meals. And this correction stuff. You haven't been correcting.
Please, please, take care of yourself.
If you had a normal blood sugar, your Correction Factor (CF) would probably be 50. If you want to use a CF of 150, fine. But please correct. And correct every 3-5 hours. And write down your doses and how much your blood sugar drops. And if it always drops 150 units for each unit, great, your CF is 150. But my bet is, you end up with a CF more like 50.
So please, consider taking the first step. Try to establish more appropriate basal and bolus regimes. And check 3-4 hours after each meal, if you are still high, make a correction. Just do it at one meal a day first and then work up. Just target a "better" blood sugar. Just get your average to 300. Just make some first steps.
I was also going to comment that with that high a number your results would be unpredictable. But reading Bsc's post it sounds like he has taken the time to review your history and gives you some excellent advice about the big picture of your D management.
I did mean to point out the unpredictability for having been high for so long, but in my rush to get out the door this am, it slipped my mind. I brought my logs to work today to see if keeping a better eye on this and logging as I go instead of at the end of the day will help me. It usually does, and my numbers have been worse during work than non work days, so that is todays start.
The other thing that I should point out is that if you have a very high blood sugar, you can start to enter DKA. DKA results in your liver actually producing glucose and ketones. When you inject insulin and have mild DKA, that can "turn off" the DKA. This could explain the larger than anticipated blood sugar drop as well.
As you know, we are generally told to for ketones when over 300 mg/dl.
Would you please check back in with us and let us know how you are doing?
I have been checking for ketones, granted not at every sugar test that comes up high, but whenever I do check, they come up negative.
As for checking in with how I am doing, yesterday was a better day, average for the day was 341. Not good, but for where my daily averages have been, that is almost a 100 point drop. Started off with another pretty high number this morning, but corrected and came down for what I would call an improvement. When I corrected, I tried 1 unit of Humalog to see how much it would drop me again, and checked more frequently. This time, at 1 hour, I had dropped 42 points. By 2 hours, I dropped a total of 167 points. And by the 4th hour, I had dropped a total of 183 points. This was with no other insulin on board except Lantus from the night before, and no food on board.
bsc has given you some good advice. I see from your profile that you have been diabetic for almost 20 years. I would like to encourage you to gradually get your glucose readings down to below 140, as that seems to be the number where damage occurs. My son has retinopathy and neuropathy after years of high blood sugars, which means he's gradually losing his eyesight and is in terrible pain in his legs and feet. He is trying for tight control now, but the damage has been done. Please don't let this happen to you. And you will feel so much better with more normal blood sugars.
That's a great step, ryryguy! The more data you have the more you can see patterns the easier it is to tweak your doses to get your numbers more in range. I log all my blood sugar readings, (waking, before and after each meal and bedtime), how many carbs I ate, what dose I took and all corrections I make.
One thing to remember is that at very high BG numbers your meter is not going to be super accurate. Meters are allowed to have a 20% variance and at a BG of 400, that can be 80 points. So you know you were really high and your BG came down, but I don’t think that you can count on the readings being accurate enough to know exactly how much 1 unit of. Insulin brought you down.
I didn't even think about the variation of the meters and how it could be skewed by a larger count the higher the actual reading was running. Yet another variable to toss a wrench in the works.
That is great, I'm glad you aren't showing ketones. I presume that you did the urine strips. They also make a ketone meters and strips that allow you to test your blood levels.
What matters is that you are testing and correcting. Until you get your blood sugar more normalized it will be really hard to figure out what your CF will be. I'm glad to hear that you are working on it.
my correction factor seems to be about 40 for 1 unit or 20 for 1/2 unit, but I think it varies a lot depending on what is going on with me-I have not done that many at all and hardly any lately since my bg has been more stable with a low carb diet.
I was in dka at 279 or so, my highest was 363 that I know of at the er- you can go into a coma at your current levels. I'm glad you brought this down a lot.
I think you need to talk to your doctor asap to see what is going on and what you need to do to get yourself to a normal range.
I still have weird drops and times when I think my pancreas or liver must be controlling things, like when I don't eat for a few hours and my bg goes up anyway or when I drop like a rock on low doses of novolog and lantus.