Crazy Unexplained Highs

Hi… I know that there have been other posts on this topic but circumstances are unique. I’m pumping humalog. I’ve been sick (colds and such) for the most of the winter… its been brutal in NYC. I’m running high most days… (last A1C was 5.7 - one coming up will be in the mid 6s for sure. I’m getting sugars relatively flat before I go to bed (70’s to 90’s)… around 3PM sugars rise from 90 to 160s… done that like clockwork the last two days. Treatments:

  1. New cartridge, insulin and pump site
  2. Sick day insulin pattern
  3. Put a 50% temp basal on top of that
  4. Gave 5!! units correction bolus.
    Sugar is stable but not dropping – I should be in tank.

My thoughts –

  1. underlying virus - possible
  2. Not enough exercise - slowed down the last two weeks - -unfortunately, I haven’t been on a regular schedule - this is a likely cause
  3. But… if one of those – the treatments I’m giving should still deal with that.

I’m clueless – ideas?

Thanks!

My suggestion, if it doesn’t start coming down soon, would be injection by needle, in stomach for fastest action.
The increased insulin by basal and correction could be not absorbing well at pump location.

What is your sick day pattern compared to normal ?

Also check for ketones.

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It came down but this is happening frequently lately. Sites are changed when this happens. No ketones. What are ya thinking ?

My situation is not exactly the same as yours, but I can share what has been happening to me and my blood sugar management. I got a cold/virus just after Christmas and dealt with that for almost the whole month of January. I didn’t see the doctor as I did not run a fever.

Then I got an infected cyst and saw the doctor who prescribed an antibiotic. That antibiotic had a side effect of thrush/yeast infection elsewhere in the body. All the while I am dealing with these ailments, my blood sugars were running in the 200s - 300s in spite of using correction doses, frequent infusion set changes, and a temp basal of 150%. I even resorted to using a temp basal of 200% which did bring the high numbers down to target range.

Don’t underestimate the influence of infection on the body. If you are having high blood sugars, infection could be one of the reasons. See a Doctor to eliminate any other possible causes.

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This has been my experience, too. When I’ve had infections, I’ve used up to twice as much insulin per day with poorer control than before the infection.

I like @MM1’s suggestion to inject with a syringe when experiencing “sticky highs.” I would likely do a double fingerstick when acting on a BG number that means a significant correction insulin dose. I like to deliver such doses into muscle for faster effect.

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Also, in addition to the other suggestions, make sure you are properly hydrated!!! I’ve experienced similar symptoms (unresponsive highs) when I did not have proper fluid intake. May not be the issue for you, but it’s easy enough to check off the list of suspects.

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I’ve been having terrible highs that I can’t get down. I dont have a cold, but you should see post from Robyn_Hovey at A walk through insanity and basal adjustments

Hum, i’m very confused…you’re checking ketones at BGs of 90 - 160s, you think those numbers are ‘high’. 5 units sounds horribly dangerous and sound like you’re going to get yourself into trouble, fast! and those sound maybe like ICR or meal bolus issues, no?

ONE DOESN’T CHECK FOR KETONES OR WORRY ABOUT BG’S OF 90’S TO 160s

‘CHECK FOR KETONES’…AT 90’S TO 160’S. I’m sorry but what are you even talking about? This is ridiculous, these are not highs and no even close to checking for ketones, these are normal blood sugars. OMG.

There was additional information in post, such as BG not coming down after repeated insulin doses. The meter readings can be in error. Many other things were tried by original poster. So under these circumstances, I think ketone test is valid.

But a routine 160 that comes down soon after, no problem.

one doesn’t even need to check for ketones until BG’s are nearly in the 300’s, some say above 250 other endos say anything above 300s.

Who are you, to tell anybody how they should manage their diabetes? If checking their ketones gives them piece of mind, good for them.

It sounds like your bgs are more predictable and static than my son’s and this afternoon rise is a clear departure to normal for you. It isn’t uncommon for Caleb to see basal needs change with a period of higher than usual bgs like you describe for your 3PM period.

If Caleb is ill and seeing higher numbers, we often charge up his basal with a temp basal - could be as much as double. If illness isn’t an issue, we’ll adjust his basal schedule permanently when a trend is noted. He’s a growing teen though, which may explain why this occurrence is more common for him.

Checking for ketones when seeing higher than normal numbers when ill is definitely not a bad idea. I’ve seen Caleb with ketones with in-range bgs when ill. For him, hydration is key to counteract that.

Oh! I just saw this post is from a year and a half ago! I suppose you have this all figured out by now!!

Not sure why this was resurrected. @Sarah97 - You seem to have a different experience regarding ketone protocol. I’m glad if that works for you. There’s no harm in others taking a different approach.

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