Highs that don't respond to insulin

I am out of ideas about what to do…
For past five days I haven’t been able to bring my BGs down. They run constantly between 150 and 230, no matter how much insulin I use to correct. I’ve changed my set, cannula (three times), used new insulin bottle, I’ve tried correcting with needles but still my BGs won’t come down. No signs of flu or other illness… First I thought my insulin froze because it’s really cold here (like -10 °C) but a brand new bottle did not help :frowning:
Usually, my BGs are between 75 and 160, so this kind of freaks me out. I can’t think of what’s causing the high BGs nor how to bring it down. I’ve tried insulin, exercise but it just does not work.
Any ideas?

This sounds very anxiety-producing for you! I don’t have any brilliant solutions, but just a couple thoughts. Have you also tried changing the site of your infusion set? Perhaps the area of your body is causing the problem and if you change to a completely different area it might help? Also, not all flu or illness is immediately apparent. You could be incubating something that hasn’t yet presented symptoms so stay aware for a painful tooth, urinary tract symptoms, etc. But even then, the corrections should bring it down! So I would say the site, and also check your insulin batch. See if you can get a completely new batch from the pharmacy.

I know you know this but be careful with stacking corrections if you get desperate and feel nothing is working. Also, stupid as it sounds try a very hot bath which often dissolves pooling of insulin. (and check your sites for lumps). Hope any of this helps and it resolves soon!

Chele I am sorry you are dealing with this problem. It’s hard enough just being diabetic let alone dealing with high and low sugars and then having a period of time like your going through where nothing seems to work. I am type 1 also and have recently this past January started going super low carb with DR. Bernstein and his diabetes diet. There is a group of us that follow him on this site. I don’t know your daily carb ratio but when nothing is working to bring my sugars down I try and eat only protein for a day or so. Sometimes this seems to work along with more insulin usage. Just hang in there and keep trying. Over the weekend my sugars where running higher than most days for me and I couldn’t stay lower where I wanted to be. But I ate mainly protein and in a couple of days was actually fighting lows. At least your on top of it and not just saying whatever with your sugars.

your cycle can make you less sensitive to insulin… about 10-12 days before my period kicks in, i up my dosages and avoid complex carbs more diligently. i keep track of my cycle on a calendar, it helps me keep track of the highs really well! on unexplained high usually means i’m entering a different phase in my cycle.

also, i once took my insulin to the pharmacy to tell them i thought it was denatured or defective because i was running highs in the 200s with no explanation, especially at night. it turned out that my stress levels at the time were elevating my levels (cortisol) and making me less sensitive to insulin as well - a bad combination.

if you continue to stay high, def call your endo!

i hope that helps. good luck!



Thank you for responding!
I did change the cannula and inserted on a different place, but it did not help. I am wondering if I can be allergic to teflon cannulas or something - but would it present itself after a year of pumping?
That’s what I am confused about, that corrections don’t work. Maybe I just need to “restart” my system, if I could just get my BG down and keep it there for a while and then start all over again…

Yeah, I thought about the stress factor too. New semester just started… I guess I’ll just have to be patient. I’m seeing my endo on Friday, so if I can’t solve it myself by then, I’ll ask her for help.

I’ve returned vials to my pharmacy & exchanged them with no questions asked. I made sure the new insulin was from a different lot number n case the entire lot was defective or stored improperly.

Correcting by injection usually works when it’s a site issue. What I do for persistent highs (use MDI) & when sick is take small corrections every 1.5-2 hours rather than larger doses at once. Works better for me because the absorption rate is faster with small doses.

You can become allergic to something at any time. If it was the teflon, you’d have a reaction at the site. Some people develop a resistance to a particular brand of insulin & need to switch to another.

Hope things improve! So frustrating!

This is going to sound really bogus, but… stress and anxiety cause your body to increase production of adrenal hormones (cortisol, adrenaline) and they make you insulin resistant. Whatever started the problem may be producing sufficient aggravation and anxiety that the insulin you’re using just isn’t working as efficiently as you’re accustomed to seeing, and that’s creating more stress, which means you have a self-perpetuating problem. So at the risk of sounding like a lame-■■■… try meditating, a cup of chamomile tea, yoga, whatever methods you usually use to chill. Because it might be something as simple as your stress levels that are doing it to you. BTW exercise only helps if it’s not high-intensity, because high intensity exercise ups your cortisol levels too! So don’t to a full-out aerobic work out – go for a 30-minute walk instead, and see if that helps.

Oh, whoops, just realized I was preaching to the choir, but that’s the first place I’d look anyway.

You are a smart gal, you have done the things that “should” normalize your blood sugar. But something is keeping your blood sugar elevated.

While you don’t have any outward signs of illness, is it possible you are sick or injured in a way that you don’t notice or have not associated with your blood sugar? Have you sprained your ankle or injured yourself? What is your body temperature? Have you noticed any bleeding of your gums? What about a UTI? And have you been sleeping poorly?

Sometimes, you can actually be sick and fighting a condition without actually feeling unwell (such as with gum disease)

And average blood sugars do go up in cold weather, if you are really not used to cold weather, the stress of the cold and exertion under those conditions may affect you, particularly if you spend a lot of time outside doing activities.

I exercise usually in the morning - I get up at five to find some time to exercise because the rest of the day is just crazy. Yesterday I actually did yoga before I went to bed and I don’t know if it helped my BGs but it definitely felt good :slight_smile: and woohoo, today my BGs seem to be back to normal, in the nice 80-140 range with one exception of a pizza-caused 162 :slight_smile: thanks everybody for comments, now when I think about it, I should probably focus on keeping my stress level down in the long-term…

Are you on Novolog? If so, drink water. Lots of it. If you have the slightest trace of Keytones Novolog will NOT work. This sounds exactly like what happens to me when i have keytones. +100% basal and bolusing every hour won’t bring my sugar down till i have some water.

The only thing I can think of is an infection or inflamation that is running under your radar, or possibly producing no symptoms. I would recomend visiting your doctor for a general work up and blood work. Hope you eventually get your sugar down, this must be horrible. Good luck.

Stephen - Is the inability to work with trace keytones your experience or do you know a study that supports this? I would think that a rapid insulin that doesn’t work at all in the presence of keytones would be pulled off the market very quickly.


well, theoretically, there could be something true about that. If the body currently “runs” on energy from fat -> free fatty acids, beta-hydroxybutyrate and acetoacetate, it does not use glucose that much - partially due to Randle’s phenomenon, which is that in the presence of fat, some cells decide to stop using glucose (via the inhibition of pyruvate-dehydrogenase, glucose phosphorylation and even glucose uptake to the cell). I think this concept should apply to all meal-time insulins.
But I never thought about that before… I have however observed that when treating highs, if you eat fat, your BG goes down much slower than if you don’t eat anything (and drink water to stay hydrated)…
And yes, I am on Novolog (Novorapid, but it’s the same thing, just a different name).

Once you get to the point of having ketones, you are likely pretty insulin resistant, no matter what insulin you are on it will take a little bit to get that number to move. It’s not that the insulin won’t work with Ketones, it’s that the ketones are a sign you are insulin resistant. :slight_smile:

There is a recall of Animas cartridges, so you may want to check if you have any from the affected lots. Insulin is leaking out of the cartridges, causing less insulin to be delivered. Don’t know if you got a recall notice yet.


There are many things that will kick your blood sugars up. Things like stress, a cold, bumping your head or shin. If it continues to stay high call your Dr.