Been running some great flatline BG readings for 2-3 weeks, and last night everything went…badly. Went out to dinner and estimated 25-30 carbs on the plate, but there was fat involved, so I upped it a bit and did a square wave of 2.5 at 6:00. Had placed a new insertion kit that morning with a viable vial of insulin. Was visiting my mom-in-law, and only brought another insertion, but no insulin. Here is what has happened:
145 at 10:00pm—no correction 303 at 1:30am—3.1 correction--moved to a new insertion location
207 at 5:30am—2.0 correction
114 at 8:00am
173 at 9:00am—1.1 correction with BOB
11:00 at169am--.8 correction with BOB
1:00 at 140pm—19 carbs—1.5—changed insulin bottle, pump insertion. (at home)
2:30 pm at 185--.4 correction with BOB
Is now 4:00 and climbing upward from 152.
OK, OK. I know that I have only eaten 19 carbs since 6pm yesterday, plus LOTS of water. I am terrified to eat with BG readings like this that are unexplained. No ketones—just tested. Must admit to a bit of hunger,
however :(
Have taken 11.4 units/19 carbs over 22 hours and am still climbing. Not sick, not stressed,except for the BG readings, changed equipment, insulin vial.... Thoughts? Ideas?
Sorry you're struggling, Spock. It does seem like you keep popping back up after you come back down, so something is up. But for me it doesn't yet indicate enough of a pattern to make changes with. I do notice that your ISF seems to be around 1:50 which is fairly low especially for mid-day (mine is 1:27 during the day, 1:48 at night) so you might want to look to change that.
You might not feel sick but you could be incubating something causing the higher numbers which will reveal itself in time.
My other guess is an absorption problem. Even though you've changed your site, you might try changing it to a completely new body area in case you are not absorbing well in the area you are using; that once formed the solution for me. I would also have done an injection especially when you had the super highs of 303 and even 207 - first to get it down more efficiently and quickly, second as a diagnostic to see if the infusion is your problem. Even though you are not super high now you might still try that.
If you continue with high numbers I would start looking for a pattern as to whether it is meal related or at a specific time and do some basal or I:C adjustments accordingly. Also consider tweaking the ISF.
I keep getting the lesson that it doesn't matter as much "why" something happens as what you want to do about it! My so-called new-found DP which caused me to raise basals (slowly) from the .500's to a peak of .900 just as slowly disappeared (I started being in the 40s when I woke up) and I'm back where I started!
I've been experiencing unexplained highs this summer as well. Maybe it has something to do with the heat? Also, Medtronic just recalled a lot of leaky reservoirs. Could that be an issue?
Yeah, weather has huge affects on me, but we have been 110 in the shade for weeks now, and all has been fine. I checked all my reservoir lots and they are fine.
Sorry, Zoe. Just googled it. Unless mine changed dramatically in the last 24 hours, it is not an issue. I have really tweaked my basals in the last month to react to the insulin sensitivities at various times of the day and am confident they are good..
Hi Spock. What kind of carbs did you eat when you went out to dinner? Did these carbs include any gluten or dairy? Have you noticed higher blood sugar levels than normal after consuming dairy or gluten? Did anything in your routine change the day before or the day of the initial highs, including a change in sleeping pattern or longevity, increased stress, or feeling ill?
As far as I see it, the initial high could have been from the carbs, but the remainder of the highs could be (a) an immunologic response including release of glucose from the liver in response to the gluten or dairy protein, or (b) a release of extra glucose from the liver due to stress, sickness, or a change in routine.
It doesn't seem like an occlusion problem because you changed the insertion and reservoir. It also doesn't seem like a contamination or ruined insulin sample because you loaded from a new bottle (that hasn't been open for more than a month?).
I was given some information by my dietician about how gluten and dairy protein can negatively affect blood glucose levels because the body sees them as pathogenic materials and results in an immune response. He gave me the following links for reference:
ISF is not basals, Spock. It's your correction factor. For me mine is 1:27 during the day. In other words one unit lowers my blood sugar by 27 points. You find it by trial and error. If you find that what you are currently using frequently doesn't lower your blood sugar close to target in three hours than that is indicating that perhaps your ISF needs tweaking.
I noticed your comment about ISFs. My ISF is 1:65 during the day. It may be possible that that isn't the reason for the highs, if Spock is very sensitive throguhout the day, like me. I liked your insight on changing sites to a different body area. I also think that's a good idea.
I wasn't thinking that was the primary reason, but just a factor in why she is struggling to get it back down after corrections. To me if repeated corrections fail to lower BG than the ISF may need tweaking.
Thanks, Zoe, but I was not referring to the ISF as basals, except that I have worked really hard and successfully to flatline them. And I would think that insulin sensitivity would affect a lot more that the correction factor?
1:65 has worked very well for me for many years—in fact, until yesterday, it was a winner. Oddly, as I get older, my basal and bolus factors have lessened a lot, but the correction has stoically remained the same.
Amanning—no noticeable reaction to lactose or gluten ever. I had a problem a few years ago (non-D realted) and was allergy tested out the whazoo, and feel confident this is an anamoly and not allergy related. Fat is what usually gets me, but this was a broiled crab cake and a salad with 1T of dressing (FAT..I know, but not enough to incite this) The carb was a roll. Should not have caused this level of problem.
Absorption could be a factor, after 10 years of pumping, but I am pretty careful and keep track. It had been 3 months since I had used those areas. I know I have scar tissue, but am running out of places I do not…
See what happens overnight. Often I crash big time after things like this.
You all make me think out of the box and I am truly grateful for your help.
Oh, I agree, Spock, that insulin sensitivity affects a lot more than the correction factor. I'm not sure why it's called the ISF; some people (like Walsh) just call it the "correction factor". I think I learned to use the term "ISF" on here.
Hope you figure out the reason for the highs or better yet it just goes away and remains, like so many things with D, unexplained!
Finally decided to take your good advice and not worry about "why?" I must say though that I can live this type of thing, if there is a tangible reason, like a huge piece of chocolate cake!
I settled down about 9:00 last night and flatlined at about 100 overnight. Back to normal, for now.
Glad things settled again. Can't help you in the cake department, but sorry we both have been paying hostess to those darn gremlins; they are particularly annoying to logical people who expect things to make sense!
I'm glad things are back to normal for you at the moment. I've had unexplained highs for approximately the last 3 weeks and could not figure out WHY. After trying everything I could think of, I called Medtronic helpline. A young tech support person there suggested I try a longer cannula and place it in a totally different part of my body. They sent me samples of several of their infusion sets including one that I had never tried. Maybe it is the longer cannula for me or maybe it is just luck, but my numbers have been much better in the last few days. Hope you continue to improve. Good Luck.
