I know this is pretty late (at least in my end of the world), but I wondered what people do to bring their really high numbers down, when they have ketones.
I’ve been sick the last few days, and finally sucked it up and saw my GP. I think what ever my doc gave me, is having disastrous impact on my numbers. I had been hanging around the mid-upper 200s pre-doc visit. For at least 9 hours, I haven’t been able to get below 417. Twice my meter has read hi.I keep following my pump correction suggestions, but it is not bringing my bgs DOWN. To top it off, I can’t seem to get rid of the moderate-high ketones despite loads of water and what seems like massive boluses. I have already doubled my daily dose.
The doc gave me 2 different shots, and told me that neither one would affect or raise my blood sugar…ya think? There’s no way I’m starting the medrol dose pack tomorrow!
Sorry to be ranting… I had a couple of hours where I felt better, but now I feel really nautious and crummy. I broke down and took a regular injection for my last bolus about 2 hours ago, but my blood sugar headed back up to 487. Any suggestions? I don’t think I’m in serious danger or anything, but I hate cotton mouth, and I would like to actually sleep tonight. Diabetes SUX!!!
Did you try a new bottle of insulin? This happened to me a couple weeks ago. Tried changing my site, then gave myself a shot when that didn’t work, but still no luck. Changed my site again, but this time I changed to a new bottle. STILL no luck. Was having small ketones so downing the water. I sent my endo an email and 30 seconds later my phone rang. He said it was one of two things: bad insulin or an infection of some sort (he mentioned urine infection or mono). Since I had already tried a new bottle I didn’t think that was it, but it was the easier place to start. Sure enough, my blood sugars came right down and have been fine ever since. The first two bottles I used were from the same batch, so something must have happened to them in transit. I took them back to my pharmacy and they gave me a new bottle (only one to replace the two, but I think they thought I was crazy!). I hope that you find an easy solution like I did. I know how frustrating it is!
We’ve had a few good discussions recently about what those steroid shots can do to your sugars and how to bring down highs when sick with a cold or the flu.
You are probably doomed to some crazy insulin dosing for a few days, but you HAVE to bring your sugars into target range and reduce your ketones. Tons of water, tons of insulin (as needed), and careful eating.
I changed my site this morning, and did indeed open a new bottle of insulin. Unfortunately, it’s the only bottle I have. I guess I immediately looked to the meds, because It didn’t start really going up until the early afternoon. How long did it take your blood sugar to go up after you started using the bad insulin? I’m impressed your pharmacy, took it back. Should I take it back tonight? Glad my pharmacy is open 24 hours…
If something in those injections contained a steroid that would help to explain your elevated levels. The medrol dosepak is as follows. It is a member of the glucocorticoid family. Whenever I have taken that it has shot my sugar through the roof. Be careful when taking it and make sure that you are drinking plenty of water, and testing a bit more often.
Also because you are sick and are fighting an infection in your body, your sugar level will naturally rise due to that.
I sure hope you feel better, and yes diabetes does suck, i was all over the chart today. i am doing a pump exchange with someone my charcoal 722 (can’t use the sensors, ins. won’t cover and not enough body fat) for their purple 712. So the past three days on injections have been he!!.
I will pray for your sugar levels to return to a safe level. Try rotating where you’re giving your injection/putting your site. Sometimes that does the trick too.
Well I didn’t really give them an option…I did give them the old ones back, and mentioned I had been going there for 15 years, and never had anything like this happen before. They were a little defensive in the beginning, but I assured them that I wasn’t blaming them, that it probably happened in transit (that’s what my endo mentioned). They seemed a bit baffled, but gave me a new one. Probably thought I was going to cause a scene:)
The first bottle was a bit rusty in the beginning, but not bad. It really went bad on the second tubing I filled with it, but it took me awhile to figure it out since I blamed it on my crazy Thanksgiving meals and being out of my routine. It was quite suddenly though.
Thanx for the links! I must admit, I’m really mad at the Dr if it was a steroid shot! He specifically told me that it would not affect my bgs. He totally blew my question off and didn’t tell me what was in either shot. He was filling in for my regular GP, so I wasn’t really trusting to begin with.
I hate using tons of insulin at night. Fear of it stacking and going low are great! I live alone. I hate being high too, but less scary than a low from a huge dose. It will be a night of constant bathroom breaks and water. So much for being sick & needing my rest.
I’m worried about you…high ketones and 500+ blood glucose is major stress! Are you feeling sick (not germ sick, but sick to your stomach, nausea, that sort of thing) at all? Please be careful and get a hold of your doctor if you can’t get your BG moving down significantly in the next couple of hours. Ketoacidosis can be very difficult to get yourself out of once it really starts moving, even if you get your blood glucose back into the normal range.
I really appreciate your concern! I’m liable to be concerned my self in a minute.
I definitely feel sick, but it’s hard to tell, when your sick because your “real people sick” or diabetes sick.
Diabetes sure doesn’t help. Right now, I feel nauseated, but my stomach is practically a fish bowl with all the water swishing around in there. Sometimes water alone will cause me nausea.
I am concerned about the ketones. I thought they would be flushed out by now. I guess I am hoping it takes a few hours to completely clear the kidneys. Needless to say, if I don’t see them getting smaller or if I start throwing up, I will page the doc on call. I just hate bothering people, much less admitting that I can’t control this on my own. Must avoid the ER AT ALL COSTS!
If your insulin isn’t working right, your body will continue to generate ketones. Drinking a lot of water can definitely cause nausea, and furthermore too much water can be toxic to the point of death.
I would stop trying to flush the ketones with large volumes of water and focus on getting your BG down to a normal level. Don’t wait a few hours. If you are using rapid-acting insulin via injection and it isn’t making a dent in your BG, get to the pharmacy and tell them you have a bad bottle. I saw that you changed your site already for your pump. Did you also change out the reservoir and tubing? I’ve had that end up being the bad guy once.
Eliminate all the variables in your treatment until you find the culprit. I totally understand wanting to avoid the ER but if you don’t get your BG down you will end up there no matter what.
Just wanted to say how thankful I am for all of you that posted your thoughtful comments and suggestions. There really is nothing else out there that compares to people who KNOW AND UNDERSTAND!
After a very long night of spending a small fortune on strips, and poking so many holes in my fingers that they now bleed on command, I have made it under the 400 mark! 381 to be precise!
While I am thankful it is at least headed down, I’m still confused that I still have moderate ketones after many massive doses of insulin. I took Toni’s and Oneless’s suggestion about the insulin being bad (THANX!!!), and I remembered I had one lone insulin pen hiding in the butter compartment that I know was good. I went ahead and doubled the suggested dose that my pump gave me and gave three shots in different areas hoping that would speed up overall absorption. I also checked the new sites tubing and reservoir for leaks or problems and found none, so I figured it wouldn’t hurt to try a temporary basal of 140% if the insulin was bad, and might help if it were good.
I’m now starting to think that the insulin in my pump is OK, since the pen still didn’t dramatically impact my numbers. I’m still returning the bottle though, just to be on the safe side. I’m also sucking it up and calling my CDE/pump trainer for advise. I love her and she is type 1 as well so I trust her.
I just don’t understand why I STILL HAVE KETONES? How much insulin does it take? And even with the lower blood sugar, I feel a little more nervous because I still have nausea without all that water sitting in my stomach and I have actual pain. Not terrible pain, but a very real reminder of how I felt the last two times I went into DKA, before I started throwing up.
Jeez, I thought trying to actually get better would help my numbers, not do the exact opposite. It’s made me feel worse and only God knows how much damage I’ve done to my body. These are the times, that make me question why my endo, can’t be my primary care doc. It would just seem to make more sense…
I went to my doc on thurs and had had a night of 200+ readings (high for me) and unable to bring it down.had tried a shot as well…he told me thought i was getting a virus and had me start titrating my basals up every 24 hours–took till yesterday afternoon and a temp rate of 120% to gett hem down…and I now have the scratchy throat, runny nose classic cold symptoms. help to ahev a doc who is T1 too. he ttoldme to tittate upto double what I normally would take…if that didn’t so it to call him or if i got keytones…he has been able to keep most of his patients out of the ER by helping them over the phone to get the BG down and the keytones down…hopefully your CDE will call soon to help you through this w/o an ER trip
Hope you’re feeling better now. Am worried about you dealing with this alone.
I’ve also had bad insulin. My pharmacy replaced it with no questions asked, so perhaps this happens more than we realize. They even checked the batch number for me to be sure I got effective insulin.
Injections will work faster than your pump–glad you did this.
Please don’t be concerned about bothering anyone & call your doctor as much as you need to. If you don’t believe he’s helping, go to the ER. Yea, no fun at all, but they can help get those numbers down. Been DKA & don’t want this to happen to you.
Sending all good thoughts your way. Keep us posted, if you feel up to it.
I’m not a Type 1, so I can’t address the main issue here, but I can say that family doctors and orthopedic doctors are FOS when it comes to telling you that drugs won’t affect your blood sugars.
I have experienced dramatically elevated blood sugars for days from a steroid shot into a sore shoulder. Later I was told electrophoresis would not push steroids into my blood stream when I had a foot problem so that was a safe way to treat it. WRONG. Again, days of high blood sugars.
A supposedly bioidentical estrogen preparation from a compounding pharmacy called “Tri-est” pushed my blood sugar WAY up too, though I have never had any problem with other estrogen supplements.
Doctors are extremely ignorant about the side effects of many drugs. I have a study linked on my blog somewhere that found most doctors don’t even recognize the most serious side effects caused by commonly prescribed drugs when patients describe them, and dismiss them as unimportant when some can even be life-threatening.
When a doctor wants to give you ANY medication, insist on knowing what it is before hand, and make them look up the side effects to check for hyper or hypoglyemica. If it is pills, look it up yourself and find out what the special considerations are.
I have some special issues, and I cannot tell you how often doctors have prescribed drugs for me that are specifically warned against with black box warnings for people with my condition. The doctors will assure me they are perfectly safe. They are not.
