The quest for control continues

So, today I’ve tested almost every hour:

7:00 - 4.4 (79)

8:30 - 6.8 (122) - Small correction

9:00 - Breakfast (15g)

10:00 - 13.1 (236)

11:00 - 9.4 (169) - Correction

12:00 - 7.4 (133) - Lunch

Yesterday afternoon I switched over to contact-detach sets. So far they aren’t having any impact. Today after breakfast I changed to a completely new batch of insulin. I get pen cartridges and I use them up in about a month or five weeks, and it occurred to me that that’s when I started needing a ridiculous amount of insulin (for me). I’m not so worried about my control but this control with the amount of insulin I am taking is ridiculous! I’m now using an I:C ratio of 1:6, a correction ratio of 1:1.2 (1:22) and a basal rate of 26 units. This is basically double what all my settings used to be (well except basal which used to be around 22-23u). And I’m STILL running high. (Well, except for the random lows …) I just find that ridiculous!!! I might be wrong, but I don’t think someone can develop “double diabetes” over the course of a month. I’ve also made a doctor’s appointment with my GP to let him know and see if I’m sick or something without knowing it.

I just hope I solve this soon, either my insulin doses go down OR my control gets better with the current ones, because I just find it so frustrating that I am doing everything I “should” be doing (low carb, exercising 30 mins. a day, testing 8-10x per day, changing sites every two days, keeping a log) and I still have such crappy control!!

Ok, so let me try to get my head around this. You used to have a basal of around 22 u, and if you followed Walsh (from Using Insulin) you should have a 50/50 basal/bolus ratio. So your total dose used to be about 44u and you used about 22u in bolus. Is that about right?

According to Walsh (rule of 1800), then your correction factor (ISF) was about 40. He also suggests that your I:C should have been 1:10 to 1:12. Are those comparable to what you used to use?

Now that you are following low carb, the rules given by Walsh don’t fully apply. However, you I:C and ISF should be roughly the same. Your numbers suggest that they are not, and that somehow you are markedly more insulin resistant. This could happen with a weight change, ongoing stress, inflammation, etc… But for whatever reason, this also suggests that maybe your basal is off. If you ISF is half of what it used to be, your basal may be as much as “twice” what it used to be.

Have you done a true basal test recently? I am talking real fasting.

And if you have been sick, that could explain everything. You could have a lingering infection or something.

helpful or ??
This is new …by my Pharmacy when I picked up my supply …a sticker attached to the box with NovoRapid insulin 10 ml : " Discard unused portion after 28 days ". I had figured this out previously …but it is good to see it on the vial box

@bsc: You are exactly right about my doses. Basal used to be around 22u, I:C ratio used to be about 1:11, correction was just over 1 unit per 2 mmol/L, and TDD used to be about 45-55u (keeping in mind I used to eat 250-350g of carbs per day, sometimes even more!).

I am actually taking around the same TDD now as I was back then, but I’m eating 200-250g of carbs less per day …

With the new batch of insulin my pre-lunch reading was 7.4 (133), an hour after lunch (which was 25g) I was 8.4 (151), two hours after lunch I was 7.6 (137), three hours after lunch I was 4.7 (85), and four hours after lunch I’m now 4.1 (74).

In regards to basal testing I have not done it recently, mostly because in the past I have gotten different results when I do it twice in a row which drove me crazy. But I am willing to do it now if it would help my control.

In regards to being sick, I don’t know if it’s possible to have an infection without knowing it but if so it would explain everything. I have been having chronic sinus problems which my doctor claims is not an infection but just due to chronic year-round allergies and I should just start allergy shots to make it go away, but I am going to question him on that and make SURE there is really no actual infection there. I know allergies used to affect my blood sugar when they weren’t year-round, so I’m also wondering whether the fact that they’ve now (in the past six months to a year) become year-round might just be causing my body to act like it’s permanently sick, and in that case maybe allergy shots actually would help.

With a low carb diet you don’t have to cover the carbs you no longer eat. You should be using less insulin, but you aren’t.

Your readings with the new batch of insulin seems actually quite good.

It is something to try. Perhaps just focus on basal testing around lunch?