Unexpected highs suddenly

For the last 2-3 days I have been experiencing unexpected highs. Earlier I thought it could be due to miscalculation of carbs. But even during the times when there was no food taken in the last 4 hours, the corrections haven't been working as they should be. There were few bubbles in the reservoir but those were champagne bubbles, I got ride of them - no control. I changed the infusion set - no control. This all have been happening ever since I got a new batch of insulin on Sunday. In the past I never experienced bad insulin. It is clear to me while writing this post it is the bad insulin batch. If corrections, carb boluses and basal nothing has been working ever since I opened the new batch what else it could be? So far out of 5 only one cartridge has been used. I'm thinking to open the new cartridge
I still need your opinions...

Your cartridges come pre-filled? You do not fill them? If you do fill them, I would abandon the current bottle of insulin and try a new one. If it works, you know that bad insulin is the cause. However in 50 years I have never experienced bad insulin.....

Couple more thoughts: are you getting sick? Have you changed your routine? Are you maybe eating foods with higher fat content?

Problems like this are so normal. Breath deeply--it will get better.

(And try giving a correction dose with a syringe--it works like a charm.


Spock - no my cartridges don't come pre-filled. I fill them myself. [In India analog insulin only comes in the Pen-cartridges, which I think is due to the fact that not everybody here could afford analog and those who could surely afford Pens.]
Even I don't remember when was the last time I experienced a bad batch.
No I'm not sick, No change in Routine, Not eating Fat food.

I definitely would try a new cartridge, Chadha, but another option is to switch to a completely different part of your body. Sometimes one of my areas seems to get "worn out" and stops absorbing well.

Zoe - yes, I'v put the new cartridge out at room temperature already... I'm gonna change it in the morning if the latest correction that I gave an hour back. I've only been inserting in the stomach but I always make sure I dont get around the lumps/bumps. To ensure the right site I changed it n placed on the area I never inserted before. above belly on the left side of the stomach.

as spock suggested, are you correcting with a syringe - injection after all this? how high are you, are you checking for ketones? careful not to stack insulin, too. if insulin w/syringe brings it down, it's not the insulin. i too have never had insulin go bad. this kind of sounds like a basal thing if no food on board and corrections not working, liver dumping glucose and can't get BG's down, everything gets messed up if basal dose isn't right.

There is the possibility that your package was not handled properly. For example it could have been directly exposed to sunlight or heat. In that case the whole package could be ruined because x percent of the insulin will be ineffective. If you have to cope with this degraded insulin you could try to adjust your basals and I:C to compensate for the degradation factor x. The question is if this is possible at all.

Okay, so many suggestions at one time... Last night I gave myself correction bolus even when insulin was working from the last bolus. Morning I woke up with 63, had a glucose tab. Had to rush so withing few mins I ate my breakfast n left for class. I checked 2 hr PP and it was 140 and after 4 hours it was 141. Recently I set my basal and there's no reason my basal could fluctuate in a period of 5 days period.
At the moment I have some things in mind -
1] Bad insulin
2] Basal needs increased suddenly - [ I doubt this one as it couldn't be possible my basal just changed within few days.. I'm still confused what to say.]
I haven't given corrections n boluse with the Pen so far.But how will it make any difference with the PEn, Since I fill the reservoir using Pen cartridges and they all the 5 cartridges come in the same batch.

The numbers don't sound too out-of-the ordinary to me. Your 2 h PP of 140 is pretty good, after 4 h you might have expected it to drop a bit, but it's not way out. If it were me I would be happy with the 2 h PP. I probably wouldn't bother to correct for the 4 hh PP as you will still have active bolus insulin on-board for another 1-2 hours.

A lot will depend on exactly what you ate for breakfast and also when exactly you took your bolus. Do you take your bolus before you eat. Maybe if you were in a rush, the timing was a bit different???

I have been pumping for 6 years and taking insulin for 37 years and I have never had a bad batch of insulin. If I do have problems with unexpected high numbers, it is almost always a problem with the infusion set. Some insertion sites absorb less well.


Actually I've also realized the insulin is okay. The out of range seems to be the call for tweaking up doses again...
I always take bolus 10-20 mins before breakfast or any meal... The 2hr PP 140 was okay, but I expected a drop in the next two hours. Like usually I ate 3eggs n a cup of coffee for breakfast. What I think is in the school I feel somewhat stress that may be adding to it. But then again my boluses are't working properly.

If your breakfast was 3 eggs and a cup of coffee, and that was all, I make that zero carbs. How much did you bolus?

Personally, I wouldn't bother about the flat 140 from 2 to 4 h pp. In practice, carb-counting is far from an exact science. Even if you are able to EXACTLY count the carbs in a particular meal, how these absorb will depend on the GI and a lot of other unknowns. Your I:C ratio will depend to some extent on the direction your BG is going (climbing or falling) before your bolus. AND one thing to come out of the artificial pancreas studies is that even under controlled conditions, basal requirements change from minute to minute and may be different from one day to the next.


This sort of thing happened to me recently but my numbers were MUCH higher. I was able to trace the start of my problem back to the date I received a steroid shot. Have you taken/received any unusual medication recently?

I haven’t taken any new medication in the last 3 months. No steroid, nothing.

I don't know what to say.. Like 1.5 hours back I checked my sugar it was around 237, since there was some insulin active in the background so I took only 2.2 units. After the Correction bolus was taken I was still feeling dry mouth, I ignored as I was supposed to check after 1.5-2 hours anyway. And it rose to 240 now.
Immediately talk n bolus with Pen. Let's see if it works.
I'm afraid it is 2 in the morning here. What if the insulin is at fault and I wake up with 300-400 in the morning..

Have you changed the kind of infusion set you are using? If I use a Cleo or any other straight set I need 30% more insulin in my basal rates compared to using a slant set.

Also remember that if you run high for a while it can take more insulin to make a correction. See how using the pen vs the pump works. Have you considered it might be a pump issue? If you disconnect and then bolus a unit does it dispense and insulin?

Hobbit, last night I Dropped from 240 to 182 in an hour after taking 3u from the new cartridge injected by Pen.
YEah, Pump is working fine.. It is dispensing insulin. checked it, several times.
I've been experiencing this since Sunday n I remember on Monday I changed the infusion set to ensure about the site issue, but the problems continued. So todat after the school I changed mu infusion tube, old reservoir and, filled with the new cartridge I used with Pen last night.. So far at least it is showing reasonable figures.
I'm surprised how come it could be just one cartridge[Remember I used Pen cartridges to fill the reservoir not bottle] issue not the whole batch, as the packl contains 5 cartridges anyway. While one worked and oither failed.

Have you looked at the lot number on the cartridge? Is it the same as the one that worked? Are all the penfills the same lot? Was the packaging unopened when you got? Is the labeling identical to prior packages? Do you trust your supplier?

Hate to say it but there are counterfeit pharmaceuticals out there. It happens with antibiotics, antimalarials and even chemotherapy drugs. Also you do not know what the storage/transport/shipping conditions have been before it was in your hands. If it was the outside cartridge in the box it may have been further away from what ever temperature stability media was used in shipping to your provider.

Other things to consider----

Since changing reservoir and tubing seemed to fix things, rather than a site change, you may be waiting too long to change either your reservoir or your tubing. Are you reusing to conserve funds? Or just continuing to use until insulin loaded is used up to avoid waste? Did you notice if there was any color change in either your reservoir or tubing? If so it can be an indication of deterioration and a need for change. If using a screw type reservoir is there leakage around the O-ring?

Another thing to consider, don't know if you are using aphedira as your rapid but it has a tendency to precipitate out in pump cartridges and infusion lines and can cause occlusions that may not trigger an occlusion alert from your pump. Some pumps have more troubles with this than others. It would still work as an injection though since it is not plugging up the infusion line/site.

Unfortunately, sh@t happens some times and you just have to go with the flow! Glad to see that you have been able to figure out/come up with a fix. If it happens again the reservoir/line change will be first on your list.