Unexplained Highs 365-466 past two nights

Can anyone help me? I’m a 22 year old female hat has had type 1 diabetes for 10 years. I have had excellent control through the years. I switched to an insulin pump a year ago because my blood sugars were becoming dangerously low in the night and it has helped me to reach a a much better control.
The last two nights I have had HIGH blood sugars at about 4 or 5 in the morning (365-466). This is very very abnormal for me. Each night before bed at 10 pm my blood sugars have been stable (between 80 and 110) for at least 2-3 hours and I don’t eat anything that would raise it to the highs listed above. I usually have to EAT to avoid lows in the night. I am at a loss and feel badly. I raised my basal up just a little but I feel like it wouldn’t even help if I raised it a lot.
I think the problem is that I left my insulin in a hot car while we did white water rafting a few days ago. That is the problem I’m sure of it.

When was the last time you changed your site? That’s always the first thing I do when I get to unexplained highs. You might want to also try putting your pump site in another area. You may be developing scar tissue which inhibits good insulin absorption.

I’m sorry you’re going through this. My philosophy is always…when it doubt, change it out. Good Luck!

Sarah :four_leaf_clover:

If it was the insulin, it would seem that your blood sugars would be high all the time, not just at 4 or 5 in the morning. The timing of this suggests either you might have rolled over on your insertion site (unlikely two nights in a row) or that something happened with the early am hormonal (cortisol) release-?

My daughter is having unexplained spikes up to 360 (would be higher but she does massive boluses) several times a day, with the timing random. She is seeing an endocrinologist her diabetes MD found for her. If your problem continues maybe you could ask your diabetes MD for a similar referral.

I would change out everything - new cartridge, new bottle of insulin, new infusion set, and put it in a spot nowhere near you’ve put one in the past month. Wishing you the best, let us know how it goes. hugs!

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If your BG was good before you went to bed then you probably do not have a insulin problem, but it would not hurt to change bottles…JMHO

Anytime you have a unexplained high BG you should do a correction with a syringe and change out
everything and if the correction works then it was probably site rejection and if it does not work it could be the insulin…but I would also not rule out some form of temporary insulin resistance…again JMHO

I’ve been on insulin since 1978. Never had a bad bottle and I used to use a LOT of insulin because of my past stupidity (not counting carbs til 1996 for example and just plain over-dosing, going low, rebound high, corrections, etc)

If the high is happening at the same time in the early morning hours, I would look to blood sugar falling low and rebounding or, possibly the liver being stimulated to produce glucose for some reason.

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My daughter tried no coffee today, with good results. She had given it up for a year and just resumed. But I guess you are not drinking coffee in the middle of the night! Still there IS an answer. Rebound low, excess cortisol, excess glucagon from liver, about to get sick, stress, hot weather, sudafed etc. etc. Anything seem to be possible?

somehow I missed that comment. I’d use another bottle of insulin! Sorry I previously missed your comment about leaving insulin in a hot car. they can easily get over 120 degrees and possibly over 135.

sounds like you may have answered your own question…

I’ve never had insulin go bad personally… But we all know how hot a car sitting in the sun can get. That would be the first thing I’d rule out… I think the the inside of a dark car in direct sunlight can get much much hotter if they’re in the sun for a long time…

i agree w/ JohnG; the first thing i do w/ a serious correction bolus is use a syringe. this way i can tell if my insulin is working. if so, and i respond to the shot, like most others have suggested, i change my site immediately (rotate, rotate, rotate!!!) . if i am still having a problem, i change my pump. the insulin has already proved that it is good, you’re in a new site, now just redo your reservoir and you should be good to go. when my BG is that high, i usually take a shot anyway; its always seemed to be much more effective in the short term. also, there could be air bubbles in your tubing so you’ll want to make certain when you prime the tubing, you let quite a bit of insulin to come dripping out before you reconnect to your infusion site and fill the canula. good luck.

be aware you can’t keep track of IOB when doing shots which is why I seldom do that. I have to see my current IOB at certain times to know how to get/keep my bg’s at a safe level. YMMV

you’re 100% right about shots w/IOB. i do keep obsessive impeccable records of everything, so i can get a sense of where i am going. also, i test more frequently to keep everything above ground.

thanks.

That’s really unfortunate as mentioned by several I would swap out the insulin and cartridge. Here’s some information concerning insulin storage etc…

http://www.fda.gov/Drugs/EmergencyPreparedness/ucm085213.htm

Cheers…

You can keep track of IOB when using insulin via syringe,. After giving the shot just disconnect the tubing from the infusion set, give a bolus for the amount of the shot, the insulin will come out of the end of the connector when it’s finished just reconnect. The pump will now show the shot amount in the IOB calculation. Unfortunately this wont work with an Omnipod only a tubed pump.

i agree with john. the first thing i do is give myself a shot. then, if i notice that my BGs are going down, (even a little bit) i know that the problem is NOT the insulin. i would change infusion and site and do a correction bolus if necessary (only if your last shot is still not bringing you back into a more normal range). perhaps you need to adjust your basal rates for those morning hours. perhaps you could set a temp basal before those early morning hours. of course, i know that this would require you waking up in the middle of the night to make the pump change. but, personally, i would try everything. i would also contact my endo and make an appointment for asap.

good luck. don’t give up. its great that you’re reaching out.

i just thought of something else: what did you eat for dinner those two nights? was it high fat foods? if you had had a steak or something like pizza, a burger, etc, you might not see those high BGs until much later in the night/early morning hours. this has happened to me on more than one occasion, and i know it is not pleasant.

just a thought.