Urgent Advice Needed

I did something stupid tonight--I ate a high-carb meal for dinner (please spare me--yes, I know better, yes, I'm stupid, moving on). However, where this will normally bring me up for a little while and then I'll come down again, between the stress from finals and being sick with bronchitis, I've been hovering at 200 for more than two hours.

Part of this is because I'm on Invokana, which doesn't seem to be working as well as Cycloset did. Part of it is because I'm just stupid and didn't realize how many carbs were going to be in what I ordered. Part of it is that being sick and being stressed don't work well with my blood sugars. Most of this was just the perfect storm of stupid.

I've been drinking a lot of water, since I know the Invokana is going to dehydrate me, but it hasn't been helping so far. I can't go out and run up and down the stairs because I won't be able to breathe. For some reason I feel fine, but I'm worried about that, too, since that appears to be because I'm already not feeling well and probably don't know the difference. I need to go to sleep because I have a final tomorrow and because I'm sick and need the sleep, but I'm afraid that I'll crash once I start to come down. Does anyone have any ideas for what I should do next?

Going to bed at a 200 a few times won't kill you. If it did, i would have died a LONG time ago. If you feel dehydrated, go drink a bunch of water. It does help.

Just grab a small amount of candy or a small snack and leave it next to your bed. If you wake up with a low, eat it and you should be fine.

If you are still worried, set an alarm for 3am or something and check your bloodsugar then just to make sure.

Good luck on the finals though, I have some myself next week!

My opinion? What you should do next? Relax. For many Type 1's excursions to 200 and hovering there, while not an everyday event is not that extreme. Correct, don't stack, and test. Then relax. If you are confident in your ISF there is no reason you should crash. But testing to see what is happening will reassure you. Live and learn. Don't beat up on yourself.

Don't worry about screwing up - we all do it, that's part of life with diabetes (heck, it's part of life in general!). Just last night I had a situation that sounds similar to yours. I vastly underestimated carbohydrates at dinner (and also wore my infusion set a day too long) and as a result spiked to 473. I corrected, of course, and was still 400 an hour and a half later, so added a bit more on to the correction (per my pump's suggestion). Then I ended up with a major crash - I dropped 256 points in ONE HOUR! I ended up eating before bed and setting my alarm clock for 3:00 to make sure I didn't go low. I woke up at 46 a half hour before the alarm even went off. Needless to say, it was not a good diabetes night.

I agree with the others to relax, though - stress has an amazingly negative impact on blood sugar (as does being sick), at least for me. Also, I find that if I'm really stuck with a high, any type of exercise helps - it doesn't have to be all-out running up and down the stairs; even just walking up and down the stairs will help get my blood sugar unstuck. So you could try some light exercise, if that's an option. I personally wouldn't worry too much about going to bed at 200 - especially if you're worried abotu going low. If I was worried about going low I would set my alarm for one or two times overnight to test and eat, if necessary.

Good luck on your exam tomorrow! It always seems that diabetes acts up at the most inopportune times.

I'm not on insulin, only on pills. Like I said, I'm not worried about the 200, I'm worried about the crash when my pancreas wakes up and screams, INSULIN!!!

At the moment I'm 150, but that's up from 120 (which had been steadily dropping) even though I didn't eat anything since dinner. *sigh* I really hate diabetes sometimes.

Oops, sorry, I don't understand what makes you crash without insulin, and have no practical contributions to make, but I know managing D however you do it is hard! But the "relax" part is still the same! As you are pre-D I'm sure 200 sounds horrible, but really if it is an occasional thing it is not a cause for big concern.

Countless people who aren’t even diagnosed with diabetes spend many hours every day at 200ish. You will be fine. I promise. Worry about going to sleep and doing well on your final tomorrow not your blood glucose. I would even suggest having a big glass of wine or 2… It’ll take the edge off the stress, help you sleep, and likely lower your bg

Totally up to you, man, but I was in pretty much the same situation as you and chose to add insulin to my arsenal so I could be fully in control of my BG.

You might want to talk to your doc about getting one pen of humalog for occasions like this.

I've been asking for insulin repeatedly for more than a year. I truly love and trust my endo, but I'm really, really tired of this.

Did it eventually come down (and not too far)?

Can I ask what your most recent A1C is, guitarnut?

I second what Zoe said!

Come on, give us the "dummy stick" you're beating yourself up with, hand it over (Holding out his hand) come on.

200 is nothing. You're sick. Try and get some electrolytes too.

How you feeling today?!?! How your finals go?

Exercise when blood sugar is above a certain point c. 250 +/- runs the risk of making you climb even HIGHER. For most it is a "text book" diabetes problem, versus the real world diabetes but, it can happen.

Be careful more than a little if you are meaningfully high/higher.

Good thing to keep in mind. I wasn't talking about exercising as in doing a full-fledged workout. My suggestion was to walk up and down the sairs or do some other walking - a lot of people wouldn't even consider that "real" exercise.

My understanding is that exercise (as in a full-fledged workout) when high is fine as long as you don't have ketones and aren't extremely high (like 300+). Regardless, if you're high and worried that exercise might make you higher, you can always test shortly after beginning to see if you are dropping or rising.

I haven't found that the bg level doesn't matter as much as what type of exercise you do. Aerobic will push it down and anaerobic will push it up. I think having a correction and going for a walk is more productive than just sitting around waiting for insulin to kick in. I also sort of think that sometimes highs might be due to insulin with a "slow hand" more than too many carbs, in which case the walk can also get that going. This can be "exciting" but if you are cautious, you can be ok.

One of my local buddies, Phyl here, had txted one night that she was high (BG, LOL...) and I said you should go for a walk so we went for a walk and she reported that it seemed to help get things going. I think the ketone argument is overrated for the most part. I mean if your BG is 300 all the time, it may not be prudent to do things because you may have more things going on but I think it's a very effective way to cut off an isolated spike.

Yes, I did come down, after several hours. I didn't crash and I slept fine, albeit not enough. Thanks!

My last A1c was 4.9. My endo said the most likely reason I have normal A1c's is that I don't usually remain high for long periods of time. Especially when I'm on pills, I don't sit at 200 for more than a half hour, and I don't sit above 140 for more than 3. I also stop eating carbs when I know I'll just be high again, because I can't handle the way I feel when I eat them. At this point, though, I think if I weren't on meds I'd have a higher A1c, which wasn't the case when I started.

Despite the fact that I don't sit high for very long, I'd still prefer insulin because I'd be able to inject early enough that I wouldn't spike. Yes, everyone makes mistakes, especially on insulin, but I'd be to blame rather than the quirks of whatever pill I happen to be taking then, which means there would be somehing I can change.

frankly, no doctor in their right mind would ever consider putting you on insulin with an a1c of 4.9 an the information you just provided… I’m just being honest. You don’t need it. It appears you have some issues that cause occasional postprandial glucose elevations-- at worst prediabetes… But you are light years away from being prescribed insulin.