BG running really high

Hi, my 15 yr old son was diagnosed with T1D this past July. As challenging as it’s been we’ve done a pretty good job of controlling his sugars. The past week he’s been running really high, and not even dropping at night. He usually sits anywhere from 85-130, but now he’s been sitting at close to 200 for days. We haven’t changed anything. Any idea why this is happening???

@Randala hi Randi, welcome to Type One Nation. I hope you are still in close contact with his CDE/Endocrinologist. Diabetes is a game of continuous blood sugar monitoring and continuous changing of insulin to match background and meal-time insulin needs. One thing that type 1 diabetes is NOT, and that’s consistent. Sometimes what worked yesterday will not work today.

As your son grows his insulin requirements will change. This won’t stop through mid to upper 20’s. I am an old man now, but my insulin requirement changes significantly when something like my average activity levels change, as well as when the seasons change. When I see a rend, such as “I am high all the time” comes up, it’s time to test basal rates and meal time insulin requirements.

If you like self-paced learning I recommend the book “Think Like a Pancreas”, If you need additional support I recommend staying close to a good CDE.

anyway if I need to say it another way - the only thing that stays the same, is that everything changes.

Hey @Randala! Welcome to TypeOneNation; we’re so glad you’re here! This is a great place to ask questions and meet other folks with T1.
It sounds like you’ve been doing a commendable job of adjusting to your son’s diagnosis… congrats! That said, I totally understand it can be frustrating to be riding high for a few days with no apparent cause. There’s a few possible culprits here:

  1. This is very rarely the case, but occasionally I’ve forgotten to replace my insulin vial after it expires, or accidentally kept it in very hot conditions (like at the beach in the summer) for long periods of time. Either of these things has the potential to make the insulin less effective–if these apply to you (which I’m guessing they don’t, but I thought I’d mention it anyway), then try replacing the vial and that should fix the problem.
  2. If I’m running high for longer than a day or so, I tend to assume that I’m fighting off some kind of illness. I’m sure your son’s doctor has talked to you about “sick days” and what they can do to blood sugar levels–if not, I can send you the info sheets that my doctor gave my parents the first time I got sick after diagnosis. Basically, anytime the body is under a lot of unusual stress, the liver releases excess amounts of sugar in a misguided attempt to provide extra energy and fight the pathogens causing the illness. Of course, in PWD, this isn’t actually helpful, it’s just annoying. :roll_eyes: Your son may or may not be experiencing any symptoms of illness, but my endo told me once that sometimes the body can be “fighting something off” without the patient even being aware of it. When I have days of unexplained highs, I tend to assume that that’s the cause.
  3. Similar to my above explanation–I’ve noticed that high levels of mental stress, as well as physical stress, can cause a “sick day effect” with my bg. For example, I tend to run very high during final exam week. If your son is having a particularly busy or stressful time at school, that could be causing his bg to go higher.
    The bottom line is, as stressful and confusing as it can be to have random unexplained high numbers–don’t stress too much about it. Whatever the cause, it will most likely go back to normal after a little while. Of course, I encourage you to contact your son’s endo with any concerns–they may be able to help you adjust your ratios or basal rates to combat the problem.
    Best of luck!

Thanks so much for your responses. It definitely helps to know there’s a community of understanding, helpful people out there!

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@Randala Hi Randi and welcome to the TypeOneNation forum. I hope you find support here and suggestions for “diabetes details” that you may want to discuss with your son’s medical team; I also suggest that you urge your son to sign up here so he can get a good start in becoming his own diabetes doctor, a necessity.

In addition to offering you very sound advice here, Abby @bookwormnerd13 could direct your son to some places where he can share his diabetes experience and learning with his peers. [Thanks Abby!]

My experience over more than 60 years trying to manage insulin with diabetes has taught me, like it has taught @Joe, that change is the one constant in effective diabetes management. You will notice that your son will need to make slight changes in his insulin dosing as time goes on; but he will need to be cautious when making changes and know what he is doing and also know the probable outcome. This will come to him over time.

Good luck, and stay in touch!

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Hi Randi - Diabetes is an unusual disease. Once you think you have it controlled, it makes you think again. I have been Type One for 74 years now and meet new conditions almost too frequently. One problem that I have found is that insulin loses its strength is exposed to heat for too long a time. If using a pump, the reservoir containing the insulin must be refilled each three days as it has been exposed to body heat for that long. Some persons have found that it must be refilled after two days with fresh insulin. Beyond that there are MANY control factors. Try Dr. Stephen Ponders book called “Sugar Surfing” and you may find some interesting information.

Surprised nobody mentioned it, but your son was likely in the “honeymoon” period. Upon initial diagnosis and the beginning of injections, the pancreas will often still have the ability to produce insulin, making BG management much easier.

Basic recommendation is to review the data with your endo, and probably modify his ratios. I have 2 boys with T1D, both diagnosed 3 years ago, one at 7 the other at 13. We have changed ratios multiple times as they have grown, too.