Blood sugar won’t go down even with extra insulin

Hi!!! So I’ve noticed my blood sugar won’t go down even with extra insulin even when I do corrections and skip meals so it won’t spike, I also tried to work out and it still didn’t bring it down I also do not have large ketones they have either been negative or a trace or even small I’m also drinking a lot of water not to mention I only eat or do corrections every 3 hours, what should I do ? I’ve been a diabetic for awhile but this has been happening more often. I would love to know if anyone else has this ? Or has tips? It would be appreciated:).

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Hi @Kiwigirll even though this is going to sound obvious, insulin makes your blood sugar go down. You didn’t say pump or pens or what kind of testing so all I can say is if your actual blood sugar is high you may need more insulin. You may have to adjust both your meal time and your basal (rate or shot). Your best bet is to talk it over with a doctor. Cheers and good luck :four_leaf_clover:

I use a pump and depending on circumstances will switch to injections if I can’t bring my numbers down. If I do that, and drink plenty of water, and STILL can’t get my numbers down I’ve found I usually have an infection. I’ve had s couple of UTIs with no burning or pain - the only clue was my numbers. I’ve also found I should see my dentist if I have a toothache while that’s going on - I’m a dental coward and in those cases I’ve had a cavity the progressed to needing a root canal.

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I agree with Joe, discuss with your doctor. Could be any one or two of a number of things going on. It is great you know your body and know something is not going right. There are some food items in my diet, that will drive my blood sugar up so my regular corrections won’t work. I am on a pump now, so Sometimes something is wrong with my site. When I was on shots, Sometimes it was the location of the shot. Try to get with your doc to figure it out. Don’t go it alone. I hope the two of you can figure it out.

Alyssa @Kiwigirll as has been suggested, this may be a signal for discussion with a doctor who knows how your body performs and reacts to insulin.

As you have lived with diabetes “for a while” [I don’t know if “a while” is 18 months or 18 years], you have most likely observed that dozens of factors, other than food, activity and insulin, can cause your glucose to rise and stay elevated, or drop and stay lower than you wish no matter what you eat or do. Just this crazy thing that diabetes does to us.

Over your lifetime, you will very certainly observe significant variations in amount of insulin needs infused/injected in your body every day, other than the variations affected by food or activity level. As an example, my average 30 day total dose of insulin has been 19.83 units to balance out 223 grams of carbs with moderate activity - four decades ago I needed about 100 units of insulin a day for similar food and activity. Sensitivity to insulin effectiveness will change over time; it may be time for you [with guidance] consider the fact that your body is just needing more insulin for a while.

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Hi Alyssa,

I have a couple of thoughts on why your BG is not coming down. First, if you are using a pump, there are several things that could cause this:
1) a bent cannula
2) Kinks in the tubing
3) Reservoir issues
4) Over-used infusion sites (can be the cause of slow insulin absorption.
If taking insulin shots the last item above can be the cause as you may have scar tissue from too many injections in the same area. Also, insulin resistance, which can develop over time, could be the cause. Or, if you have recently changed the type of insulin you use (IE: switching from Humalog to Novolog), it could be that the new insulin works differently than the old one.

As you can see, there are many things that can cause this. This is why it has been suggested, and I will also suggest, speaking with your medical provider about this to figure out what the cause is. You can use out suggestions of possible causes as a starting point, but please keep in mind that there may be other causes not listed.

Hope this helps and that you find the cause soon!

Pam K
T1D 56+ years and counting!

Keep a diary of what you eat, your pre- and post-meal blood sugars and your insulin dosage. Share it with your diabetes educator or nurse. There are some foods that take a long time to metabolize and can keep your sugars well above normal for several hours. This happened to me with onion rings on more than one occasion.

I want to say hello and I am sorry. This is my experience I hipe it will help. What your explaining is something that has got real bad for me over the recent years. A lot is from me giving up and not eating or just saying I am to hungry so I eat anyways. For me it is like it will store my insulin or it is flushed out some how. Along with the insulin not being effective my body won’t process carbs in the middle of the night. I wake up at about 12 treat a 65 BG with a juice box and cookie. My BG rises only a few points then drops again about 3 I eat a pb and j sandwich. I wake up with usually a 78 to 90 BG. My BG will rise a couple hundred points in just a few minutes. Usually so fast my cgm stops working. I have given myself over a hundred units it a 4 hr period before, my blood sugar would never go down. My body ended up becoming allergic to synthetic insulin. I had to switch back to regular. I also had a lot of other problems from this insulin I ended up in a wheel chair for a couple years. 2 years later and I still have the same problem sometimes but not as often as before maybe a few times a month. The Dr spent 5 years running tests and they have no clue I had to read the warning label I had developed 90% of the side effects of novolog. There is a lot of factors now that effect my bg from all the years of un managed type 1. Dont give up keep reaching out it is a hard battle but it can get worse if you dont take care of it.

Very frustrating! It sounds like you covered all of the basics. This is a bit “out there,” voodoo-esque, or at least that’s how I feel when I bring it up to healthcare providers. Yet like other replies here, I recommend a food diary. Even further, I recommend a cursary review of the Autoimmune Protocol Diet (AIP), and cross-reference its restricted food list with your food diary for any hyperglycemia triggers. Most are aware that there are “problem” foods, like pizza, bagels, etc. for some. Yet, my body freaks out into hyperglycemia with carb-free dairy like unflavored greek yogurt, or with rice if I do not do 5x’s more insulin with 80% of it given 3 hours after consumption, etc. I, and my previous iron-gut resilient self, never would have believed it if I wasn’t experiencing the hyperglycemia pain firsthand. Other less safe things I do is exerice with IOB and I crash down my BGs very quickly. I also monitor and adust my ISF, I:C, duration of insulin, etc., too, as it gets frustrating trying to trust the alogorithms and not stack peaks, etc. Good luck!

If you don’t eat regularly your Liver will assume that you are starving and will deposit sugar in your bloodstream adding insulin only makes the problem worse, eat a bit before you take Insulin to stop the liver. If this happens in the early am it is called Dawn Phenomena.

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Hi @mamamaegs . Why do you call a diary “voodo-esque”? It was an endo who first recommended I keep one (this was decades ago when everything was recorded in paper - I love my app now!). It’s particularly helpful when I see a nutritionist: in the early days I would have a consult and leave with instructions to keep a food diary for a couple of weeks - this way we’re ready to go and I save myself a trip back.

Hi Dorie,
Happy Sunday to you. My original comment isn’t right here, and I am not sure if you are the original commenter struggling with hyperglycemia, yet I believe I was referring to my food sensitivities and their version of relief via the AIP diet as voodoo-esque. As I overheard someone say about me, “I can’t tell if she’s full of sh*t or not.” There’s a disbelief in the level of pain I have and can experience with certain foods that seem benign for the general population, as well as nearly all T1’s. I wouldn’t have believed it if I hadn’t experienced it. This food experience also has severe hyperglycemia as a symptom, not just nerve and arthritic like pain and nausea. And, the hyperglycemic foods aren’t logical in carbohydrate and fat terms as many of the hyperglycemic foods are carb-free dairy like unsweetened greek yogurt. The rice high’s make more sense, yet shouldn’t require 5x’s more insulin than my standard I:C ratio, and have a delayed spike as though there is fat slowing the absorption of carb. All of that is obviously difficult for traditionally trained medical folks, and even lay people with Dr. Atkins knowledge, to accept. When I read the AIP/Paleo lifestyle info, it didn’t specifically speak to hyperglycemia from the “leaky gut” theory, yet something about the inflammation must affect the blood glucose, like infections do, when I am in a particularly sensitive timeframe. I hope you find an oddity that even if it doesn’t make sense for why your blood sugars remain so high, it can at least be eliminated from your life to feel tons better.
Another random thought I just had was that I atypically went insulin sensitive during PMS and on Yasmin birth control. I didn’t test my glucose frequently before Yasmin, or have a regular cycle to know if it was the PMS or medicine inducing the insulin sensitivity. I needed about 30% less insulin 3-4 days before my menses, and a few days into it. When I saw the lower dose “white” pills coming, I knew to change to my pre-programmed lower basal rate on my pump. Maybe something with those hormone effects could be happening for you, too? I find diabetes life easier when I am insulin sensitive–much quicker to fix a low and move on with your life, than a high. I HATE menses, yet I wouldn’t mind that PMS hormone blend being perfected for my glucose control every day of my life. It reads like you could certainly feel better with that kind of increased insulin sensitivity, too. Most eastern medicine providers do a saliva testing for hormone levels–at least all the way back in the like 90’s and then 2010’s, they did. I am not aware of anything similar that has happened for me with my traditional lab tests, etc., to see if adjustments are needed. Overall, if types of food, insulin, or exercise biggie variables aren’t the answer, maybe a different approach via naturopathic care could also be helpful in detecting an oddity?
And, I am a hand-writer. There was a fave CDE that liked to share that humans own their diabetes numbers more by handwriting them. It was something psychological about taking the responsibility of it. I saw him “school” a T1 physician on her refusal to do anything other than her iphone for tracking, if she tracked :). Teenagers had to show their journals to their parents (both sets if that’s their case), every week, and hopefully, in exchange received less daily hounding about glucose control. On how to track, whatever keeps me consistent is the correct answer for me. And I am consistent with my handwritten journal. Although my life is infinitely better since advanced diabetes technology, I am perpetually burned out, if not sleep deprived, with all of the button touches, sirens, flashing lights, flesh maintenance, etc., of what literally keeps me alive before I layer on cell phone security codes, screen swipes, butt dials, calls, texts, apps, sounds and more. It must be a nice way to legibly present food data to HCP’s, though. There is an app that I enter much of my food info into for a weight maintenance program that would be nice to be able to download for HCP consults, yet I am a little done overburdening myself. They get a photocopied and scanned version of my journal, and sometimes they even choose to review it. It’s more for me, the only kind of patient that lethal titrations of medications on the minute by minute basis is left up to—I believe that’s how that same T1 CDE refers to the T1 patient glucose management experience. It’s a lot, and quite unique in its “alot-ed-ness.” Most other kinds patients (i.e. blood pressure, etc) have their medications titrated like twice a year, if that, and by a med school graduate. Anyhow, good luck to you! May you feel euglycemia soon!
Maegan

Thanks Maegan. I was not the original post-ER but hopefully they are still following the thread and see you very detailed response. I much prefer my app, to tracking on paper but everyone has their preferences and each of us has to do what works best. Wishing you all the best.

Whoops! I don’t follow this board regularly and I responded to a “wadarabbit” below as if it was you, and as if it was in a more private email. Not sure if any of the info will be helpful for you. I hope you are already feeling better and in tighter glucose control.

1st you should for sure go to your doctor and then while you are there ask him to change your dosage because I went through the same thing and then when my BGL was to high we would go to my doctor and get the dosage up. I really hope this helps. Please tell us if it does. Good luck