Unexplained highs

my 22 yr old son is having unexplained highs. same food, same activity level.
why would this happen? can being too warm affect his bs?
can drinking water bring down the high?

hello @Jemma Jane,

there’s a million reasons for high blood sugar, most of the issues come down to explainable events or problems… I had a moment so I thought of these:

hidden carbs in food
carbs absorbing much later than insulin absorption
as in very high fats
as in gastroparesis
forgetting to take insulin
not enough insulin
insulin not delivered (as in occlusion)
insulin not delivered as in pump failure
insulin not absorbed
scar tissue
use of steroids or other drugs that could increase insulin resistance
physiological insulin resistance (such as type 2)
issues of the endocrine system where your lived dumps stored sugar
including stress
including physical problems with the liver, kidneys, etc.

if you are dehydrated… then drinking water will make it appear that your blood sugar is dropping, that’s a concentration issue. if you are not dehydrated, then drinking water will not reduce blood sugar except for when the kidneys are dumping sugar through urine and then you are simply replacing water while you have extremely high blood sugar.

if his blood sugar is always high, or high after meals, or randomly high, then he’ll have to backtrack to change the thing that caused it… most typically 15 to 45 minutes beofre it happened.

good luck.

hello Joe, thanks so much for your detailed reply! I’ll pass on your thoughts to my son

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Hi Jane @Jemma, Welcome to TypeOneNation Forum!

As @Joe says there are a million things that can or could cause an increase in Body Glucose Level [BGL]. There was a widely circulated publication a few years ago that said “Forty-two causes of High Blood Sugar”; the Medalist Group [people living with diabetes for more than 50 years] went on to expand that list to more than 100 “causes”- all corroborated.

Warm weather, usually tends to decrease the amount of insulin I, and for many other people with diabetes, need to maintain BGL in ‘normal’ range, so I will not offer “being warm” as a possible cause - although with your son it may be. You didn’t say ‘how long’ your son has been managing with insulin - a body’s insulin needs change over time. It may be time for your son [using medical team input] to:

  • validate his meal-time insulin to carbohydrate ratios for each meal time,
  • his insulin sensitivity factor for different times of day,
  • his background insulin or basal rates if using a pump.

I’m not a medical doctor; my suggestions are based on many years of actively living with diabetes.

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Hi Dennis, your suggestions are very welcome. thanks so much!

i was suprised at how fast insulin loses potency in a plastic reservoir!!! Should be in a reservoir, or associated tubing for more than 3 days…

I wondered if the potency changes. thanks Val

more guidance needed please…Adam has been on humalog and Lantus for 5 years. The Lantus is working fine but he is high two hours after taking humalog.
Could he be building a tolerance to the insulin?
Can he give himself more humalog to get rid of the high or just wait until his next scheduled injection?
thank you in advance…

Hi @Jemma. If you are injecting Humalog 15 minutes before eating, and if you are testing at 2 hours after eating, then his blood sugar will be higher than when he started eating. The rule of thumb si he will be 50 mg/dl higher at +2 hours (if he was 120 when he started eating he should be about 170 at 2 hours).

Humalog works for 4 Four hours.

You take as much Humalog as necessary for the carbs you eat such that at +4 hours after eating, his blood sugar returns to his target blood sugar.

Jane, yes continue asking for information, hints, guidance; I and many other knowledgable people her are willing to help your son. Has your son explored these forum posts for information and suggestions?

The second slide of a presentation I’m putting together for a meeting of people affected by TypeOne has one word - “Change”. That will display behind me as I tell listeners that “just because it has been working this week doesn’t mean it will work tomorrow”. The take-away from that, in your son’s case, is just because his meal-time insulin:carb ratio for the amount of Humalog he took for a meal had been working was sufficient and may not be correct now - or if he is like me, he is putting a bit more on his plate and still thinks the carb count is the same. I periodically pull out the measuring cups - especially for pasta - and keep a scale and book with carbs on the kitchen counter.
Lantus and Humalog are both awesome tools [I began using each of them within a month of FDA approvals] that can be used effectively used. They remain constant, but your son’s body like all living things will change over time. There are many, many things in addition to food that can increase the amount of insulin needed; stress and anxiety are just two. Here is a link to that article, and diaTribe is a “trusted” site for good information.

The “Medalist Group” to which I belong went on to expand this list to about 100 Factors.

Hi @joe thank you. his bs isn’t returning to target after 4 hours. it’s just staying up.
so confusing

thanks so much @Dennis I will check out the site.

Even people who arent diabetic get BG swings throughout the day. There probably isn’t a person on earth who’s BG doesn’t increase after eating and then drop once their pancreas compensates, it’s just non-diabetics supposedly don’t go over 150.

With a CGM, if youve had the exact same meal before, at the exact same time, with the exact same activity level, you can sometimes figure out how many minutes premeal to bolus so that your blood sugar doesn’t spike. But almost every meal I bolused perfectly looks like a bunch of 15 minute long peaks and valleys, of maybe 20mg/dl BG swings on my CGM. It’s a squiggly line until about 3 hours later it stabilizes for me. I guess your stomach doesn’t break all the various carbohydrates down in a perfectly linear fashion, and neither does the insulin work totally smoothly. The human body is perhaps the most complicated machine in the known universe.

thank you @SpecialEDy I’ll try and reassure my son. He has an anxiety disorder and the numbers freak him out.

so, he just checked and he was in target, thank goodness. I know the lows are scarier but he gets very upset about highs as well. thanks for your help!

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One thing I’ve learned is that everything affects blood sugar… don’t know if he does injections or shots, but have him up his basal rate so he’s getting more long acting insulin rather than constantly correcting with short acting… let us know how he’s doing!

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@hopper166 thanks for the idea! he’s going to his Endo this week. will see what she says

Also another tip - doctors are amazing, but, make sure he knows that he can make his own decisions too! (I’m not saying he doesn’t know this, but it took me a while to do things that my doctor didn’t tell me to do. She was happy I did!)


Back when I was using a combination of basal (lantus) and bolus (Humulog) insulins, and I had any patterns that were unexplainable I would have adjusted the basal insulin as hopper166 said. If my sugar were running consistently high with no reasonable explanation like the causes stated earlier I would add a unit or 2 of lantus and keep it that way for a few days of testing. If after a few days of testing and no consistent low’s occurred I would keep it or add more if still running high. The trick is to go slow and try to avoid hypoglycemia which is more dangerous in the short term…

thank you @MikeW that sounds like a good, safe plan