Disclaimer: my endocrinologist is already aware of the situation and I’m in contact with her about it, I just thought I’d come here for some more unofficial opinions.
So, I haven’t been the best lately when it comes to tracking my blood sugar. My A1C went from ~7.5 in December of 2016 to ~9.1 in May of 2017 – a huge spike in my long-term blood sugar. I’ve been trying to work to bring my numbers back down consistently, but since late May/early June I’ve hardly been able to keep my levels lower than the low/mid 200s. Before calling my doctor’s on-call number to bring the issue up with her last week, I felt like I’d tried everything in the book. I had checked for ketones multiple times (all of which came up negative), I’d started waiting longer in between meal injections and my meals (for context: I’m on Novolog 1 unit/10carbs at meals), I started applying correction dosages much more liberally (for me it’s normally 1+unit for every 50 points over glucose levels of 150) and nothing would bring my blood sugar down. I was consistently anywhere from 210-330 at all times of the day.
As I mentioned, last week I called my endocrinologist’s urgent line and explained my situation. We decided on a few more courses of action – changing my injection sites from my arms to my legs, increasing my nightly Lantus injections from 20 units to 22 units, and increasing my correction dosages from 1 for every 50 over 150 to 1 for every 40 over 140. I also switched to a new insulin pen in case there was a chance of the insulin I was using being expired, so I moved to a newer box that I had on me.
At first, these helped keep my blood sugars much more stable, and I was consistently between 80-160 with these new protocols. However, since this past Tuesday my numbers have gone back up to the low 200s and will not fall back, even after I’ve changed up my insulin routine.
A specific example of how crazy it got yesterday was as follows: I was at 191 before lunch (I’d been back in the 200s on Tuesday night, so it had gone down at least a little bit), so I followed my usual protocol, took correction dosages, etc. Two hours after lunch I was at 323, which made no sense to me given what I’d eaten, so I took an 8-unit shot for what’s normally a 3-unit meal. I decided to wait as long as possible before eating my meal just to make sure the insulin had time to take effect. 25 minutes after I’d taken the shot, I was only at 263. 40 minutes after I’d taken the shot, I was still only at 262, so there’d been some kind of plateau. At this point, I’d decided to just forego the meal and see if the 8-unit shot would’ve brought me low as it should have. Right around 2 hours post-shot, I was still only at 143 after an 8-unit shot, which normally would bring me crashing low in 20 minutes without eating. I ended up hitting low at 72 nearly five hours after taking the shot, almost as if I’d just eaten anyways.
Today I’m still around the high 100s/low 200s, but I also took another 3-unit shot when I was at 211 around 3 PM and still did not fall low at all, with no meal. At this point the only thing I can think of is that my insulin might be expired, hence why it’s not being effective and having me run high, but I’m just going crazy trying to bring my numbers to a stable level without success after weeks of dealing with this. Any advice would be immensely appreciated. Thank you!
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