Crap! High Blood Sugar!

Can I say “crap” here? Well, seeing as I’m the senior staff reporter, managing editor, and publisher all in one, I suppose so… And any of you PWDs (people with diabetes) out there who’ve experienced the Sudden Unexplained Surge (SUS!!) certainly understand my frustration.

It has been a week of highs.

Hosting the Grand Rounds was a blog high (and also a helluva lotta work considering everything else going on). But the mysterious flight into the 200-300 mg/dL zone actually began several days before GR work even commenced. One night I go to bed at 117, and wake up at 300! WtF?! So I correct, go low, eat, go high, correct again, feel nauseous — the usual crap (oops…)High_sugar_1

So I chalk it up to a bad D-day and move on. But tomorrow is no different. And the next day either! So I start leaving frantic messages for my CDE, to the tune of WtF?! Here are the theories (bear with me):

1. Live-in nanny gives us 4 days’ notice that she’s flying back to her home country for a family emergency — after I’ve committed to a veritable “carnival” of work projects, and become the default leader of a community development protest. The patient is experiencing stress.

2. Scrambling to get said work projects under control before said nanny flies the coop, i.e. lots of extra time on buttocks facing PC. Patient’s activity level has suddenly decreased sharply.

3. Stuffy nose and pain in ear hit one night about 3am (of course!). Patient’s glucose levels elevated due to existing infection/approaching illness.

4. The patient’s diabetes honeymoon is over (?!) Gulp…

CDE doesn’t think too much of No. 2, or No. 1, either. So that leaves us with No.s 3 & 4. Crap!

Definitely time to rethink those insulin-carb ratios, if I had any idea what was going down here…

As Jay of Cyber-Pancreas so aptly puts it: “Tomorrow I will test more, work harder, and make it right. Today though, I get to be frustrated. Today I am not fine.”

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17 Responses

  1. Andrea
    Andrea October 20, 2005 at 8:00 am | | Reply

    Hey, I’m going through similar “crap” myself. I’ve been experiencing rollercoaster blood sugars, which have been extremely frustrating and have been driving me crazy. Though for me, I don’t see a reason to why this is happening, which is making me even more frustrated. The time that gives me the most problem is mid morning/right before lunch. I have been around 300. It usually does come down, but it usually isn’t for long. After dinner, I’ll run into highs again. It makes me so angry and emotional at times, b/c I feel I’m doing everything I can…and yet I’m having these problems. I feel like there has to be an easier way. I am way overdue in seeing my Endo, i’m going next week, but I’m going to definitely express how I feel and how I strongly believe that things need to change.

  2. Laura
    Laura October 20, 2005 at 8:16 am | | Reply

    Whey doesn’t your CDE think anything of the stress that may be causing your sugars to rise? Seems to me it would be a good reason for those highs. Stress always sends my sugard sky-rocketing not to mention being sick on top of that.

  3. Kirk
    Kirk October 20, 2005 at 8:31 am | | Reply

    Amy:

    The truth about D is somedays 1+1=2 and other days 1+1=43.

    You have to learn to go with the flow and expect the unexpected.

    Change and variability are a way of life; unless you want to live like Bernstein.

  4. Jay
    Jay October 20, 2005 at 9:38 am | | Reply

    I certainly know how you feel. My finger tips now ache from the near tripleing of my tests. Keep battling, it’ll get better.

  5. Nick
    Nick October 20, 2005 at 12:57 pm | | Reply

    Some days, I just have to forget the insulin-to-carb ratio and inject three or four units, or four or five units even, rather than just one and a half. Just to show my blood sugar who’s boss.

  6. Jana
    Jana October 20, 2005 at 4:12 pm | | Reply

    I’ve had the opposite kind of hell in the past two days. I’ve come out of my honeymoon (since being diagnosed two years ago) to a limited extent…meaning that I switch off between a 25-30 total daily insulin and a 8-10 total daily insulin every three to six weeks. On Monday, I was still in the 25-30 range but due for a shift down, and then I came down with a cold and assumed that the illness would nullify the shift. But it didn’t. Wednesday was particularly bad: an hour and a half after breakfast (and right when I arrived on campus for my German exam) I had a BS of 48, so I took only a unit of Novolog with my lunch (since I had 12 units of Lantus on board) but still ended up at 51 three hours later. Finally, I took no Novolog with dinner, but had a 63 at bedtime, so had to have a substantial snack, which I didn’t want since I’m sick and have little appetite. Argh!

    Today I cut my Lantus to 6 units and had a normal day. Finally.

  7. Bill the diabetesdoc
    Bill the diabetesdoc October 20, 2005 at 5:44 pm | | Reply

    Amy:
    Add at least one more possibility: “bad” insulin. If you have been using an old bottle, it may have lost potency if it’s been exposed to environmental extremes (that is, sitting on a radiator, or accidentally frozen in the wrong part of the ‘frig or in a car in winter in the northland). And if you used a new bottle, it could have been damaged while “in the pipeline” from the manufacturer to wholesaler to pharmacy to your refrigerator.

    Be sure to check the “clear” insulins for particles (a sure tip off) and even if there’s no visual change, try a new bottle (from another lot if possible).

  8. Jo
    Jo October 21, 2005 at 3:48 am | | Reply

    A the Diabetes Life! I finally went on Lantus and now I’m waking with headaches and this am …. 59! Doc is happy with the levels though and we are reducing the Actos (Yipee) so I can take off some of my weight gain. Hang in there … I think it’s all 4 btw ;)

  9. AmyT
    AmyT October 22, 2005 at 3:00 pm | | Reply

    Thank you all a million for your encouragement! I know it’s not the insulin because I was able to get some normal readings in-between. Today is Saturday, and I’m finally down in an acceptable range. Hooray!!

  10. Ben
    Ben August 2, 2006 at 12:50 am | | Reply

    Hey guys, I’m a 13 year veteran type 1 diabetic (had a 1 yr honeymoon period after getting the disease at 15)I am 28 now.

    I’m addressing the high postpradial blood sugars after meals (breakfast and dinner mostly) mentioned on this board again and again)in hopes I can use my personal opinions, views and theories to help.

    I need to make these rebuttals to these 2 modern diabetic medicine proclamations first:

    1) Food takes 1.5 to 3 hrs to digest: TRUE MOST of the time…larger meals ABSOLUTELY FALSE. Pizza…FALSE. Certain days of the year…FALSE. THe human body is ever varying day to day. You cannot set a catch-all timer on a diabetic’s digestion (which has EVERYTHING to do with blood sugar control)

    2) Humalog insulin is the most accurate in representing the way the human pancreas adjusts for blood sugar spike. FALSE. As one increases the amount of Humalog, it becomes FAR more potent than the average human pacreas’ insulin. Resulting in 40 minute to 2 hr postprandial lows after large meals followed by highs when the insulin prematurely wear off and digestion continues at the 3, 4 and sometimes even 5 hr points.

    For years. I always had extremelly HIGH post breakfast blood sugar levels, then fine throughout the day, then high again after dinner.

    I FINALLY solved the prob. Here’s how.

    One morning, I woke up and my stomach was KILLING me. Acid reflux, heartburn after every meal…I had a very stressful month with my band. The heartburn went on for WEEKS. Then by Blood sugars started doing INSANE stuff…like shooting up to 300mg/dl some days, then dropping to 35 the next hour. I was worried I had gastroparesis…a diabetic condition brougt on by years of poor blood glucose control where the nerve that controls stomach contractions to digest food gets damaged and basically food sits in your stomach undigested for hours, days, etc..causing extreme lows 40 minutes to 1 hr after eating, (as the insulin kicks in but the food does not) or extreme highs when the stomach suddenly starts working and there’s no insulin or warning to stop your blood sugars from going through the roof.

    My doctor didn’t think so. Here’s why, …gastroparesis sufferers usually have the disease for over 20+ years and run glycos of well over 10 the entire time (prolonged high blood sugars is one of the only things that can cause this kind of nerve damage), but my glycos have always been in the low 6′s. PLUS, if you get gastroparesis, you start vomiting…you cannot hold anything down…OR your so naseous all the time, you’re unable to eat. I didn’t have these symptoms..but i HAD been suffering from high postprandial blood sugars afer meals over 200 mg/dl for years no matter what I did…they’d always sink back to normal 4 hrs or so after eating, but the 2-3 hr points were always bad. If I took more insulin…I just ended up low 1.5 hrs later, less insulin, and I ended up fine 1 hr later…but 1.5 hrs later my blood sugar would shoot up 100-150 points! It was definitely a lose/lose situation for me.

    As I did more reading about gastroparesis, I realized something doctors have been overlooking for YEARS. As most of us know, diabetic nerve damage is gradual. As are most bodily complications….yet every documented case of gastroparesis on record indicates that the onset is acute (sudden). I then realized what the prob was….the high blood sugars after breakfast and dinner for years (although my fasting BS’s were great and my glycos 6′s) were invariably playing havoc on my nervous system…and hence…they were affecting my digestive patterns. Duh!!

    Days i had high BS after breakfast always meant an ensuing blood sugar roller coaster at some point later in the day. What did this mean??…well…here’s my theory (and I think I’ve proven its validity). If food is sitting in one’s stomach (in any amount…say even a small amount of undigested carbohydrate), then the next time one eats..it stimulates the stomach to work…waking up the already confused nervous system and them digesting not only the carbs being eaten at said meal…but the remaining carbs from the prior meal. Think of it as slight or temporary confusion of the nervous system brought on by roller-coaster highs and lows (perpetated over years)…hence affectng stomach contractions and food digestion. (even people with full-blown gastroparesis have been shown to exhibit sudden temporary working stomachs when sipping small amouns of water, chewing gum. etc…it’s like poking a jelly-fish with a stick to watch it contract…no matter how sick it is…it’ll probably respond to the prodding. I hope this analogy makes sense :)

    In my humble theory, Obviously, years and years of high blood sugars only worsen the complication of stomach “Vagus nerve” damage (Vagus being the name of the actual nerve controlling stomach contraction), and for an un lucky few…they will eventually suffer from complete gastro-paresis. (again…this is my theory and leading points to it)

    Makes sense…right?? So basically…if high blood sugars lead to gastroparesis..we (as in the collective sporadic blood sugar diabetic population) could ALL have varying, early warning signs of the possible eventual complication.

    Well, not accordig to most doctors who for some reason believe gastroparesis to be a disease of sudden onset.

    IMHO, this is crap.

    Here’s how I fixed my problem, the same problem I keep reading about on these and every other board I read and which took me 10 freakin years to discover…I’ve proven my theory in my own case, but I sincerely think MOST OF US type 1 diabetics are living with the same underlying problem…a problem the medical community has yet to understand. I dare you to try this! (with doctors permission OF COURSE!!)

    I simply STOPPED eating carbs at dinnertime and I backed my breakfast carbs off considerably. See, I finally figured out why my Blood sugars shot up so much after breakfast but not any other meal (even though my breakfast was the exact number of carbs my lunches were and my activity levels identical)…I had undigested food/carbohydrate sitting in my system from the night before (not related to “gastroparesis”, but definitely related to my roller-coaster blood sugars creating temporary delayed digestion at spradic times, (which I believe could certianly eventually lead to full-fledged gastroparesis if tis went on for decades!).

    When I looked back on most of my weird BS’s, I found most bad mornings came after dinners the night before when I ingested high fat with carbohydrate based dinners. (even steak with say a small serving of potatoes and bread, etc). I cut carbs from my dinners and WHAM…no more high morning breakfast blood sugars. Try it with any meal and watch how steady your sugars for that meal and the one after it suddenly get…it’s amazing.

    Try eating a high protein, hearty dinner with less than 15 carbs…(steak + salad and fruit) or fish + salad and wine, etc)…adjust your insulin accordingly (you’ll need to lower your dosage considerably I’m guessing)

    You should wake up the next morning with much better blood sugars, waaaaay fewer nightly lows (once you get your dinner dosage sorted out with above mentioned type meals), and your 2 hr postpradial breakfast blood sugars should be drastically improved!

    Also, Always, always, always eat SOME protein with your breakfast…and if possible, keep your breakfast carbs under 40 carbs.

    I just wanted to share this looong explanation with everyone…it took me 10 years to figure out. BTW…if you’re having similar probs after ANY other meal during the day, try switching the previous meal (from the one you’re noticing high blood sugar after meal probs with) to a low carb, high protein meal. This should work wonders on blood sugars after that meal and the following meal.

    And if your STILL having probs, read The Diabetes Solution by Bernstein (the guy Atkins ripped off). 50 years ago, he went to a strict protein ONLY based diet for ALL 3 meals per day as a type 1 diabetic when he was 28 (he almost died due to complications of the disease before going to the special diet he invented). 50 years later, he has written a book. He has the metabolism of a 29 year old and is in better health than most non diabetics. Thats absolutely amazing for a type 1, insulin dependent diabetic, whom for the first 20 years of his life didn’t even have blood glucose monitoring capabilities!

    Doctors are going to have to stop seeing diabetes as an easily explainable diease “by the numbers” and start noticing the details. My stomach probs have finally cleared up because I caught the regression and corrected my blood sugars. My nervous system has obviously healed considerably..I have no more sporadic lows and my once crazy after meal blood sugars have been reduced from an “everyday over 200 at least 1x” fiasco to over 200 once a week or less. In my opinion, it’s blatantly obvious that gastroparesis is the end result of YEARS of strain on the nervous system and “brittle diabetes” or “sporadic blood sugar fluctuation” is simply the body’s way of pre warning one years in advance as to the steady regression into eventual complete stomach paralysis.

    This methodology woked for me…in addition to plenty of excercise, a job that keeps me on my feet 8 hrs a day, and lots of water.

    I cannot guarantee this will work for everybody, but if my theory is correct, it should help a lot of you out. Just remember…everytime you have a crazy high after a meal..and you took the correct amount of insulin with your meal (and di not have alchohol, or anyhting out of the ordinary)…there are only 2 things that could cause the high. #1)…bad insulin absorbtion or bad insulin OR…the more likely culprit…you had some unused food still left in your stomach or small instestine and that left over food got digested with the new food…hence…60 carbs becomes 80 carbs..etc, etc, etc (yet you only bolused for 60 carbs not knowing you were still storing part of lunch or that snack you had a coupla hours ago). Now, if that storage is stricly protein…how will it drastically raise your blood sugar?? it can’t…physically impossible. But if you’ve got part of a cinamon roll left in there….we could be talking 100-200-300 additional points. Makes sense…correct?

    Hope I helped. B

    Of course, if you catch the probs early enough, you can heal your nervous system (retinopathy, vagus nerve damage, fingertip and toe sensation, sexual dysfunction) before it reaches that point.

    Also…it’s been proven that human digestion is dicey and NOT predictable. Taking carbs out of the equation is the ONLY way to trump this problem for diabetics. Even IF your tummy decides to hang onto partially undigested food 2 hrs longer 1 day than the next (for various circumstances from hot to cold days to your activity level)…digesting late protein particles is going to do nill to your blood sugars as opposed to late digested carb particles which can raise BS’s 100-200 points at the most unexpected times.

    Eventually, i feel the medical community will catch on…they’ll see the correclations and start heavily weighing digestion into the equation of weird “random” blood sugars…but I’m convinced there is no such thing as a random blood sugar that is NOT caused by some external stimulus combined with the state of an individuals nervous and digestive patterns.

    1. Jerry
      Jerry May 2, 2012 at 11:43 am | | Reply

      Thank you Ben! This post was a life saver for me. I was scared when I had a 380 blood sugar for no apparent reason. Back to low carb high protein at night for me. I had, just as you said, a high carb high fat meal last night. I’m scared straight now. One question, do you feel it’s okay in the low carb high protein meal to also have high fat?

  11. mara
    mara September 15, 2006 at 2:11 pm | | Reply

    i feel better already- i have had digestion problems for years before being diagnosed as type 1
    my blood sugars are actually worse since going on the pump in july and my endo has referred me back to my pcp as he believes there is an illness creating havoc-

  12. ev
    ev November 13, 2006 at 2:02 pm | | Reply

    I am about the start trying this low carb concept, I have been type 1 for 24years and I am 28 now and for the past 3 months every morning has been high, between 12 and 33, 6 or 7 being preferred. Nothing major changed in my diet, I still run when I can in the mornings, I hope this helps it out. thanks.

  13. Susan H.
    Susan H. January 13, 2008 at 12:31 pm | | Reply

    Thanks for the possibility of bad insulin or poor insulin absorption. I have never had tight control but today I awoke with BG of 119, went to church, nothing to eat, prior to eating it was 244. I also have had a good BG while exercising but then a high (400) 1 hour after exercise without eating. I have had diabetes (Type 1) for 16+ years and am an R.N. But, being a nurse doesn’t help anything in keeping good control. This disease is very frustrating and even more maddening.

  14. Dawn
    Dawn March 12, 2008 at 4:29 pm | | Reply

    I had no idea that insulin could go bad, but I’ve had “particles” in my insulin for the last 2 bottles! Should I switch pharmacies?

    Lately I have been having high BGs all day. I take the right ratio, I don’t have a car so I am always walking, and I go to the gym. The last few days have been so frustrating I’ve cried.

    Is there anyway to report bad insulin or exchange it for effective stuff? It’s too expensive to go bad after only a week!

  15. Erika Roe
    Erika Roe October 8, 2009 at 1:43 pm | | Reply

    Thanks everyone. I have been having the same problems.
    I had gotten a bunch of Novolog from Medco via mail order and it got here later than it was supposed to. They sent me a replacement and for some reason never asked me to return the second bad batch they sent me. So I decided, what the heck, I’ll try it and see if it’s any good. The pharmacist said it should be fine. It got here a day later than it should have. I think the order was ready after their outgoing truck came so it missed the overnight shipment truck. It was filled with cold packs but didn’t feel cold when it got here, a day later than it should have back in January.

    If you get it from a retail pharmacy usually you can get a replacement if it’s gone bad.

    This morning my BG was fine, but then I got to work and it was 344 after breakfast. When I got up it was a nice 120. Yesterday after breakfast it was 413 and I was sure if I should change my Omnipod. For lunch today it spiked 150 points over my pre-meal reading (about 150). Sometimes I don’t eat anything and it just spikes to 300+ for no reason. My blood sugars are going to hell. I am getting a fresh vial of Novolog at a retail pharmacy I trust that has given me good insulin before.

  16. Terrie
    Terrie December 17, 2009 at 11:41 am | | Reply

    I’m on the bandwagon with the “meal before” concept as outlined here. If I eat a low carb dinner, my sugar levels are fantastic the next morning, and lunch is also fine. If I eat a high carb dinner, it takes me a long time to recover, and the roller coaster ride begins.

    I’m a type 2, but I was diagnosed at age 16. I am not overweight, never have been. My “condition” is unusual, but becoming more recognized. When I was diagnosed almost 30 years ago, they automatically assumed type 1, due to my age and the fact that I was skinny. i think the insulin I took, unecessarily back then, has afforded me some protection. I have very little issues (retinopathy in one eye, that comes and goes and some high pb, but that’s it).

    Terrie

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