Endo

I went to my endo yesterday.
I can't say I'm really happy.

It went okay, and my weight is finally normal, and my a1c is good for a teen girl (7.1), but it's above what it's supposed to be and going on the pump was supposed to lower it. I'm thinking the pump needs a bit more time to adjust, but I really should be bolusing more :).

One of the things we talked about yesterday was going high right before bed, then knowing that I'll somehow be normal the next morning, and not taking a correction. I thought that was just because I was going low, and I prevented that by not giving insulin sometimes. But he said that it's because my pancreas has to work all night to get it normal and I should really just give the correction and preserve my pancreas's emergency insulin.

I think my pancreas died last night.

Of course, just getting home from the endo, I completely blank on bolusing for dinner, but then I bolus for some other snacks. So at 10pm, I'm a horrifying 332.

I did insulin. I thought that would be fine, then.

15 minutes later, it gets worse- 367.

It doesn't make any sense, how I got higher, with insulin. But in 15 minute increments, I was then 347, 345 and then half an hour later, 328.

At which time I fell asleep.

At 2am, my mom tested me, 284. Ugh. We gave some more insulin.
6am- 204 (getting closer!) And more insulin.
7am- 272. Wow.
7:30- 228. Let's just hope it doesn't get higher.

I am completely at a loss for why insulin is making me go higher. I haven't had anything to eat since 7 last night. No candy- honest!

If it doesn't go down, we're calling. I just want a nice 120, or lower! Or even 130. Anything below 200.

Staying high all night feels really crappy. I almost puked when I went to bed last night, but that was when I was still in the 300s.

Highs, highs, go away, don't come back another day...

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Comment by Shannon on November 5, 2009 at 6:19am: Sounds like you're having one of those bizarre, endless highs. They're so not fun, and I know how frustrating it can be. One thing I've learned is that when I'm really high, my insulin sensitivity is not as good. So, while my typical correction will work for an average high, I'll need to take almost double to correct a "super" high.

Also, did you check for ketones? What you wrote about feeling sick before bed was a big warning sign for me. When I'm high and feeling sick, I almost always have ketones. I'm not going to lecture you on DKA, but be careful, ok?

As I write this, I'm 215 and feeling pretty crappy. I'm going to go for a walk (around my office) to try to get it down lower. Hang in there!

Comment by John Smith on November 5, 2009 at 7:00am: Maybe your insulin is going bad? One way to test this is to give yourself a shot of insulin from another vial and see how your BG trends.

Comment by Billy Williamson on November 5, 2009 at 7:23am: I've leasrned over the years that there are going to be days where nothing works. But John did make a good point about the insulin maybe going bad. It's happened to me before.

Comment by Sloane on November 5, 2009 at 7:48am: Thanks, everyone! We changed my insertion set, and the insulin, and I just tested- 89!! :)

Comment by MelissaBL on November 5, 2009 at 8:10am: Sloane, you're also expecting insulin to work a lot faster than it really does, to be honest. I mean, YES, you should have been back to normal by those later tests, but you cannot expect insulin to start bringing down a high within 15 minutes. It takes me about an hour, hour and a half maybe, before my CGM arrows even start to move after a big correction bolus. Insulin's going to stay active in your system and should correct you within 2-3 hours and then trail off for another hour or two. If your blood sugar was still rising when you put the insulin on board, it's not that weird that you were higher 15 minutes later.

What's weird is that it didn't move more throughout the night.

Then again, the teen years are hell on blood sugars. Often, it's hormonal changes you have little control over. You did the right thing, changing everything out and waking through the night to test and make corrections. You're such a smart diabetic!!!!!! Maybe it was the insulin, maybe it was the pump, maybe it was some unknown factor (food, stress, infection, hormones, etc).

Shannon made a good point though - if you had ketones, you may have been needing a lot more insulin to bring your BGs down. Next time you're that high, make sure you test for ketones.

Comment by Kelly Rawlings on November 5, 2009 at 8:14am: PS: And good work on your mom's part for helping you wake up and test overnight!

Comment by snowangel66 on November 5, 2009 at 7:28pm: I have been there with the night time highs and constant insulin giving, to the point why i couldnt figure out why i was going high but realized it had something to do with lack of sleep and stress. ugggh it is a pain, but we all have nights like that once in a while, and as you just started the pump it starts out to be rocky as your body adjusts to it, but when you get your basals and ins/carb ratio under control you will be all set :)