[Anomaly]

Hi I'm new here and not sure if this is the best forum/sub-forum, so let me know if I should ask elsewhere. (I'd actually call my doctor but he's off today).

Generally/historically, I am low-end type 2 and have been on and off meds (met and actos) since diagnosis 4 years ago. Not currently on any.

I also suffer from ulcerative colitis. When I recently had a severe flare requiring hospitalization, it was finally time to take prednisone. We had, of course, stayed away from it in the past because of its effect on blood sugar. This time my primary, who happens to be an endo, followed me for the diabetes and decided to treat me with basal/bolus insulin. My basal in Lantus. My bolus is Humalog. For the past 6 weeks it has been working fine, while I have been tapering down my prednisone doses toward weaning off entirely in the next month. Dropping the Lantus accordingly and doing the bolus as usual.

The last few days, the bolus is not working. This morning is a great example. Blood sugar was 94 before breakfast (a little low because I forgot that I had reduced my Lantus by 5 units last week and took too much). Calculated my bolus based on that reading and the following food and its carb content (admittedly probably not an ideal diabetic diet, but the prednisone makes me very hungry and since I'm only temporarily on insulin ...). Anyway.

Two slices of low cal bread (18g total), with 2 tbsp. cream cheese (4g), 4 oz. of lox (8g), onion slice (2g), 4 cheese sticks (4g), a small bag of apple slices (8g), and sugar-free lemonade (1g). Total carbs - 45g (I'm not subtracting out any dietary fiber). Normal bolus calculation would have been 3u. Since I've had this problem for the past couple of day, I added a couple extra units and took 5u just before leaving the house.

I eat on the way to work, over the course of the next 30 minutes. Took my reading 2 hours after I started eating and my blood sugar was 186. I'm fairly confident the readings are accurate, as I'm getting overheated and a little headachy.

I've been eating similar breakfasts throughout the past 6 weeks with no problems (although because of the colitis, I only recently was able to eat apple, before I would have a banana). I would have only slight rises in blood sugar. When I saw my doc last week, he said my readings looked great.

Could my Humalog be bad? What other things could be causing this?

Sorry for the long post and thanks in advance for advice/suggestions.

[UpNorth]

It could definitely be the Humalog gone bad... Try a new cartridge/vial and see if that helps

[xMenace]

Originally Posted by Anomaly

Could my Humalog be bad? What other things could be causing this?

Not likely. You'd be through the roof. A 186 pp high but not is not excessive.

Are you rotating injection sites? Some sites are good and some are bad. An over-used one is bad.

Our mornings are generally tough anyway given our dawn phenomenon tendancies.

You eat a lot of carbs for breakfast. Maybe cut back some.

As a type 2 with a body full of steroids and new to injections, I can see your pancreas being a bit confused. You may have had extra insulin production and now for some reason it's holding back.

There's a full moon!

[peej07]

I had this same thing for the last few days but my highs were in the 300's. I think I have some areas that are no longer absorbing insulin.

[Anomaly]

Thanks for the responses. I do try to rotate my sites - left side one day, right side next. And try to remember where the last injection was and work my way in from sides toward center. Sometimes, of course, I can't even remember where it was I just swabbed myself seconds before

Could sites be overused after only 5 weeks of 4 shots a day?

Also If I end up with some bruising/black & blue at an injection site or get a pinprick droplet of blood when I do an injection, does that mean I've hit muscle or something instead of a good fat site? I.e., might not be getting absorption?

[xMenace]

I eat consistant breakfasts. All I know is that when I'm within target I'm happy. When I'm not, I usually don't have an explanation. Absorption is usually not the problem with me that time of day. I usually change sets in the evenings after work for some reason.

Don't play the lotto when this happens