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Many people with T1D talk about having a "stubborn high" when talking about those frustrating instances of high blood sugar that don’t seem to respond how we would like them to, however this phrase means something different to everyone. Which of the following circumstances would you consider a “stubborn high”? Select all that apply to you.
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Most things in life are ephemeral, transient, evanescent, and fugacious.
But [expletive deleted} stubborn highs may be due to
a) pump problems
b) insulin problems
c) biological kinetics problems or
d) lack of direct injection problems
Whatever it is, it is another of life’s subtle thriller conundrums. 🤣
Mine are usually because I am distracted by everyday life circumstances and forgot to bolus before eating.
For me a stubborn high is not based around only time but how much insulin is required to lower. Needless to say it takes much more insulin to bring down a high bg than it does to prevent it. Pre-bolusing helps me time the reaction of active insulin with the rise of post meal bg’s. Greatly reduces those post meal spike (for me).
So true! A forgotten or delayed meal dose is the most common culprit for my stubborn highs!
A darn cheeseburger (on a bun) and onion rings got me the other day. I did dose premeal, but should have used extended bolus.
Have never been over 300. And rarely 200. Once in awhile have dawn phenomenon but usually my own dietary fault. Sometimes talked time to go down to normal
for e a stubborn high is when blood sugar is over 200 and with auto correct and/or correction by me, blood sugar does not come down for hours to where I want it too be. usually I think when I am not active enough. I wish it could be faster when this happens but if I am sitting for a couple hours it is hard to do.
My son , age eleven, has never “liked” bring over 200 for very long. If after two hours, correction vis pump is not effective, he will ask us to do a correction via syringe.
It doesn’t matter what the blood sugar is if you want it to come down lower and it won’t. Could be the food I ate such as fats or the site is bad. Just frustrating.
Treating highs with subcutaneous insulin typically takes at least 2-3 hrs. So, I would define a “stubborn high” as a sustained BG over 200 mg/dl for over 6 hrs that does not come down after 2 or more correction attempts.
If it takes longer than 3 hours via pump correction, it’s a stubborn high.If I think the problem is caused by not receiving the full amount of correction I may change my infusion set to another location, and take an injection. Novolog does not bring down highs quickly but I’m allergic to other insulin types/brands.
Interesting question. I felt like I was taking an old high school quiz.
Anyway, I said above 200 for 2 hours. I read the previous responses. Many are technically based upon the amount of time it takes for insulin to take effect. My response is based upon personal feeling that I want my blood glucose to go down to normal range as quickly as possible. If I’m over 200 for more than an hour, I’m working hard to get it down. I most likely will take more insulin … and wait … , or I may go for a run.
I find those numbers and durations unimaginable. I almost never get above 125 and then only for minutes at most.
What are you doing with all of this t1d info that you receive each day from your participating subjects???
It runs high from sweating
I wait at least 2 hrs after injecting a supplemental 1 or 2 units of Humalog (lispro) for bg to normalize. If close to usual pre-meal bolus injection time I add the 1 or 2 units to usual bolus. Up to 149 bg I add one unit. Between 149-200 I add 2 units. 200 to 250 I add 3 units. Never exceed 4 units extra in 4 hours. Just wait; it will come down…unless flu or extreme stress.
Any number which does not respond to using short acting insulin. A “stubborn” high could be HIGH or 300, the specific number is irrelevant. When you use any (sic. of the newer) short acting insulins and achieve zero result from that insulin dosage, THAT is a @*(#&@* stubborn high! Readings below 300 while Diabetes text-book “high” are not typically considered anything very serious/meaningful. In a perfect of ideal D universe maybe, but in the real world… 300 is a basic threshold for a typical “high” with ~attitude~ (i.e. stubborn). Rarely happens, but when/if a stubborn reading happens and gives the finger to our best efforts, you CAREFULLY try again, until you find a viable solution.
The numbers do not make that much of a difference to differentiate “stubborn highs”. Simply the length they last and how they react to variables that should bring them down, although I definitely do not desire the higher numbers.
I selected “none of these,” because I have never heard the term ‘stubborn high before.
I define a stubborn high as anything over 200 for any length of time. Once I’ve risen to 200, all my BGs seem to be ‘stubborn’. Yes, I admit I micro-manage, must to my endo’s dismay.
I don’t experience “stubborn highs” very often, thankfully. An unexplained high for an extended period of time (more than 2 hours) has always been due to inadequate insulin plus my dawn phenomena effects, or due to a pump insertion problem (catheter bent) or an underlying infection like the beginning of a urinary tract infection or a low grade virus. If I spike a fever, my glucose will also become more difficult. I also change my pump every third day when alerted by my Omnipod pump but sometimes will find that I have a lot of lack of normal effect by insulin (and therefore correct more) in the last 12 hours before changing the pump. I suspect that my insulin then is not absorbing as well at the site due to the fact that my body has mounted an attack by macrophages and other cells around the catheter insertion site. Once I change the site, all clears up. Pumps have helped T1Ds tremendously but the perfect pump or perfect system would be internal and well protected from the onslaught of our immune systems. But, that has remained a huge challenge for medical researchers to solve. One could move from having to inject insulin only to have to start taking antijection drugs or vaccines. So, is our cause really advanced?