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When you have unexpected high blood glucose levels, what are the most common reasons why?
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I get rebound highs after lows even if I really didn’t go low. Example, I might get a rebound high (go up to 160 or more) after eating 4 grams of carbs to raise my sugar which never got lower than 75.
Iām on MDI and once in a while Iāll forget a shot before a meal. It happened just today. I maxed out at 330 before it started down.
I put “other” because most of the time, I have no idea why I went high. I can eat the same thing for lunch 3 days in a row, with my starting BG in the same range, and one day I’ll be fine after eating, one day I’ll go high, one day I might go low.
Most annoying cause are bubbles in the tubing.
Fascinating and somewhat expected the way answers are grouping up trying to determine “most common.” (ē¬Āŗ čøĀŗē¬)
Iād have added another answer, though, under āother,ā such as āDamned if I know?ā
LOL… I was just thinking that!… except my expletive was “hell” instead of “damn”! ;p
Almost always high bgs are related to my gastroparesis issues.
I usually run higher towards the end of the 3rd day, before I change my pump infusion site. Whatās unexpected is when I donāt run higher.
Yes! I choose other and mentioned absorption issues from a flooded or over used site. This is a big one it should have definitely been on this list!
Did not enough led time prior to eating
I checked almost all of them because I am usually unsure of the cause.
Seems that I forget to take my insulin a lot lately. Usually busy doing other things and forget. Also, miscalculations. My wife likes to try new recipes, and I sometimes just guess wrong. I also get sooo hungry when I have a low bg’s that I just won’t stop eating.
Other reasons include occasional dawn phenomenon and also a meal higher in fat/protein than I usually eat. And as mentioned above, sometimes the third day of a pod isnāt always as effective.
I;ve looking at my life as a T1 – keep detailed records on food, exercise, sleep. etc. Last August started using a CGM. Result – damn if I can figure out a pattern, though I have seen that exercise related hypoglycemia is followed by a spike that often exceeds the level read before exercise by up to 90 points.
The ‘why’ in the question is superfluous.
Insulin absorption issues from an overused and or flooded site from too much insulin flooding an area to correct high.
happens with high-intensity physical activity
For me it can be a multitude of reasons. From a secondary spike from eating pizza to forgetting to bolus to hit insulin to miscalculation all of those have effected me at one time or another. Most commonly it is probably miscalculation due to not reading every single food label.
Occasionally my glucose will rise unexpectedly high when the site is less than 24 hours old. If I bolus, a time or two, above what my Tandem T-Connect pump gives me, I can eventually get the glucose down and stay within a normal range until the next site change.
Iāve been diabetic 53 years, & using this pump about 1.5 years. In connection with the Dexcom G6 sensor, it normally works great. My time in range is 97-98% looking back 90 days.
I wonder if this happens because I didnāt get all of the air out of the system, but really donāt know.
If your time in range is 97%,that is an amazing fea
Achieving being in range 97% of the time is amazing. For me it is unbelievable, as I achieve being within range about 60% resulting in an A1c of 6.9%. I’d be curious to know what the parameters of your range are and what A1c level you have.
Just about all of the above except problems with pump or line. Gastroparesis, miscalculating carbs, rebounding. I went along great for a month and now canāt seem to stay on target. Maybe that bottle of insulin I had stored at my sonās house and finally opened. Exp date was 10/22ā¦ā¦.who knows? 111111
Most of these would apply at various times, but quite often I have no idea why an unexpected high occurs. My regime does not change from day to day.
Strenuous exercise.
I answeredāotherā since I can do all the things I usually do and still get some unexpected high numbers. Stress and not having a good absorption site may be the cause. (MDI)
Dx 67 yrs ago this week. I could have checked most of the boxes. Too much is still a wild guess.
First cause is missing a bolis. Second is mis calculating carbs. Third is morning phenomena. And third is end of resivor rise.
Sometimes inaccurate carb guessing, sometimes delayed rise, sometimes completely unknown…
Most of the time though, it’s because my Dexcom G6 sensor indicates my glucose dropping farther or completely falsely causing the tSlim X2 with Control IQ to suspend my Insulin delivery and keep the Basal cut off too long so by the time the pump resumes Insulin delivery, my BG is already getting too high so my pump then gets stuck in a glucose chasing rollercoaster!!!
I have the same issue fairly reularly using the same products. Usually in the first or last 2 days of sensor life. Recently my reading was “Low” (below 40) when in fact my bg was 162 and climbing with insulin delivery halted.
My diabetes is “brittle”. My insulin requirement changes frequently and for no apparent reason. (Oh, there’s almost always an apparent reason, you say, but no, not for me.) Yesterday, for instance, I needed double the insulin for a midday snack as I did for the preceding breakfast. (Yes, I know how to adjust for the content of the meal or snack.) I needed elevated doses the rest of the day yesterday and again today. All I can do is adjust. (I’m _always_ adjusting.) When my insulin requirement remains stable, I’m on “vacation” as the diabetes becomes easy to manage. I’m rarely on vacation. Interestingly, my Levemir requirement did _not_ change last night ā my blood sugar was stable. Why should the correction factor vary by a factor of two (or more) with no change to the basal requirement? I have no idea.
I find that because my physical activity is not steady as I never know how physically active I will be on a particular day, I can never have two days in a row with the same basal amounts. I just adjust by eating small increments of carbs to raise my sugar or give micro-boluses to bring down my sugars. I think diabetes is just a tough disease to keep under control as you certainly can attest.
Other is not nailing the pre bolus. You’d think after 20+ yrs I’d be able to do this by now buuuuut nope.
I Hey put down all the usuals for high glucose levels but the one I face daily is insulin that won’t absorb. I have to sit there with a hot water bottle on the injection site to try to force the insulin to absorb. Some days it doesn’t matter what I do the sugars just keep going higher to the point of having to take more insulin
The most common reason for me going high is being too still after a meal. I usually go for a walk after a meal and that prevents unexpected highs most of the time.
My answer is very similar to others…
I rarely get the timing of insulin “right”… so, my BSes can go high after a meal, but I wouldn’t really call that “unexpected” more than just “annoying.”
But, yes, also agree with the “hell if I know” responders! When the high is _unexpected_, because that means I had no idea it was coming. Which means I couldn’t take steps to prevent it. And, if there is more than 1 of the “35-ish Reasons Blood Sugar Goes High” happening, it’s nearly impossible to pinpoint precisely. I might be able to narrow it down to 2 or 3 reasons, but not one single factor. And, then, thinking of the 35-ish reasons and just going, “Crikey… how am I supposed to figure this out? Oh, just take insulin and move on….”
When I go out to eat should be an option. I always over eat when I go out or to someoneās home. And, I can only enter 90 carbs because if I enter the true amount, I find I go low before I go high. Not on a sensor so afraid to just ride it out. But, like others, if I ate the same thing everyday at the same time, there still will be issues because there are just too many variables. I can go out and bolus every 2 hours and keep it in range. But when I go to bed and wake up, I will be high. If I over eat, I will go high no matter what. Except if I had a CGM perhaps, but who knows.
All of the above doesnāt happen often yet at some point Iāve encountered all of whatās been indicated on the list.
It has to have something to do with either the insertion site and/or the pump. Often, my BG won’t come down even with a correction bolus. My next step is to go to an old fashioned direct injection. Comes down within the hour.
checked several and then there is the unlisted but probably popular one one “I have no idea”.
I have a recurring problem with lag time of insulin after delivery by pump! I am using Tandem I’t:slim X2 insulin pump Control OQ with Lyumjev (In pharmacodynamic euglycemic clamp studies following a 15-unit dose, healthy subjects receiving Lyumjev and Humalog experienced an onset of action of ~17 minutes and ~22 minutes, respectively. Lyumjev subjects had a duration of action of about 6 hours.) Lag is up to 2 Hours & results in Blood Sugars of over 200. ? Any suggestions Y’all
Plan ahead. Unfortunately, that’s easier said than done. When you want to eat, you want to eat. You don’t want to wait for 20-30 minutes. I think this is where major improvements to A1c level can be made. All it takes is discipline! Does anyone have some extra they could lend me?
By tracking, tracking, tracking, I have come to the conclusion that the majority of the times my sugar goes high is because of absorption problems at the infusion site. So now if the site starts itching, feels uncomfortable in any way or if BG doesn’t respond, I immediately change the site.
As a general practice, I do not use the control IQ during the day, unless I’m doing some exercise that will bring me down. The problem with IQ is that it cuts off the basal as soon as I’m under 110 and then later on I run short of insulin and go high.
Another tactic I used is to give 1/2 of before the dinner bolus 15 or 20 minutes before and the other half plus adjustments for eating more than I was planning, about 1.1/2 hours after dinner. In this way I avoid going low right after dinner and high later on.
So… the pump and the control IQ still leaves me doing a lot of work, but it’s worthy. Out of my last 90 days, I’ve been able to achieve 85 days over 80%. And.. that my friends, for me its a great success. Thanks the Lord, I have to say.
Trying to stretch my Insulin to cover the 4th day in the DEX 10-day cycle and all the other issues that I marked.
Pretty much any level of fat and I get a big delay in BG rise. So if I’m under 90 when I eat, I wait until it starts to go up to take insulin. If it takes too long for that to happen, I sometimes forget until Dexcom beeps at me.
My most common cause of bgs that won’t come down is the Tandem reservoir just can’t be counted on with less than 25-30 units left. But I’m not willing to waste 30 units in addition to the 12 unit tube fill waste. Just override the CGM based calculations with double or triple the suggested correction.
But – anything can be the cause at any given time.
I did NOT check “Miscalculated carbs” because many times the “Total Carb” counts on the packaged food nutrition labels is inaccurate. When you enter the correct carbs, but your BG goes up over 200 and does not fall back suddenly after eating the same serving 3 times, I conclude the nutrition label is inaccurate. There should be a study conducted on how accurate nutrition labels are….. the current focus on “Net Carbs” (I joke in my opinion) and low-carb foods makes it profitable for companies to understate their carb counts. Oh, “Sugar Free” labels are legal, but false the majority of the time.
Most common source of highs for me is forgetting to bolus pre-meal. Sometimes I program but realize hours later that I didn’t hit the last check button to deliver. Sometimes I hold off on bolusing because I’m heading low and then forget to follow-up. Sometimes I just straight forget. It is biggest ding to my time in range.
I share your situation as I often forget to hit the last button, thinking I had done everything I needed to do. You must have a Medtronic pump. Right?