# Advice needed for T1



## ARD28 (Jan 30, 2020)

Heya. I’m 28 years old, work full time and have been a T1 now for 12years. I have always been on novorapid as my fast acting and recently changed to Levimer as my long acting. However, this past 3 weeks I have been experiencing high BMs of 16 and above. Sometimes I have ketones, and sometimes I don’t. I’ve been advice by my GP nurse to start the sick regime however it’s not working. My latest BM is 26.6. Any advice on what I should do??


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## Kaylz (Jan 30, 2020)

Have you done a basal test since you started your new basal? When was it changed?

Have you changed pens/cartridges to make sure they haven't been compromised in some way?
xx


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## ARD28 (Jan 30, 2020)

Kaylz said:


> Have you done a basal test since you started your new basal? When was it changed?
> 
> Have you changed pens/cartridges to make sure they haven't been compromised in some way?
> xx



I’m not 100% what basal tests are but I’ve only done blood sugar readings and readings from my Libre sensor. I’ve also done ketone tests. Checked everything yeah and everything is in date 
Xx


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## Kaylz (Jan 30, 2020)

ARD28 said:


> I’m not 100% what basal tests are but I’ve only done blood sugar readings and readings from my Libre sensor. I’ve also done ketone tests. Checked everything yeah and everything is in date
> Xx


It doesn't matter if it's in date it could still have became compromised and lost potency so I'd try changing them

Basal test is conducted to see whether your basal dose is the correct dose which if new pens don't change things I'd say yours isn't correct, I don't have a link but if you google basal test you will get results on how to do one xx


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## Thebearcametoo (Jan 30, 2020)

Yes change your insulin vial to make sure. Also where are you injecting? If you’re using the same sites all the time your body will lose the ability to absorb insulin there. 
I presume you’re carb counting and all of that.


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## rebrascora (Jan 30, 2020)

Just to be clear, can you explain what sick regime you are following and do you feel like you are struggling with an illness or infection or have you been prescribed other medication like steroids which might be having an impact or could you even possibly be pregnant as that can cause increased insulin needs I believe?  
You would be best seeking advice from the nurses at the diabetic clinic as they are far more experienced than the nurse at the GP surgery. There should be a helpline number to ring and certainly here you have to leave a message for someone to ring you back.

Those levels are getting seriously high, so you do need to take action. Are they coming down with correction doses of Novorapid?
Are you taking a split dose of Levemir morning and night? Just wondering if you are only taking half the dose you should as it is usually recommended to take Levemir twice a day, but if you changed from a single dose of a different basal insulin, you might have not picked up on that or perhaps be forgetting the second injection occasionally.


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## Pumper_Sue (Jan 30, 2020)

How many times a day are you using Levemir? I ask as most need to use it twice a day.


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## everydayupsanddowns (Jan 30, 2020)

Hello @ARD28 

You've had some good pointers already, certainly swapping to a fresh vial/pen of Levemir is a good call. 

Great that you have access to Libre. Are you cross-checking occasionally with a BG meter to see that your Libre is reading similarly to capillary blood?

Since this seems to have started since you switched to Lev, it certainly seems that your dose on the new insulin may not be adjusted correctly. Of course different insulins are often not straight swaps unit-for-unit, so it may just be that you need a different set of units and splits (as Sue says Lev usually works best 2x a day) 

Glad that you are keeping in close contact with your nurse. Are you seen at a hospital clinic too, or only at your GP surgery?


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