Insulin needs suddenly increase

For past several weeks, my sugars have been running high. I use insulin aspart in tandem pump. (this is a generic novolog required by Medicare) Bolusing extra doesn’t seem to work; need multiple boluses. Often resort to manual injection of lyumjev. Have increased basals and correction factors etc. Changing sites, starting new vials doesn’t help. Any ideas?

Has anything changed for you in recent weeks? Less activity, eating more, less sleep, more stress, etc?

Thanks for responding, Eric. Nothing has really changed. Normally if I’m active, I’ll need to use exercise mode but not lately at all. I just stay high (well over 200) until I rage bolus or use lyumjev. Very perplexing and frustrating. Seems to me to be the insulin. I’m going to contact dr next wk. Only thing new is I’m using cpap for past 6 wks so getting better quality sleep.

Did you try new vial of insulin and reload a new cartridge?

Or does injected insulin from new vial work?

I’ve done all those things. Changed sites, cartridges, changed basals, insulin to carb ratio, new vials etc. Only thing that works is lyumjev manually.

Another question - what pump are you using?

Tandem tslim

Can you look at your total basal amounts per day, and compare them to what they were before you noticed this problem? It would be interesting to see what the difference is.

Also, when did you start using the generic insulin? And how long have you been using the Tandem pump?

Basals previous to this were around 14.5u/day. Now about 15.5/day but I’m making lots of corrections & only the manual lyumjev works. But of course that’s after lots of aspart. Started new generic at least 9 or 10 mos. ago and tandem about 10 or 12 yrs ago. I’ve also put on about 5 - 8 lbs lately.

The weight increase could be behind your issue. Higher body weight increases basal requirements and can decrease short acting sensitivity. I lost about 20+ lb (unintentionally, side effect of a medication) and my basal (Lantus) went from 12 units to 7 units. I’ve gained some of the weight back and my basal is now 11 units (which is a little too high I think, still adjusting).

I was amazed at how much my insulin requirements changed after the weight loss.


Ditto what @Jan said!

And if you take more insulin, your pump site can also deteriorate more rapidly.


And the other thing I’m wondering about is whether your exercise regimen has changed? If I’m not exercising, the insulin seems to be less effective, and v.v. So if you have become more sedentary over the past couple of weeks, that might affect the way you react to insulin.


@mstan - is there a chance you could have asymptomatic covid? I am recovering from first time covid and was ASTONISHED by the increased insulin requirements that the infection created. Sorry that you are dealing with this – so frustrating.


Thanks everyone for your helpful comments. I’ve increased my I:C ratios and that seems to have done the trick :grin:


I find season-related changes in basel rates, but usually spring goes down with more hours of day light.
Just a wild thought. Last fall when I changed the time on my pump due to EST, I accidentally changed from AM to PM… It took me a long time to figure this out. My basel BG and meal bolus PP were crazy; and I kept changing the basel rate seeking harmony. When I noticed the 12 hr shift in time (duh) I dented the drywall in the house. Needless to say it was a quick return to harmony and peace.

After 58 years I thought I had made every mistake, but not so!

Don’t discount weight change as a cause, or change in exercise.

And another thought, if my basel is out of wack my meal doses can be incorrect as I try to adjust for PP highs. I see it when my BG curve looks like a roller coaster. YMMV



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