Sometimes blood glucose levels might be high for a variety of reasons, and they might not always be so obvious. People can end up adjusting insulin’s on blood glucose levels which may not be reliable, and wonder why they go low very quickly, or blood glucose levels actually end up rising more. It is important to go through the following checklist before making any decisions on insulin adjustments.
The following are the top 10 reasons here at Diabetes Insight as to why blood glucose levels maybe high in the absence of an obvious reason:
1.Residue Left on Finger Tips Altering Readings
Most people realise that if you eat a piece of fruit and check your blood glucose levels immediately after without washing your hands, you may get raised levels, due to residue of the fruit on your finger tips.
But did you know handling newspapers etc and not washing your hands can affect levels in the same way due to the ink/dye from the print? This is why we always suggest to wash your hands before taking your blood glucose levels regardless of what you have been handling. At Diabetes Insight we have seen blood glucose levels of 16mmol/l become a level of 5mmol/l after washing hands. This is vital if you are taking insulin and adjusting your levels accordingly.
2. An Outdated Blood Glucose Monitor
The older a car becomes, with wear and tear the more unreliable the car can be. The same can be said for your blood glucose monitor. With more use and the older it is, the less accurate readings may be. It is recommended that you upgrade/change your blood glucose monitor every two years.
At our weekly clinics, Diabetes Insight sees frequently individuals who do not change their needles with every injection that they give. Sometimes we see people only changing their needle with every new pen that they use!!! Reusing a needle more than once is like injecting with a barbed wire, it can lead to localized swelling and trauma at the injection site, which may not be obvious, but absorption of the insulin may not be guaranteed.
Also not changing your lancet on your finger picking device, can cause it to also become blunt, which can make picking your fingertips painful. Blood residue can be left on reused lancets which may also alter readings.
4. Site Rotation – Lipohypertrophy
Injecting into the same sites can cause painless lumps, but when continuously injecting into them, causes the insulin to not reabsorb properly and can lead to high levels. Therefore it is really important to rotate your sites to avoid lumps from forming at injection sites.
5. Ensure Insulin Has Not Crystallized
Always hold insulin up to the light before injecting to ensure there is no crystals floating within it. If you do spot crystals etc floating within the insulin, it may suggest that the pen is leaking &/or it has been exposed to extremes of temperature. Dispose of the insulin and get a new pen/cartridge. It is recommended not to let insulin pens at room temperature for any more than 30 days.
It might be obvious to many people, but it always important to ‘stress’ that stress can raise blood glucose levels. the body cannot determine the source of stress, it just knows it is. Stress can come in many forms, an argument, an infection, post flu vaccine, stressing over blood glucose levels can even rise blood glucose levels! Stress causes a fight or flight response which triggers adrenaline and cortisol to be released into a persons system. These work the opposite to insulin and makes insulin work less effectively, therefore in turn rises blood glucose levels.
7. Injecting High Doses of Insulin
When injecting doses of insulin over 40 units at any one time, absorption of the insulin can be an issue. This is usually in relation to background or basal insulin, which is a once a day injection, and a person may have to inject 40 units all at the one time. If absorption is an issue, it is recommended when injecting over 40 units, to split the dose into two, therefore injecting 20 units x 2 at any one time, to ensure the insulin absorbs properly.
8. Leaving Blood GlucoseTest Strips Exposed to Air
Always ensure that the lid is kept sealed tight on your blood glucose test strips all times, especially when not in use. Exposure to extremes of air temperature, especially in damp settings, can lead to altered blood glucose levels.
Novofine needles should only be used on Novonordisk insulin pens, as full absorption of insulin cannot be guaranteed when used on other types of pen devices. If in doubt, use a universal needle that can be used on all pen devices such as BD Penfine or Unifine needles. The size of the needle has been shown in research to be of no bearing on the absorption of insulin.
10. Unassuming Foods
Processed sliced ham contains sugar, which is used as a preservative. Many powdered sauces and soups also contain sugar, but can often go unnoticed and are not included in carb counting. When used in unison and in large quantities, they can influence blood glucose levels. Portion Distortion can also occur. For example one scoop of mashed potato is the equivalent of two medium sized boiled potatoes, but many people might count a scoop of mash as just one potato. Sometimes it is not just the type of carbohydrate &/or the quantity, but also how it is cooked affects the sugar content of the food, and how quickly/slowly it can be released in the body.