Type 1: Can't remember if I took my bedtime basal

[birchy66]

I woke this morning and my BG was 14.6 which for me is twice what it normally is. When I went to bed last night it was 6.3.

I do have a cold at the present time which might be the cause or could it be because I might not have taken my Lantus last night. I was feeling so tired at bedtime I just can't remember.

What should I do, just monitor throughout the day and correct my bolus as I go?

Thanks for any advice.

 

[noblehead]

Likely your cold is to blame for the high bg levels, in times of illness just follow the Sick Day Rules, here's a handy flowchart:

http://www.mydiabetesmyway.scot.nhs.uk/resources/leaflets/SickDayRulesForType1Flow.asp

 

[asparagusp]

I don't think a cold would cause such a big increase. When I have a strange reading I always take another. Yes keep monitoring your levels today. Good luck.

 

[birchy66]

I don't think a cold would cause such a big increase. When I have a strange reading I always take another. Yes keep monitoring your levels today. Good luck.

Thanks. that's what I thought as I've had colds before and have never had a high rise like this. I've just taken my BG again and after 3 hours it's now 18.2. I couldn't have taken my Lantus last night. Would you take it now or say half om daily dose of 26 units. In other words I could take 13 units now and then 26 at bed time as usual. I'm worried now.

 

[Juicyj]

I don't think a cold would cause such a big increase. When I have a strange reading I always take another. Yes keep monitoring your levels today. Good luck.

Hello @asparagusp this is incorrect it is possible with type 1 diabetes to hit these levels so yes a cold could be causing this.

@birchy66 follow sick day rules for today, do you have these ?

 

[Juicyj]

Thanks. that's what I thought as I've had colds before and have never had a high rise like this. I've just taken my BG again and after 3 hours it's now 18.2. I couldn't have taken my Lantus last night. Would you take it now or say half om daily dose dose of say 13 units. In other words I could take 13 units now and then 26 at bed time as usual. I'm worried now.

Hello Birchy - if you believe you have forgotten to take your basal dose then you will need to take one - we cannot give you advice on how much to take as no one here is allowed to give you advice on your doses, please take into account that it's now almost mid day so taking a half dose could cause you to overlap into your evening dose and if you decide to then you will need to test every hour. My personal advice is to call 111 and ask someone to call you back as it's out of hours. Are you taking correction doses of novorapid ?

 

[jaywak]

I had the problem of remembering if i've injected if my blood sugar rises in the morning without good reason so I bought one of those timer caps that fit on pen about £25 well worth the money you then can't have any doubts whether you injected or not. It could still be the cold, i;ve had similar results if i'me not feeling well

 

[azure]

I don't think a cold would cause such a big increase. When I have a strange reading I always take another. Yes keep monitoring your levels today. Good luck.

Bear in mind that Type 1 is a very different condition to Type 2.

It's most certainly possible to get highs like that with Type 1. I often get to 11 or 12 with a cold and have to do frequent corrections.

 

[Mep]

I know when I get infections whether viral or bacterial my sugars can go quite high too. But I can understand you may be concerned whether or not you missed your basal. I was worried myself last night as missed my usual basal injection time due to being in ER, I was expecting to try and correct with my bolus today. But I seem fine today with my BGL's, so taking it over 2 hours late wasn't too bad on me. I agree with others about following the sick day plan. I wish you the best, and hope you feel better soon.

 

[catapillar]

I don't think a cold would cause such a big increase. When I have a strange reading I always take another. Yes keep monitoring your levels today. Good luck.

That's because you have type 2 diabetes treated with basal insulin only - clearly you are making your own insulin. OP is type 1 and has been for nearly 4 years so probably not making any insulin. Illness in type 1 diabetics can cause dramatic changes to levels in type 1 diabetics.

Please bear in mind type 1 and type 2 diabetes are different. And this thread was started in the type 1 diabetes section of the forum.

Thanks. that's what I thought as I've had colds before and have never had a high rise like this. I've just taken my BG again and after 3 hours it's now 18.2. I couldn't have taken my Lantus last night. Would you take it now or say half om daily dose of 26 units. In other words I could take 13 units now and then 26 at bed time as usual. I'm worried now.

To be honest at this point you are probably better off testing frequently, doing small corrections with fast acting, continuing to test and be cautious of insulin stacking. It's possibly a bit late in the day for a top up of basal now, it would create a bit of an overlap tonight. Don't worry too much about it - that'll be sending you up too. It's just one bad day, not the end of the world. Hope you have managed to speak to someone at 111, follow the sick day rules and check for ketones. Illness can send me up, especially if it's an infection, or it can send me down - it really just depends.

 

[birchy66]

Hello Birchy - if you believe you have forgotten to take your basal dose then you will need to take one - we cannot give you advice on how much to take as no one here is allowed to give you advice on your doses, please take into account that it's now almost mid day so taking a half dose could cause you to overlap into your evening dose and if you decide to then you will need to test every hour. My personal advice is to call 111 and ask someone to call you back as it's out of hours. Are you taking correction doses of novorapid ?

Thanks Juicyj. I decided to take half of my daily dose of Lantus at 11.00am which is approx 12 hours after I would normally take it. I might get a little bit of overlap but I'll keep checking my BG. I am back to 14.1 from 18.2 so it's going in the right direction at least. I am also following sick rules so fingers crossed. Thanks for your help.

 

[Juicyj]

Thanks Juicyj. I decided to take half of my daily dose of Lantus at 11.00am which is approx 12 hours after I would normally take it. I might get a little bit of overlap but I'll keep checking my BG. I am back to 14.1 from 18.2 so it's going in the right direction at least. I am also following sick rules so fingers crossed. Thanks for your help.

Glad to hear you are coming down, take it easy today and keep testing every hour to ensure you don't hypo, best to be safe. It's a minor blip in the scheme of things, I have forgotten my basal in the past too and it's a pain as you have to be extra vigilant, but making a mental note when you do take it, such as writing it down or investing in a timed insulin pen will help in future, a minor investment for peace of mind, if it's a cold then keep to sick day rules, let us know how you get on today

 

[birchy66]

If I couldn't remember if I'd taken my basal or not, I'd just continue taking correction doses until my next basal is due. I wouldn't want to inject, just in case I had taken it.

Just because your levels acted one way when you had a cold, doesn't mean they will respond the same way next time you have one. Funny thing about type 1 is we never know what the heck is going to happen. Certainly keeps us on our toes.

Thanks Mahola. I agree type 1 certainly does keep you on your toes and is a challenge at times. Ah well tomorrow's another day!

 

[Type1Bri]

A timesulin pencap would defo help in this situation, I reviewed on a while ago https://type1bri.com/category/reviews-and-equipment/timesulin-pen-caps

 

[birchy66]

That's because you have type 2 diabetes treated with basal insulin only - clearly you are making your own insulin. OP is type 1 and has been for nearly 4 years so probably not making any insulin. Illness in type 1 diabetics can cause dramatic changes to levels in type 1 diabetics.

Please bear in mind type 1 and type 2 diabetes are different. And this thread was started in the type 1 diabetes section of the forum.



To be honest at this point you are probably better off testing frequently, doing small corrections with fast acting, continuing to test and be cautious of insulin stacking. It's possibly a bit late in the day for a top up of basal now, it would create a bit of an overlap tonight. Don't worry too much about it - that'll be sending you up too. It's just one bad day, not the end of the world. Hope you have managed to speak to someone at 111, follow the sick day rules and check for ketones. Illness can send me up, especially if it's an infection, or it can send me down - it really just depends.

Thanks for your advice catapillar. I panicked and took half my daily dose of Lantus at 11.00am so will be watching for insulin stacking after my daily dose around 11pm. At the end of the day it's all experience I suppose.

 

[birchy66]

Glad to hear you are coming down, take it easy today and keep testing every hour to ensure you don't hypo, best to be safe. It's a minor blip in the scheme of things, I have forgotten my basal in the past too and it's a pain as you have to be extra vigilant, but making a mental note when you do take it, such as writing it down or investing in a timed insulin pen will help in future, a minor investment for peace of mind, if it's a cold then keep to sick day rules, let us know how you get on today

I'll have to get a better system for recording my basal injection. This is the first time in four years I have forgotten (at leaat I think I forgot?) my basal. Thanks again.

 

[Type1Bri]

I don't think a cold would cause such a big increase. When I have a strange reading I always take another. Yes keep monitoring your levels today. Good luck.

Type 1 diabetes is very different to type 2 with regards illnesses. The OP is 4 years post DX so probably makes no insulin anymore at all, the slightest illness or infection will cause big changes in BG numbers.

 

[birchy66]

A timesulin pencap would defo help in this situation, I reviewed on a while ago https://type1bri.com/category/reviews-and-equipment/timesulin-pen-caps

Thanks Type1Bri. I've just ordered a Timesulin pencap from Diabetes.org.uk. No more such worries hopefully!

 

[Mep]

Type 1 diabetes is very different to type 2 with regards illnesses. The OP is 4 years post DX so probably makes no insulin anymore at all, the slightest illness or infection will cause big changes in BG numbers.

I'd agree with that if T2's still have their own insulin being produced. I'm insulin deficient myself and don't make the insulin I need and that's why I'm on MDI. So for me I definitely get quite high readings when sick... like I see 15 on my meter, etc. I remember prior to insulin I wasn't as high when sick.

 

[birchy66]

Glad to hear you are coming down, take it easy today and keep testing every hour to ensure you don't hypo, best to be safe. It's a minor blip in the scheme of things, I have forgotten my basal in the past too and it's a pain as you have to be extra vigilant, but making a mental note when you do take it, such as writing it down or investing in a timed insulin pen will help in future, a minor investment for peace of mind, if it's a cold then keep to sick day rules, let us know how you get on today

Hi Juicyj, Feeling much better today and my readings are down from yesterday. I was 10.3 before bed and 8.7 this morning so looking better. I should be back to better readings today hopefully. Oh and I ordered a Timesulin cap for my Lantus, a little present for myself at Christmas! Thanks again.