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Type 1 30+ blood sugar

Sorry DD but you are wrong. The DAFNE rule state:

Ketones present and BG above 13mmol 10% of TDD as QA every 2 hours if + or++ Once ketones reach +++ take 20% every 2 hours. I am reading this from page 87 of the book.

Smidge
 
It's going to be very difficult to try and match your basal needs at a time when your body is healing and experienced a stressful event. I should know - I think I have the dreaded manflu at the moment or something equally sinister. Not pleasant at all. As part of the immune response your body pumps out additional adrenaline and glucagon, raising blood sugar. I've always wondered what a non-diabetics bg number is at a time when they are suffering from an infection. Anyone know?

Anyhoo, I'm very reluctant to raise my basal to counteract the next few days of sickness and raised blood sugar, preferring to use corrective doses of bolus every four hours instead. At least this way, I can plan to avoid that moment when insulin sensitivity returns and I don't get hit with overnight lows because of too much basal.

How much insulin are you taking, compared with before? As long as you're not skipping doses, drink plenty of sugar free fluids, and take corrective doses as needed then I think you can ride it out. However, if you start feeling sick in anyway, do not muck about and seek medical attention.
 
Hi. I think your DN's advice ref rapid correction doses is right to avoid stacking insulin and going hypo. I still doubt you are doing the right thing with your Basal. Your fasting blood sugar should be between 5 -7 mmol. I think this is far more important (my amateur opinion) than trying to keep bedtime and fasting at +/- 2mmol. Your bedtime reading can be affected by meals and rapid injections and I personally don't take too much notice of the reading if I even measure it. I do sample it to stay below 10 mmol on average but I take notice of the fasting reading. BTW, although your Ketostix are out of date they may well give a good'ish reading? Why not at least try them as a guide? Also, you say at times you take 'no carbs'? This will really confuse things if you swing them around too much. Try to keep them low but smoothed thru the day.
 
I'm on a pump Smidge now, and I have had it clearly told to me all my 30 years that fast acting peaks at 2-3 hours and to inject more often than 4 hours when correcting loke previous OP said can cause stacking..... I did say that I have been told to adjust a percentage up for corrections if levels over 12.
Personally I was told to double them...

Page 87 in your dafne book may well state their rules, however I have never had a hypo after a high level... AND my only highs in to 20's have been due to pump failure.. NOT because of problems with basal/bolus regime..


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Right, a couple of points:

I haven't tested for ketones so I don't know if I'm ++ or +++ or whatever, so I can't adjust my bolus insulin up by whichever percentage is appropriate.

My supply of ketostix was binned earlier this week (of all times to decide to bin them!) when the DSN informed me the shelf life has recently been found to be 3 months shorter than stated and they're not accurate enough after this time. I didn't think to get a replacement because next week on the DAFNE-type course we're all being given meters that test for ketones as well as blood sugars. It didn't occur to me that I'd end up as high as 30. My mistake!

I think I'll stick to 3u correction dose every 4 hours because my readings have already come down to 20 and the last thing I need is to swing the other way.


Regarding the other stuff about adjusting my doses and bedtime readings - I probably should have said that those bedtime readings are taken AT LEAST 4 hours since my last carbs and bolus insulin. The DSN said this is enough time to be 'clear' of them and for any insulin to have been used up etc. Then at that point I take my basal dose and go to sleep, leaving the basal as the only insulin working in my system without the influence of any carbs or bolus insulin. So in theory if it's the right dose, the blood sugar readings should be +/- 2mmol when I wake up.... that's the thinking behind it apparently. So it's not the actual reading itself that's important at that point, it's the difference between the two readings that's shows whether you're on the correct basal dose. Once that's sorted, I tackle the carb to insulin ratio throughout the day to get my actual BG readings to an acceptable level.

I'm just going on what I've been told in this DAFNE-type course I've been on this past week. :)


After 21 years of type1 diabetes, I am only just this past year realising how bloomin' complicated it all is! :shifty:


Oh and I dragged my mum to Tesco Pharmacy just before it closed on the off chance they had ketostix, but no such luck.

Thanks again everyone!
 
I'm not disputing that DD, but they have changed their advice on how those of us on basal/bolus should deal with corrections in times of illness. Now, as most people know, I am not a big fan of DAFNE, but their sick day rules are widely accepted as the best advice. Unfortunately, Picklebean hasn't got to that bit of the course yet.

Under normal circumstances you would be right to advise against such frequent boluses, but not when illness and high BG is involved.

Smidge
 
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