Day 6 on pump and hit a spot of bother

[Riri]

Hia all, everything running quite ok until Sunday and then gradually my numbers stated to climb. Got to work on Monday and bs at 13.8 so I tested for ketones - they were at 1.2 ! All day struggled to get bs down to below 10 and all the while showing moderate ketones. I spoke to my consultant on the phone and she upped the basal over the 24 hrs by 0.05/hr. Got home and started to feel sick so I panicked and went to A&E re: ketones showing. They were brilliant and the doc said I did the right thing to check it out as I was new to pump etc. I had an aerterial blood test for blood gases and tha proved normal. Got home and eat tea and then my sugars gradually started coming down to 6.8 by 6am this morning; apart from a spike mid morning they've been more or less below 8 all day. I think I did panic on seeing the ketones and the diabetes nurse I spoke to today said it was unusual to have ketones showing when you're bs's are around 12-13? My hubby reminds me that it's early days and it will take adjusting - I know this but sometimes it's hard not to panic. Anyway back on track and let's hope I can report good news again a the weekend. If anyone has any advice on ketones I'd be grateful.

 

[ams162]

the thing with a pump is if something does go wrong it goes wrong rapidly so u def did the right thing in getting checked. we love dylans pump life is so much easier but we have had issues with bubbles and ive noticed one bubble can make things spiral out of control very quickly but if ur on top of things then there is no need to worry.

well done on getting things back on track and for coping well with a new situation u should be proud of urself

anna marie

 

[Riri]

Thanks Anna - good to talk to other pumpers as I think you sometimes need to be invoved in a situation to understand. My sisters are great but they don't live with the condition day to day. My husband is brilliant although he does think I worry too much and make myself ill as a result.

I do test regularly (too often my DSN says!) including during the night so I'm hoping as you say I would be able to act early and quickly. Glad to know that you and your son get on with a pump. Have you had a ketones problem at all?

 

[ams162]

yes we did have a small amount of ketones with the bubbles but we sorted it quickly it did scare me how quickly things progressed with the insulin struggling to get passed the bubble tho i must admit. when a pump works its brilliant and i feel its the best choice we made for us i think the key is to keep calm and think things through. i had a big panic when dylan was in the 30s in the summer no matter how much insulin i gave couldnt understand what was going on so i tested for ketones and there were none so i sat down thought it all through and realised the insulin must be making it through as there were no ketones, so i sat dylan down spoke to him and found out he had decided to eat a load of gluco tabs, i was relieved to have discovered what was causing the problem but dissapointed he had eaten them but hey i guess thats kids for u lol

anna marie

 

[ebony321]

Hia all, everything running quite ok until Sunday and then gradually my numbers stated to climb. Got to work on Monday and bs at 13.8 so I tested for ketones - they were at 1.2 ! All day struggled to get bs down to below 10 and all the while showing moderate ketones. I spoke to my consultant on the phone and she upped the basal over the 24 hrs by 0.05/hr. Got home and started to feel sick so I panicked and went to A&E re: ketones showing. They were brilliant and the doc said I did the right thing to check it out as I was new to pump etc. I had an aerterial blood test for blood gases and tha proved normal. Got home and eat tea and then my sugars gradually started coming down to 6.8 by 6am this morning; apart from a spike mid morning they've been more or less below 8 all day. I think I did panic on seeing the ketones and the diabetes nurse I spoke to today said it was unusual to have ketones showing when you're bs's are around 12-13? My hubby reminds me that it's early days and it will take adjusting - I know this but sometimes it's hard not to panic. Anyway back on track and let's hope I can report good news again a the weekend. If anyone has any advice on ketones I'd be grateful.

Hi,

One of the set backs to a pump is that as you only use fast acting insulin your BG's can climb pretty quick if there's a problem as you don't have any 'background insulin' to cover you if you fall short with fast acting.

Then clearly as a result you are more likely to develop ketones, so i would say you are more likely to develop ketones at a lower level of BG.

You did the completely right thing though! setting a temp higher basal is the right thing to do.

It certainly is early days, even though you've had a hiccup it's a great sign you know if it happens in the future you know you can get it sorted out quick

I haven't had ketones for a very long time now.. My rule of testing is that if i have two consecutive BG readings over 13mmol i will test for ketones, or if i have a single reading over 16mmol, this is a good rule to follow as you are bound to catch things quick! i also test for ketones when i'm poorly too.

It's also a good idea to drink lots of fluids, not only will this help flush them out but it will help keep yourself hydrated. HOWEVER if you are drinking copious amounts because your are really thirsty then it's likely your ketones are not shifting with fluid and extra insulin, so make sure your aware of the difference!

Ketones sound so scary, but with little readings of them you can easily reverse them yourself with careful testing and adjusting your insulin accordingly. Of course as you so rightfully did if you are worried then always seek medical help, i can guarantee any medical staff would be happy you came in for little reason rather than leave it and have to come in for a bigger reason if that makes sense!

Hope it hasn't put you off having the pump, as your hubby says, early days, you seem to be doing really well only 6 days in, keep going at it and i hope to see great posts from you with awesome results

 

[jopar]

Riri

When did you do your last set change before your BG started to rise?

A gradual rise is more to do with a infusion set going off...

You won't notice it with the first set you used, because you would still have some of your last background insulin impact on your blood glucose.. As it take a couple of days for it to burn totally out of the system..

Bubbles tend to cause a sharp rise in BG rather than a slow over time...

You can find that different infusion sites can go off at different rates, When I'm using my left side of my stomach I've got to change my set at around the 60 hour mark, as otherwise I see a slow increase in BG, but on my right side I have no problems with adsorption and when I had to wait for a new delivery before change my set and I now problems with the site for another 36 hours.. Don't advice keeping an infusion set in longer than you should otherwise it could cause scaring under the skin and effect adsorption with later sets..

And you need to keep in mind, and as you are new to pumping keeping a note on set changes to where they are.. So that you can work out if there is any differentials between the area's you use.. As sometimes as I already said sites can go off quicker, but also different areas might need different amounts of insulin to do the same thing,,

I also suggest that if you have invest in a book by John Walsh called 'Pumping Insulin' then do so, it's the pumpers bible of control..

 

[Riri]

His Jopar - I'd changed the set on Friday night so was due a change on the Monday after work. So it had hit the 48hr mark when BGs started rising. I'll watch tonight now as I'm due a change tomorrow night. I think you might be on to something as my BGs were excellent after the change on Mmday night and by today they've crept up - not very high though - 8 or 9. My consultant has tweaked basal rates with me today as it is still very early days to be spot on with these so we'll see what happens.

I will need to look out for the points you made - very useful thanks. The one thing I'm thinking as well is that I changed my set last Friday night but, as I had enought insulin in the reservoir, I kept the same tubing - Ive read since that the set and tubng should be changed. Still learning !!

Also the one thing abut last Monday that I haven't mentioned was that I was totally stressed with a meeting I was setting up for 40 odd people - nothing was going to plan so I was rushed and flustered. Haven't paid much attention to stress levels sending BGs up before now but I believe they do!!