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High blood sugars - help

S

SusieT

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Hi can anyone give me any advice?

My son had a cold over the weekend and temp of between 39-40 for two days. His blood sugars were raised (in the teens) and I put it down to the cold. Now we are almost a week on and blood levels still too high and I'm having to give him soluble insulin twice a day on top of his normal. He is normally on 10u novomix 70/30 in the morning and 5u before his evening meal. Last night he had 6 units, went to bed at 11.1 mmols and woke this morning with reading of 14. He had 14 units this morning and I've just checked him again and his level is 20.1 mmols. He was at the doc on Tues who said there is no sign of infection but I don't understand why his sugars are still so high? I spoke to DSN this morning too and he said to just keep notching up the insulin. He seems not too bad in himself. just a bit sniffly but I'm having to keep him off school and stay of work anyway so that I can give him his insulin corrections. He is 6 and can't do them himself yet. Any ideas as I'm really worried? :(
 
No experience of Novomix but correcting with extra insulin is the usual method of bringing blood glucose down, when we are ill our bodies become more resistant to insulin and this is why often the correction doses can seem unreal. Remember if he's bg is high (above 13mmol) then it's best to check for ketones in his urine, if you concerned then contact his diabetes team again or NHS Direct.
 
Definitely check for ketones, if you can blood test rather than urine test that is better. Could you get an appointment with your son's diabetic consultant or a telephone consult? My daughter was on Novomix a number of years ago and we were prescribed Novorapid to use for correcting high readings especially during periods of illness. The Novorapid will bring his readings down more quickly than the Novomix. Your DSN or consultant should be able to advise how many units to give depending on how high his reading is. Try to keep his temp down, I have found a high temp makes control much more difficult, when the temperature comes down so the bg reading seem to settle more easily. Alternate between Nurofen (must be taken with food) and Calpol so that he is getting medicine to bring his temp down more often. Also make sure he is drinking plenty of sugar free fluids.
 
Thank you both so much for your replies. Sorry I missed info out in my post. He did have ketones first thing (2.4) but they have gone down to 0.2 now. The soluble insulin we have is Humalog which usually brings his blood down pretty quickly but it doesn't seem to be doing the job as well today. Have just checked again and blood gone up to 17.5 (ketones 0.2), so more humalog given. By the time he goes to bed tonight he will have had almost double the amount of his usual insulin and still high blood sugars. His temperature has been fine since yesteday morning so I just really don't get this. The doctor says that there is no infection but surely this indicates that there is? I'm getting so confused.
 
Susie,

Take the boy back to his gp and get him checked over again, it can take days after an illness for bg to come down and as I said earlier we do become insulin resistant when ill so taking extra insulin is nothing unusual, hopefully Sophie or some other parents may be along soon to advise, if at all concerned then call out the emergency doctor or take the lad to A & E.
 
It's not unusual for Jess to need a lot more insulin if she is unwell, and even after the temperature and illness settles it can take a few more days for readings to return to normal. Often shortly before we notice any signs of illness she'll get elevated bg readings, that's usually a sign of her coming down with something. A temperature can be caused by a viral or bacterial infection, if it's a viral infection then usually doctors just say the usual advice of go home, take Calpol to control the temperature and wait it out. Unfortunately with a viral infection there's not a lot that we can do apart from keep at the extra insulin to bring readings down and closely monitor the ketone levels. If they get too high you need to get help, advice is usually above 1 contact DSN, at 3 or higher you need to go to hospital for help. They can change quickly though, Jess went from 1.5 to 0 in a matter of a couple of hours, therefore the advice to keep checking every couple of hours. When you're using a rapid acting insulin to correct high readings for illness often you need more insulin to make the same correction compared to when your child is well. Other thing to check is that the insulin hasn't gone bad for some reason, have you tried putting a new cartridge in to see if that makes any difference? We've had hot weather recently and maybe it's had an effect on it's efficiency? Otherwise if you're still worried yes definitely take him back to doctor or speak to your DSN again and get further advice. I hope he feels better soon and his bg returns to normal, I know how frustrating it is when you're doing those corrections and they don't seem to have much effect. You're doing the right thing by keeping him off school, you wouldn't be able to monitor closely or correct when he's at school.
 
Hi folks, well I took my son back to doc yesterday and they checked him over again and said that there was no infection. I didn't feel happy at all and rang our DSN who said to just bring him in and they would check him over at the hospital. Lo and behold, he has a chest infection. I now have absolutely no faith in GP but at least I now know what the issue is and have antibiotics to treat it. Hopefully, back on track soon! Thank you all so much for your help and advice, it's great to be able to offload here.
 
I'm glad you got in touch with your DSN and managed to get him seen by someone who did the right thing, I hope your son starts to feel better soon now he has some antibiotics to help him fight the infection. I think you need to drop your GP surgery a letter of complaint to bring to their attention what has happened. A GP should be able to diagnose a chest infection and for a child with type 1 diabetes that mistake could have become very serious.
 
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