Hyperglycemia

[janetlouise]

Hi - I’ve been type 1 for over 50 yrs. I’ve been in insulin pump and cgm for about 8 yrs and it is excellent. However, sometimes if I eat, give insulin requirements for the amount of carbs and existing BG, my Blood glucose can rise quite high and there is still insulin on board waiting g to match the carbs. This can sometimes cause hyperglycaemia and I get very drowsy, but give it an hour or so and the IOB starts to work and bring the glucose levels down. Does this sort of thing happen to anyone else? I’m eating g normal types food, nothing quick or hi in glucose.
Thanks

 

[Chas C]

Do you bolus early with your pump, maybe 10 to 20 mins ? maybe 30% before food. Also do you do an extended bolus for the remaining 70% based upon the types of carb so roughly an hour or maybe double for pizza. You do need to adjust depending upon the carb type and your BG prior to eating.

 

[janetlouise]

Do you bolus early with your pump, maybe 10 to 20 mins ? maybe 30% before food. Also do you do an extended bolus for the remaining 70% based upon the types of carb so roughly an hour or maybe double for pizza. You do need to adjust depending upon the carb type and your BG prior to eating.

Hi , thanks for this. I will start to bolus early.
I’m not sure I can do do extended bolus with this. I have the 780 Medtronic with the cgm, it will give a correction dose, but not the amount I seem to need, but my BG does
drop eventually. I will have to check about the extended bolus. Thanks for the information.

 

[Hopeful34]

Which insulin are you using? Also, have you looked at changing your active insulin time? I''m not on this pump, but tagging @Nicola M and @searley who are.

 

[Nicola M]

I would see if you can bolus a bit earlier first as that usually does fix these kind of issues as the food is hitting your system before the insulin does. If that doesn’t work I would look into your Active Insulin Time and Carb ratios as even over time you can sometimes need to change these. I had to swap from Novorapid to Lyumjev (quicker acting insulin) as I were bolusing around an hour before food in the end which wasn’t ideal.

Unfortunately you can only do an extended bolus if you’re in manual mode on the Medtronic, I don’t eat pizza so no idea what people who do eat it do for situations like that. Although my lunch time meal at work is awkward I suffer with raised sugars then lows almost every single day so my solution to that was to bolus 75% 30 minutes up front and the other 25% when I start eating and turn off corrections until mid-afternoon. That took a lot of trial and error to get there and it isn’t perfect but works for the most part.

 

[Chas C]

Unfortunately you can only do an extended bolus if you’re in manual mode on the Medtronic,

Wow thanks for that, I had no idea the 780G did not allow for extended bolus in normal mode ................. a definite turn off for me.

 

[Hopeful34]

It's one of the reasons I didn't want it when I was last choosing a new pump.

 

[janetlouise]

Thanks again for this info. Appreciated.

 

[Ann48]

Thanks again for this info. Appreciated.

I’m on the 780g with Simplera sync using Novorapid and often used the dual bolus on the 640g pump. I found the dual bolus useful if eating pasta etc . Now my levels drop after meals as the food seems to take longer to process. However I find the Smart Guard excellent, except the Simplera only lasts about 5 days and stops suddenly causing a rise in my levels. I haven’t thought about taking off the Smart Guard to do a dual bolus.

 

[janetlouise]

Hi - thanks for this. I’m gathering g all info from other diabetics to see how best to go about my issue.