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Ill and need advice!

G

GBoltz

Newbie
Messages
1
Type of diabetes
Type 1
've been suffering with awful colds on and off for about 2 months now. My blood sugars for the last 48 hours have not gone below 11mmol/l.
I use a pump and have been on a temp basal rate of +120% during this time. I've been correcting constantly and I feel horrendous. I'm due to start 3 night shifts tonight and am dreading it with how I feel at present.
The irony is that im a nurse, yet I can't seem to come up with a treatment plan for myself. Any ideas what to do? I'm sick of being sick!
 
Wow rough Christmas, mate of mine is a nurse and its a tough time of year balancing celebration with hospital patients. Power too you.

Not T1 myself but do you have a food log/bg track to give maybe a hint at what is going on. Maybe for the last week. The folks that know will need some raw material to help as your post just refers to having a cold, which bumps bg.

Wish I could help more,
 
Sorry to read you have been poorly.
I just wonder, if you are still correcting, is it worthwhile increasing your basal further?
The great thing about a pump is you can tweak the basal by the hour if you need more or less.
The annoying thing is being ill will raise our BG and a raised BG will make us more likely to be ill ... and feel worse when we do. So, I try my best to bring my BG down with extra basal rather than with lots of corrections.
Apart from that, I guess, it’s the usual drinking plenty of liquids and not overdoing it.

Hope you feel better soon.
 
GBoltz said:
've been suffering with awful colds on and off for about 2 months now. My blood sugars for the last 48 hours have not gone below 11mmol/l.
I use a pump and have been on a temp basal rate of +120% during this time. I've been correcting constantly and I feel horrendous. I'm due to start 3 night shifts tonight and am dreading it with how I feel at present.
The irony is that im a nurse, yet I can't seem to come up with a treatment plan for myself. Any ideas what to do? I'm sick of being sick!
Click to expand...
If you're constantly correcting then +120% basal is too low. Why not try 130% to see if that helps? (As I am insulin sensitive, I only raise temp basal by 10% at a time, but you'll know your own body better than anyone.)

I know it's a difficult one, as the NHS is so short staffed, but if you're feeling horrendous shouldn't you just phone in sick? You wouldn't want to pass your illness onto patients or other staff, would you?

Several years ago, I was catching everything that was going around. I knew that my immune system just didn't seem to be coping. I read that green tea boosts the immune system but I couldn't drink the stuff. I went to Holland an Barret and found Green Tea caplets. I have taken 1 per day ever since. I went through 2 winters with not even a sniffle and hoped this year would be the same. For one reason or another, I missed my green tea dose a few days in a row and, unfortunately a week or two later I caught a nasty bug which led to a chest infection. Coincidence? Maybe, but I will make sure I don't miss my daily green tea caplet again.
 
Hi @GBoltz, Sorry to hear of your woes. And as a T1D, not as professional advice or opinion.
As you say, you are a nurse, but it is the responsibility of your DSN and doctor to help you formulate a sick day plan.
That this has not been done so is down to their forgetfulness, laxity etc as well as not providing you with a phone number to ring to ask for help. We all looove hospitals so much that we will do all we can to stay out of them and your health team has some responsibility in that endevour.!!!
When I am ill I increase both my pump's basal rate plus up my bolus doses as well. Usually I adjust every second day, but more frequently if BSLs getting above 15mmol/l despite correction doses and moreso if blood ketones are appearing and rising.
I increase my correction doses up as well.
All the above is on the basis that an infection will affect the efficacy of all the insulin I am injecting. And as matter of interest I have to do the same type of adjustments when I have a 'flu vaccination.
Anything that stirs up the immune system seems to be a stress to the body, at least for me !!
A 20% increase in all dose types is my usual starting point when I feel ill with something (URTI, Lrti teeth, urine (UTI) etc).
And then 10% increase as minimum.
But the change in insulin for you will depend on your usual insulin sensitivity, and I guess the course and severity of the illness. and I urge you to contact your DSN or doctor or another HCP to discuss this.
Being one's own doctor or nurse is rarely a good move.
The other 'trick' is to know when to start easing the insulin doses down. Yes the recording of lower BSLs, the appearance of a hypo set the stage for this but for me it is still an art rather than a science to know whether to step down 10% or 20% to begin with.
In terms of prevention: I note that a review suggested that hand washing plus wearing of a face mask was needed to provide significant reduction in spread of influenza www.nbci.nlm.nih.gove/PMC/articles/PMC4891197 Hand hygiene and risk of influenza virus infection in the community: A systematic review and meta-analysis Wong et al Epidemiol Infect 2014 142(2)
And there is interest in supplementing people during winter with vitamin D as there are some statistical correlations between low vitamin D levels and onset of influenza. As the article below points out, there is still work to do on substantiating these finds.
Vitamin D for influenza can Fam Physic. 2015 June 6(6) 507.
The assumption is also that spread of URTI's caused by other viruses may be stopped by similar measures but research appears to be concentrated on influenza alone.
I hope you are well soon and find a way to not be as susceptible to so many 'bugs' in future !!
 
Hi @GBoltz

I can only give you my experiences, for the last month or more I too have had a heavy cold, I've raised my basal by 20% and my bolus's by around 50% (or more - as I also correct between meals). Also as mentioned by @kitedoc I too need to take care as having larger doses does make any hypo onsets much faster.

Hope your feeling better soon.
 
I had an infection recently and was fairly shocked by just how much insulin I needed in spite of little eating.
It did come down but I had to test and correct every 2 hours. I was yearning for a hypo just to prove that some of the stuff I was pumping in was hitting the mark!
You have a cold (viral) but your insulin resistance has persisted for a long time. Could there be an underlying infection e.g. mouth.gym disease which are common in type 1s?
 
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