Insulin pumps and illness

[MushyPeaBrain]

So over my 2 years of being on a pump I've been ill and normally find a temp basal of 30-50% plus a little extra when I bolus keeps my BG in check and helps me get better faster.

However recently I have been really ill and can't seem to get my BG down. It started with raised BG and then symptoms of tonsilitus on a Friday. Went to doctor Saturday and he confirmed tonsilitus and gave me strong anitbiotics. Due to the pain I wasn't eating much and my BG hovered around 10.

A few days later I went downhill. I developed a nasty hacking cough, coughing so hard I vomited and got migraines. My throat was agony and I had fever. Phoned doctor who said I had caught virus on top of tonsilitus and it should pass. That was Wednesday and I'm still not right. Having not been able to speak my throat is recovering and I finished the antibiotics. However when I eat anything my BG rockets to levels around 16-20

Am still on temp basal and have done 3 set changes when due, all had same result so not set. Anyone else had issues like these when ill? Any tips?

 

[donnellysdogs]

If you increasing basal why dont you keep them both in line ratio wise and increase bolus? Thats what I would be doing? Every illness is different... Perhaps this one needs double of everything?? Perhaps less, perhaps more... If it was me I would increase everything till I got back to normal...

 

[Faith*]

I had a very similar problem a few weeks ago. I wasn't well, sore throat, cough, cold and my sugars went completely out of control. I did all my normal sick day rules with no effect and in the end I had to double all my basals in order to keep myself level. As donnellysdogs said every illness is different, we both have been unlucky to have one that messes with our sugars so bad. Not really got any tips, I was ready to up my basals last night as not well again but oddly didn't need to as my bs was normal! The body is a mystery!! Hope your ok now?

 

[jagger38]

I am on an animas vive pump, and for the last week have had a nasty cold. At first my sugars were okay, but as the week went on, they have been quite high, up to 18.3 today. I am having to do a lot of corrections, and increased temp basals rates to cope. I am starting to feel better, but my sugars are still very unstable. Really hoping they will settle down soon, as it is making me quite tired, and my energy levels are suffering. Good thing about the pump is the flexibility to give yourself extra insulin at time like this, I am so glad to be able to use the pump to its full advantage, it used to be a lot harder on mdi. Hopefully I will be back to normal soon, and that anyone else feeling poorly can do the same. Take care....

 

[Gregoir]

I've been advised to go to 130% basal as a starting point when ill. My first day on the pump for real.

 

[justjay]

Sorry to revive this thread, but I'm having real issues with illness and BGL at the moment too. I've had a nasty virus which has now turned into a bad chest infection for about a week now. To the extent of being rigged up to an ECG in the Dr surgery! I've been ill before but I've never had levels as bad as mine are at the moment. Seems nothing I do will bring them down so I'm worrying I'll end up in hospital if this carries on. I've had temp basal in place of at first +50% and now up to +70% but nothing is changing they are still up around 17-19. I don't want to overdo it and hypo overnight but can't carry on with these! Any suggestions? I've not added extra to any bolus which probably hasn't helped....

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[iHs]

Sorry to revive this thread, but I'm having real issues with illness and BGL at the moment too. I've had a nasty virus which has now turned into a bad chest infection for about a week now. To the extent of being rigged up to an ECG in the Dr surgery! I've been ill before but I've never had levels as bad as mine are at the moment. Seems nothing I do will bring them down so I'm worrying I'll end up in hospital if this carries on. I've had temp basal in place of at first +50% and now up to +70% but nothing is changing they are still up around 17-19. I don't want to overdo it and hypo overnight but can't carry on with these! Any suggestions? I've not added extra to any bolus which probably hasn't helped....

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Ohh I do feel for you as I too went down with a really bad flu like cold and hacking cough 2 weeks ago. At first my bg levels just rose a tiny bit but as time went on, I woke up one morning and instead of a bg of 6mmol, I had one of 13mmol. I gave myself a corrrection and put the pump on 150% tbr which didnt do much so then increased it to 250% and still nothing moving so with a bg level of 17mmol and feeling very worried, I used my pen to deliver some insulin which then started to make me drop a bit.
I eventually ended up increasing all my hourly basal rates up by 0.05u for every hour and then my bg levels started to fall back into line again which was a huge relief for me so if tbrs dont appear to work, try increasing your hourly basal rates.

Hope you feel better soon.

 

[justjay]

Sorry to revive this thread, but I'm having real issues with illness and BGL at the moment too. I've had a nasty virus which has now turned into a bad chest infection for about a week now. To the extent of being rigged up to an ECG in the Dr surgery! I've been ill before but I've never had levels as bad as mine are at the moment. Seems nothing I do will bring them down so I'm worrying I'll end up in hospital if this carries on. I've had temp basal in place of at first +50% and now up to +70% but nothing is changing they are still up around 17-19. I don't want to overdo it and hypo overnight but can't carry on with these! Any suggestions? I've not added extra to any bolus which probably hasn't helped....

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Ohh I do feel for you as I too went down with a really bad flu like cold and hacking cough 2 weeks ago. At first my bg levels just rose a tiny bit but as time went on, I woke up one morning and instead of a bg of 6mmol, I had one of 13mmol. I gave myself a corrrection and put the pump on 150% tbr which didnt do much so then increased it to 250% and still nothing moving so with a bg level of 17mmol and feeling very worried, I used my pen to deliver some insulin which then started to make me drop a bit.
I eventually ended up increasing all my hourly basal rates up by 0.05u for every hour and then my bg levels started to fall back into line again which was a huge relief for me so if tbrs dont appear to work, try increasing your hourly basal rates.

Hope you feel better soon.

Thank you for your reply

That sounds like a good plan, I could create a separate "profile" so I don't get too confused and try that one. I guess an increase of 0.05u to begin with would be safest too? Times like this it makes it all 100 times worse...!

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[iHs]

Hi

Yes create another basal rate programme and asign to another profile. Just be very careful though that if you do end up making changes to basal rates, you select the correction profile. Its more than likely that you will find your bg levels starting to drop too much as you start to feel much better so that will be the time to change back to your orginal basal rate programme. Just make sure that you keep testing your bg levels and avoid keytones...

Pumps keep us all on our toes...............

 

[justjay]

Hi

Yes create another basal rate programme and asign to another profile. Just be very careful though that if you do end up making changes to basal rates, you select the correction profile. Its more than likely that you will find your bg levels starting to drop too much as you start to feel much better so that will be the time to change back to your orginal basal rate programme. Just make sure that you keep testing your bg levels and avoid keytones...

Pumps keep us all on our toes...............

I'm writing and working it out as I type! :lol:

So just to be clear (sorry, am rubbish at all this stuff!) my 00:00 - 04:00 is 0.600 increasing this by 0.05 takes it to 0.65?

They do indeed!

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[iHs]

How much you feel that you need to increase your basal rate up by can only really be determined by the bg results you have been getting and how much your bg levels differ from what they would normally be.

The increase you do will be down to trial and error but most likely if the basal rate change is still not enough, you should then be able to use a TBR and hopefully get some 'shut eye' and get to bed. Just make sure that you set an alarm on yr mobile phone and get up in the night to test bg and then you'll be able to give a correction if needed or just leave things alone or if your bg levels drop a bit too much, you can eat some jellybabies.

 

[justjay]

It'd turning into a bit of a nightmare to be truthful. The pump program just didn't look right with the total amounts. My usual daily basal is around 18.60u. By the time I'd done the first two changes my total was 26u or thereabouts! Didn't feel confident doing that. Kinda stressing me out now! Thanks for all your help already

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[iHs]

It'd turning into a bit of a nightmare to be truthful. The pump program just didn't look right with the total amounts. My usual daily basal is around 18.60u. By the time I'd done the first two changes my total was 26u or thereabouts! Didn't feel confident doing that. Kinda stressing me out now! Thanks for all your help already

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Just remember that the more insulin you are using as your TDD, then the more insulin will be needed to correct you back to your target. I tend to use the 100 rule to get my correction factor so 100 divided by 50 (you need to add your daily bolus to your daily basal so I presume that you are using the same amount of insulin for your bolus as you are for your basal. I make it that using the 100 rule your correction factor at the moment will be 1u to drop yr bg level by 2mmol.

 

[justjay]

It'd turning into a bit of a nightmare to be truthful. The pump program just didn't look right with the total amounts. My usual daily basal is around 18.60u. By the time I'd done the first two changes my total was 26u or thereabouts! Didn't feel confident doing that. Kinda stressing me out now! Thanks for all your help already

Sent from the Diabetes Forum App

Just remember that the more insulin you are using as your TDD, then the more insulin will be needed to correct you back to your target. I tend to use the 100 rule to get my correction factor so 100 divided by 50 (you need to add your daily bolus to your daily basal so I presume that you are using the same amount of insulin for your bolus as you are for your basal. I make it that using the 100 rule your correction factor at the moment will be 1u to drop yr bg level by 2mmol.

That's where I'm a bit more complicated! My ISF is 1u=7mmol. Well according to my DNS anyway. I might just make or break for it with the program lol

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[iHs]

With a correction factor of 1u to drop you by 7mmol what was your orginal TDD to get that calculation and also was your DSN using the 500 rule to work out your carb ratio?

 

[justjay]

With a correction factor of 1u to drop you by 7mmol what was your orginal TDD to get that calculation and also was your DSN using the 500 rule to work out your carb ratio?

Cor now you're asking! I always eat different things each day, and at different times due to being a shift worker so getting a TDD that is accurate, well it ain't gonna happen

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[justjay]

An update, and thank you to iHs. Advice followed, and a separate program set up. Now, baring in mind I could not get my levels to drop be TBR or corrections, I started this "illness" profile last night. When I'm woke up I was 8.9mmol at 0830. Tested again a few hours later and 8.8. Thanks for your help

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[iHs]

An update, and thank you to iHs. Advice followed, and a separate program set up. Now, baring in mind I could not get my levels to drop be TBR or corrections, I started this "illness" profile last night. When I'm woke up I was 8.9mmol at 0830. Tested again a few hours later and 8.8. Thanks for your help

Sent from the Diabetes Forum App

Ahhhh, thank goodness you are now getting to be ok again Jay. Its really worrying when nothing goes right and I know how that feels...

If you want, you could probably increase the basals up by another 0.02 and then see how you go.......Just remember to keep testing bg and then you'll be able to find your way.

A pleasure to help......

 

[justjay]

An update, and thank you to iHs. Advice followed, and a separate program set up. Now, baring in mind I could not get my levels to drop be TBR or corrections, I started this "illness" profile last night. When I'm woke up I was 8.9mmol at 0830. Tested again a few hours later and 8.8. Thanks for your help

Sent from the Diabetes Forum App

Ahhhh, thank goodness you are now getting to be ok again Jay. Its really worrying when nothing goes right and I know how that feels...

If you want, you could probably increase the basals up by another 0.02 and then see how you go.......Just remember to keep testing bg and then you'll be able to find your way.

A pleasure to help......

You're not wrong there! Thanks again

I'm going to run this for another 24hr then see, it's all very much trial and error I think! Now to combat the extra bolus...!

Just this thread has made signing up worthwhile

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