Need help urgently

[daisynova]

OK long story short - I am in Bangladesh on a posting and was put on the pump before coming here. I don't have a diabetes consultant in the UK and my medical team here don't know pumps that well.

Today my BG at lunchtime was HI on my meter so I gave myself 10u of insulin on a bolus and waited 2 hours before retesting my BG's. When I retested I was still HI. So I have now changed my infusion set, changed the insulin and changed the insertion site for the cannula. I have given myself another 10 units bolus and will test in about 10 minutes time. What else can I do? I can feel myself going into DKA and the last thing I need right now is to end up unconscious in a Bangladesh hospital.

I am panicking!

 

[cugila]

You know what is happening.....get yourself to a GP or a Hospital RIGHT NOW !!
I would rather be unconcious in a Hospital anywhere than unconcious where there is no help or assistance available !

No if's, and's or but's. This could be serious for you - a GP or a Hospital.

 

[daisynova]

Even if I go to a hospital here they don't know anything about pumps here either. They still use insulin syringes rather than pens!

Starting to feel a lot better now that I have managed ot get more insulin into me and have eaten something to deal with the ketones.

 

[phoenix]

Hi Daisy,
Sounds like your levels are coming down. You were right to change site etc. Hopefully it was a bad site and nothing else causing the high levels.
However if the ketones don't come down you really would need to go to hospital.

The 'emergency' protocol I was given does say to switch to using a pen for boluses (correction and meals) until bg and ketones are back to normal.
I don't know what sort of pump you have but with mine (a minimed )I would also do a selftest which should check that the pump is operating properly.If there is a problem the manufacturers may be able to help by phone.

 

[jopar]

I hope that you are sorted and everything is settling down..

I was adviced in your situations with an unexpected high reading..

Take a correction does via pen/syringe rather than using the pump bolus..

Check the tubing to see if any bubbles are present (as often this can be the cause of an high) if bubles are present, detach the tubing and prime clearing bubbles

If no bubbles are present, check that the tubing isn't blocked, by detaching from infusion set, then prime you will need to ensure that around 3 units+ if there is a blockage in the tubeing then this should set the alarm off on the pump

if no blockage on tubing, check the infusion site does the cannualr appear to be inserted correctly, is the infusion site red or lumpy in any way ect..

If in doubt change the whole lot...

I have the Accu-chec spirit pump, if you switch it off then back on again, it automatically self tests, I think that all pumps run a self test when turning on...

As to dealing with the ketones, follow your sick day rules, check every bg every 2 hours, and correct if necessary (if your BG is over 14mmol/ml then it's better to correct with an injection rather than the pump) check ketones levels, remember to drink plenty of fluids to prevent dehydration and to flush out ketones.. If blood glucose has returned to normal, keep checking ketones level to ensure that they are reducing, if they fail to reduce then contact the hospital/doctor for futher advice..