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Reading of above 33.3

Discussion in 'Insulin Pump Forum' started by LauraR88, Sep 5, 2017.

  1. LauraR88

    LauraR88 Type 1 · Active Member

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    So I've beeen diabetic for 10 years and got put on the pump in April this year. I have absolutely love it! from blood test it shows it has improved my management massively!!!! However recently I've been getting a few high readings, never had keystones.
    (Apart from when I was first diagnosed and had DKA!!!!) tonight I had a high reading of 17 so I done my usual correction and dosage for our Indian takeaway, something I've not had in years! We had chicken korma and something called pshwari nan bread. After that I became unbelievably thirsty, clearly I didn't think anything of this until I started peeing a lot. (May I add I had also changed my set prior to my dinner coming) I just tested my blood to be told the reading was over 33.3 - 0.4 keytones. I added up that days doesage and took 20% to do a pen correction, but it seemed faaaar to low, so panicked and took 20 units of nova rapid!!

    Now I'm panicking and feel like I've failed I'm scared incase they take my pump off me! Or think I'm irresponsible. For the first time in years I feel like giving up!
     
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  2. Jaylee

    Jaylee Type 1 · Moderator
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    Hi,

    OK?? I don't pump.. So,I'll tag in two who do..!

    @azure & @catapillar

    "Take your pump of you?" Just a blip....;) Hold fast they will be here!

    Keep testing & keep an eye on the BS number in the meantime...
     
  3. catapillar

    catapillar Type 1 · Well-Known Member

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    No one is going to take your pump off you because of a high reading.

    You did all the right things with testing and correcting. How did you fare with the correction? Do you have any dea what caused the high of 17 before the take away? Was that before or after a set change? Did the set change include insulin from a fresh vial?

    If you've continued having unexplained hyper after a set change then I'd recommend changing again with insulin fresh out of the fridge to check there is nothing wrong with the set or with the insulin. I'd also suggest not eating anything, or at least not anything carb heavy, until corrections have been given a decent opportunity to work -a correction for a 17 could well take 90 minutes or 2hours to work, so it's no suprise that you climb to 33 from 17 after an Indian take away. I think of it that a correction has to climb the wall of high blood sugar before it can start to do anything to break the wall down, if that high blood sugar is significantly high then it will take longer to climb to the top and longer to start breaking the wall down, so I tend to avoid eating until I've come under 7 and that can take a frustratingly suprisingly long time if I'm correcting something in the teens, but once you've got to 7 it can come down fairly speedily, it pays to avoid stacking your insulin and, if the correction includes a bolus to have what you've bolused for ready to eat so you don't accidently over correct into a hypo.

    Hope you're doing alright this morning. Really don't worry about one high reading meaning no pump, these thing happen and they give out those sheets on what to do when you get highs on a pump, you've followed it with testing for ketones and 20% TDD correction, it just one of those things, nothing you've done wrong.
     
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  4. azure

    azure Type 1 · Expert

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    @LauraR88 They won't take your pump off you. If they took pumps off everyone who had a high reading, nobody would have a pump!

    The important thing is you go through all the steps to work out what caises your first high and your second high. Catapillar has given good advice above, so I won't add much except to,say that if I'd been at 17, I might have saved the Indian treat for another night because I like to,correct and wait to get down to around 7 before I bolus and eat. It's possible,that the combination of starting at 17 and eating those crabs/fat contributed to the high.

    Don't be put off Infisn! There's no reason why you can't eat an Indian takeaway.

    Nor is there any reason why you'll lose your pump :)
     
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  5. Deleted Account

    Deleted Account · Guest

    @catapillar and @azure have provided some great advice.
    I have a few more thoughts but before I start, I hope you are feeling better now.

    The great thing about a pump is the basal should match your basal requirements at all times of the day. For example, our night time basal, whilst we are not exercising or thinking or using up much energy, is typically much higher than during the day. When on MDI with a long acting insulin, like Lantus, that works for up to 24 hours, the dose was really calculated on what was needed over night. This means that during the day, there would be some spare Lantus (or whatever long term insulin you used) in our system to mop up some under-counted carbs. This spare is not available on a pump. Therefore, if we under-count the carbs, it more obvious and, as a consequence, we may be more likely to go high.

    As I've noticed these occasional highs on a pump, I have noticed that I need more insulin to bring them down. For me, when I have a BG over 15, I double the corrective dose regardless of ketones.
    I have also noticed that my body is not great at taking more than 10 units of insulin in one dose. No problem, combo-dose is here! Basically, if I need more than 10 units, I use the combo option over an hour.
    When my BG does get above 15, my finger-tips come in for a pounding. Test, test, test, correct, correct. correct, test, test, test, correct ... until I start seeing my BG come down.

    I have had my pump for 18 months and keep learning something new about it and making little adjustments on how I use it. No wonder you are still learning after 4 or 5 months!
     
  6. LauraR88

    LauraR88 Type 1 · Active Member

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    Thanks guys. Just to explain so you's don't think my comment about having my pump taken off me was an over reaction. I am forever being told that if I don't do this or don't do that then I could have my pump taken off me. So when I got that reading I just panicked.

    I've only had a couple hours sleep as was up tearing every hour and peeing I'm glad to say it's back within range this morning.

    I love my pump, but by god you don't half increase/decrease so rapidly. I have no idea why I was at 17 originally, everything was fine that morning. All though I work some crazy shifts so spent most of day sleeping.

    Thanks again for your advice and reassurance
     
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  7. Juicyj

    Juicyj Type 1 · Moderator
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    Glad you're ok - don't stress about losing your pump, it sounds like an infusion set/insulin issue which is outside of your control, you did everything right and thank goodness you're ok this morning, they will more than likely review your HbA1c to see how well you're doing with the pump and as you've shown improvement then it proves this is the right tool to help you manage. Also remember that we run high our brains don't think rationally so put it down to one of 'those' events :)
     
  8. MWilson

    MWilson Type 1 · Member

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    Hi also to say the type of bread you had is brutal on carb and sugar. I love Peshwari naan but find even using a dual wave I can't take it. Glad your feeling better now. M

    Sent from my SM-G955F using Diabetes.co.uk Forum mobile app
     
  9. MushyPeaBrain

    MushyPeaBrain Type 1 · Well-Known Member

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    The first time I had peshwari naan I almost ended up in hospital!! I don't eat any rice when I have a curry takeaway but I have a naan sometimes instead. Naans are upwards of 80 carbs each so pretty bad on BG and the fat in curry can delay the BG rise which complicates things. That night I'd ordered an onion naan and they accidentally sent the peshwari. It was so nice I ate it anyway and then my BG went crazy. Peshwari is full of desiccated coconut, sugar and sultanas so it's a coma waiting to happen. If you had rice as well I'm not surprised your BG went so high. The thing is we all make mistakes no matter how careful we are. As long as you learn from them that's what matters.
     
  10. Chas C

    Chas C Type 1 · Well-Known Member

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    Most Naan breads have a lot of sugar, its used to make the bread rise. When I have a curry I either avoid them or just have a small section. But even when having a curry I need to have an extended bolus, taking roughly 40% half an hour before I eat then the rest spread over around 2 hours, often after the 2hrs I also need to top up again with a few more units too.
     
  11. jasmine1616

    jasmine1616 Type 1 · Well-Known Member

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    What I would do, there might have been something wrong with you insulin pump site. That happens to me sometimes. I change my pump site, and my bg becomes a little high, so I would just change my pump site if that ever happens again. Give your self a pen shot to cover for the insulin, and change your pump site. If something else happens, I'm not sure what is wrong.

    Hope this helps. : )
     
  12. Jo1407

    Jo1407 Type 1 · Active Member

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    My 11 year old has just a week from hell at school with running high. Only been on pump since June. After numerous phone calls with school and diabetes team it would appear that we weren't rotating his infusion sites as well as we should. Got this sorted on Friday evening...then wham...now lows/hypos. So working on readjusting carb ratios and basal.
     
  13. Jo1407

    Jo1407 Type 1 · Active Member

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    Update to my comment above....

    Have had a nightmare three weeks with my son running high. I was under the impression that we'd not get air bubbles using the insight pump so I wasn't looking for them. Last night I took his pump off him to check insulin was running through and spotted the air bubbles. After another bad night, and a 45 minute bike ride he was still running at 21.4 and climbing. We changed everything again, and I spotted air bubbles in the tubing I'd taken off. At lunchtime rang Roche and the helpline adviser suggested it could be a faulty batch of tubing. So, after another change of tubing and insulin he was down to 4.2 before tea, then was hypo during tea. More than likely due to all of the ratio and basal changes I've been making to sort out bloods....hopefully everything should settle soon, although I've a feeling I'll be dealing with a few more hypos!
    Are air bubbles like hens teeth with the insight as I've spoken to at least three nurses on our team in the last three weeks about these hypers and no ones suggested bubbles? We even had our annual check yesterday
     
  14. .gurley

    .gurley Type 1 · Active Member

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    Don`t worry this happens and yes Naan bread is deadly at sending up you blood sugar. I ave an app on my phone cheap to buy called Carbs and Cals its on Google play store. It lists loads of foods and takeaways giving pictures and all Carbs contained therein and calories. Since having it I have got a good handle to contents of foods I am eating. It even includes seasonal! You mentioned changing your set? I find sometimes if its not in right it does not work!!!!! My sugar goes up quite rapidly and I have to put a new one in and all is okay then. Google a question on best sites etc. for you set and a whole raft of advice comes up including known issues which will help you. The pump is not perfect and actually needs our interventions to get the best out of it but it takes a bit of time and learning so do not worry no one will take the pump back. Just do some research and see you are not alone with these issues and there are answers to them!! Good luck.
     
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