Tips for getting BGs down quickly

[bonerp]

Hi
Been on pump for 3 years or so and of late I've not been doing exercise due to eye bleeds (vitrectomy booked 6/1) and my control has stepped backwards ever so slightly and average BGs are 8/9.

Sometimes I am having problems with highs and getting them down in a reasonably short period - seems to be taking forever.

I have tried square wave does and the likes over an hour or so but like yesterday, it took from lunchtime to 6.30pm to get them down to 7!

What do people do to bring down higher than average bgs - I'm taking anything around the 15 mark.

Also my DSN was surprised that I tend not to eat when BGs are high as I prefer to bring them down to a decent level rather than top up and smack in a huge dump of insulin. What do you do?

I've had/got a bit of a cold/cough so expect that it the culprit.

thanks

Paul

 

[bonerp]

Just thinking further on this, people using the Combo - what settings do you have in the meter for correcting/active insulin?

I'm wondering whether I might need to tweak it.

Current settings are:
Meal rise 4.
snack size 0 !?
Acting time 4 (but going to reduce that to 3)
Offset 1.

I use Apidra and on researching there seems to be a lot of evidence that says this active insulin lasts for about 2 hours and not 4- this would explain why I am still high so long afterwards wouldn't it?



Paul

 

[donnellysdogs]

I was told that pumpers should aim to get them down to target range by 5 hours. I used to switch to a temp basal rate as well, but don't anymore....I would prefer to come down steadily by 5 hours without risk of hypo..

The range that your pump will be aiming to get you down to is set on your target range, and correction bolus values...if these are right then within 5 hours you should be down to a normal reading...

My meal rise is set to 2.8 which is the lowest value on combo pumps...I believe that this then possibly lets the pump allow my maximum rise to be 2.8 after I have made sure that every meal is typed in as a premeal bolus (if not I don't know if it works)...if I then do a post meal bg check, it will correct to my ratio's to bring my levels down to the target bg. I think this is right, but stand to be corrected on this one...

Offest times etc are down to how your body works, and can't be tempered to what others have...same as above...

I prsonally have different carb ratio and correction factors for 5 different time periods..as my body and activity levels vary so much from day to nights...

Providing I come down to normal within 5 hours I do not worry...I would rather do this than risk going too low....

 

[bonerp]

thanks for info. I've never been told about 5 hours but that bgs should be under 9 after 2 hours. Its rarely is tho and this also worries me as if I left it 5 hours my BGs would always be too high between meals..

 

[donnellysdogs]

I always check after 2 hours... And if correction bolus's are right then will find I lowering... If it is not coming down enough the pump offers another correction and I just do it...
Saying that I rarely, rarely go into double digits nowadays... But I tried everything in early pump days...but dont do it now... This works for me... But others may have better info to consider...

 

[donnellysdogs]

Personally, i would be really in serious trouble if my rates dropped from 15 to less than 9 in 2hrs!!!
In 4 hours I would bevon tge floor n under 4 and needing hypo stoppers!!

In 16 months i have never had to go back to pen either..(touchwood!!!). My hi's after the dreadful time of bad faulty sets have been down to either basals or bolus and my fault...

If you not coming down at 5 hrs... For me, I would be looking at the background settings.....

 

[donnellysdogs]

I also have occasions when I will still eat if high as well!!! I will try not to, but I have done so...

If high, I always check 2 hrs later n bolus again if machine tells me i need it...

As my dp is so extreme, my correction bolus do vary during day and night... Are yours set the same for 24 hrs??? Dp means i need more correction, daytime less, n evenings when sat around needing more again.

 

[donnellysdogs]

I also have occasions when I will still eat if high as well!!! I will try not to, but I have done so...

If high, I always check 2 hrs later n bolus again if machine tells me i need it...

As my dp is so extreme, my correction bolus do vary during day and night... Are yours set the same for 24 hrs??? Dp means i need more correction, daytime less, n evenings when sat around needing more again.

 

[MushyPeaBrain]

If I was getting highs for a period of time, even over half a day, I put a temporary basal on for 12 hours of an extra 20-30% to start. If that works well I keep it on until things get back to normal.

I have found that I get bad blood sugar peaks when I eat more than about 35g of carbs in one go. Due to this I'm quite aggressive with my bolus. I do my usual amount 10-15 mins before I eat and then an extra bolus about one hour after if I'm over the 35g. This seems to work well but I can still have bad peaks some days.

If I'm high I bolus extra straight away. I do my normal correction bolus up to BG of 10 but I'm more aggressive over that and give myself a higher dose to bring the sugars down fast. If I then start to drop below 5 I can eat a single jelly baby later to balance it. If I'm over 15 I have to do my correction dose plus about 50% extra to get things down fast. Again I often have to pop a single jelly baby later if I drop too much. I do have very good hypo awareness though and watch my BG closely if I'm likley to drop fast.

I also wait to eat until my BG is below 5. If I'm high I do my bolus for the meal plus correction and wait longer, which works well.

It might not be the recommended way to deal with high Bg but since being on the pump I feel so ill if I get readings of 8 or over. When I'm high I normally aim for a drop of 3-4 per hour min. I'd rather over bolus and watch for a hypo than be high. I have a pumping friend who also does this and it works well for both of us.

Good luck with the vitrectomy. Not sure what exercise you do but I can't use the cross trainers at the gym any more due to bleeds and any other very bouncy equipment is out of bounds. I also take Pycnogenol to help prevent further bleeds and it works very well.