Urgent Advice Needed - Newly Diagnosed

[AshleighAE]

Hello all!

Need some urgent advice please...

I have been unwell with a bad cold for around 24hrs now, and I have had raised BG levels all day, despite my efforts to correct them. I checked 10 mins ago and it was 31.6! I have taken 3 units of insulin to try and bring it down, and I have checked ketones which are 0.2, thank goodness.

Any advice as to what to do next??

Many Thanks!

 

[Bertyboy]

Hi.

What insulin did you use to correct? What is your insulin ratio?
As long as ketones are below 0.6 I wouldn't worry, but keep checking every 12 hours.

 

[Bertyboy]

Oh, and be aware of many cold remedies (Lemsip, cough medicines, etc.) which can contain very high levels of sugar.

 

[AshleighAE]

I’m on NovoRapid (mealtimes) and Levemir (evening) 8.6.6.12 ... I’ll keep checking my ketones, and I’m taking Sudafed capsules, which seem to be working ok... Thank you

 

[SueJB]

I’m on NovoRapid (mealtimes) and Levemir (evening) 8.6.6.12 ... I’ll keep checking my ketones, and I’m taking Sudafed capsules, which seem to be working ok... Thank you

Hope you're feeling better this morning

 

[Daibell]

Hi. Apart from the cold which does increase blood sugar it sounds like you haven't yet got the right insulin balance which does take time. I note that you are not yet carb-counting i.e. adjusting the mealtime insulin to the carbs you eat. Carb-counting will help you get improved balance. Do ask the DN to move on to that. It's dead easy.

 

[Engineer88]

Test hourly but don't expect to see bloods come down very quickly. Keep drinking sugar free liquids. If BGs are above 15 check ketones (and BGs) hourly.

 

[Celsus]

Personally if measuring a bg at 31.6 mmol/L. (THIRTY ONE POINT SIX !)

Then I would at least take a shot of 8 units of fast acting NovoRapid.
(I take 11 units Lantus and 11 NovoRapid / 24 hours)
And even that dose of 8 units NovoRapid would probably only bring me down to around 18-20 mmol/L.

So two hours later I would measure again. And repeat with another injection of 6 units NovoRapid until I get down between 15-20mmol/L max. Reason being you are less insulin sensitive when you have bg above 15mmol/L. And in normal range 4-10mmol/L, then 1 unit fast acting NovoRapid brings me down by 3 mmol/L. So when getting down to around 15mmol/L I would go down in dose to correct, to land safely in the 4-10 range.

Seeing @AshleighAE 's daily normal insulin intake it appears being less insulin sensitive than me.

As @Engineer88 mentions above, keep drinking plenty of sugarfree liquids to help your body and kidneys flush out the glucose surplus that your kidneys also suffer from until bg gets below 12 mmol/L or so.

Lets hear how your high flying venture goes!

 

[Engineer88]

Personally if measuring a bg at 31.6 mmol/L. (THIRTY ONE POINT SIX !)

Then I would at least take a shot of 8 units of fast acting NovoRapid.
(I take 11 units Lantus and 11 NovoRapid / 24 hours)
And even that dose of 8 units NovoRapid would probably only bring me down to around 18-20 mmol/L.

So two hours later I would measure again. And repeat with another injection of 6 units NovoRapid until I get down between 15-20mmol/L max. Reason being you are less insulin sensitive when you have bg above 15mmol/L. And in normal range 4-10mmol/L, then 1 unit fast acting NovoRapid brings me down by 3 mmol/L. So when getting down to around 15mmol/L I would go down in dose to correct, to land safely in the 4-10 range.

Seeing @AshleighAE 's daily normal insulin intake it appears being less insulin sensitive than me.

As @Engineer88 mentions above, keep drinking plenty of sugarfree liquids to help your body and kidneys flush out the glucose surplus that your kidneys also suffer from until bg gets below 12 mmol/L or so.

Lets hear how your high flying venture goes!

Personally I wouldn't advise to take that much and then back it every 2 hours, you're likely to stack insulin (causing a hypo) even with resistance. Take it steady, no rush to get it down. Its not unusual or wrong to have numbers like this, like poo it simply happens.

Page 3 of this might help too
http://www.nhslanarkshire.org.uk/Se...Sick Day Rules for Type 1 Diabetes Oct 16.pdf

 

[Celsus]

Personally I wouldn't advise to take that much and then back it every 2 hours, you're likely to stack insulin (causing a hypo) even with resistance. Take it steady, no rush to get it down. Its not unusual or wrong to have numbers like this, like poo it simply happens.

Page 3 of this might help too
http://www.nhslanarkshire.org.uk/Services/Diabetes/patient-info/Documents/Sick Day Rules for Type 1 Diabetes Oct 16.pdf

Agreed @Engineer88 , poo does happen.
Now I also specified clearly "for me personally, I would..."
Reason being that I know that my NovoRapid it peaks at around 40-60 minutes after injection and is almost fully burned out after 2 hours in my system. And high-rolling up in the 30ties is never fun, so quickly getting it down in the more manageable 15-20 range is highly desired. As my insulin resistance is high when up in the 30ties, I don't even think the meter needle would move if just taking 2-4 units.

And our friend here @AsleighAE already takes 6-8 units of NovoRapid for any of the main meals, so definitely a fair first kick to take to get it down from 30+.

 

[Jaylee]

Hi @AshleighAE ,

Welcome to the forum.
I'm sorry you feel unwell.
My concern with you being newly diagnosed & the pancreas playing it's tricks with the "honeymoon" would be being overzealous with the correction dose.

personally? That high. i'd take 9u & monitor a steady drop over a 4/5 hour period. keeping an even closer eye out for potential hypos at the 4 hour mark.. But that's just me.!
As long as it heads in the right direction (down.)

I'll tag in a few T1s to say hello.. @catapillar , @Scott-C , @therower , @phdiabetic

I hope you have managed to bring your blood back down?

Regards.

J>

 

[Juicyj]

Hi and welcome @AshleighAE - hope your feeling better ?

 

[phdiabetic]

Greetings! Sickness is always really tough for T1's, at least you don't have any ketones. Do you have a sick day plan with your doctor/nurse?

Continue testing ketones (personally I would do at least every 2hrs). Test your blood sugar every 1-2 hours, more if you feel funny. Take insulin according to your ratios/corrections, remembering that high blood sugar, ketones and illness all can cause insulin resistance so you may need some extra. Drink A LOT of water. Try at least a glass every hour if you can, more if you want. If you develop symptoms of DKA (eg nausea, vomiting, stomach pain, fruity smelling breath, rapid/laboured breathing) then check ketones. If you do have ketones, hospital is a very reasonable option, especially if you don't feel comfortable treating at home.

Is there anyone with you who can keep an eye on you? I always tell someone if I'm feeling funny so they know I might need emergency help.

 

[AshleighAE]

Hello All!

Sorry for the late reply, I have been very unwell for a few days now, so catching up with everything now...

I managed to get my BG levels down, although it did take a while, and they are now back to normal (my last reading was 6.6 an hour ago).

@Diabell I definitely feel learning to carb count will help me, as sticking to the 8.6.6 ratio doesn’t always seem accurate depending on the amount/type of food I eat.

@Engineer88 @Celsus I wish I had seen these responses sooner! You both sound like you are very experienced and have a lot of T1 knowledge to share. I will refer back to this post if I have this experience again, I have no doubt I will...

@Jaylee @phdiabetic @Juicyj @SueJB Thank you for the love! I am feeling so much better now, and no ketones, thank goodness... I have had help help from family members and lots of cuddles from my little girl ...

Value all of your advice and support, and so grateful to now be part of this community.

 

[Juicyj]

Hey @AshleighAE Glad you're ok and thanks for keeping us updated

 

[Celsus]

Hello All!
Sorry for the late reply, I have been very unwell for a few days now, so catching up with everything now...

I managed to get my BG levels down, although it did take a while, and they are now back to normal (my last reading was 6.6 an hour ago).

Welcome back from your high flying venture - Great to hear that you are doing better!