My daughter has been a T1 for a year now. We have had our share of stomach bugs and colds since her diagnosis. We kept a close eye on her blood sugars and seemed to manage ok.
Three days ago her BG's started running very high. Tried all the usual stuff; checked her pump tubing and changed sites. Two days ago she started with cold symptoms and still with high BG's. Today she is sniffly and has a sore throat. No fever or anything. Feels ok too but, her BG's have been in the 250 - 300 range with a 60% increase in her basal.
Has anyone else experienced this much of an insulin increase while sick?
I've gone as high as 40% when sick. Just before my period starts, I have to increase by 50%. Sometimes large increases are necessary and they don't mean something is 'wrong'.
From the book, Think Like a Pancreas, "In most cases, extra basal insulin is required during an illness. If blood sugars are repeatedly high and you are not spilling ketones, consider increasing basal insulin by 25%. If you have small or moderate ketones, increase by 50%. Large ketones: Increase by 75-100%." Book also suggest sick children drink 1/2 cup of fluids per hour while awake as insulin will not absorb properly if they are not properly hydrated.
Thanks for the advise and suggestions. I did try giving her a shot and it didn't bring down her BS any better than the pump did. Spoke to her endo office this am. They aren't really sure why she is requiring so much insulin for such a minor illness. I have her basal increased 100% now and she is still in the 300's. No ketones so let's hope it stays that way.
Could the insulin be bad? If you changed site/cartridge and then a shot all out of the same vial - maybe it is expired or got too cold or hot? Might be worth trying a new vial just to see.
Usually my son runs high for a few days with a cold - corrections work to bring it down for the next test, but then by next check after that he is right back up to 250-350. Typically by the time I'm about to pull my hair out because I don't know what to do, it all goes back to normal.
Don't be surprised, every illness affects blood sugar differently. I've had minor colds where I took crazy amounts of insulin and still couldn't get blood sugar below 300. Last year I had chicken pox and felt terribly sick, but bs was fine the whole time.
Just test frequently so you can cut insulin back once she's better. And like others have said, drink LOTS of fluid since diabetics are especially prone to dehydration when sick.
Thanks so much everyone! We are still fighting her high BS tonight. I have her basal increase up to 120% now and her BS is running around 170. I'll take it compared to the 300's. Her insulin bottle is fairly new and seems to be okay now that I have increased her basal so much. I did think about the insulin vial though myself and wondered if something could be wrong with it. Keep your fingers crossed for us for tonight!
Thanks so much everyone! We are still fighting her high BS tonight. I have her basal increase up to 120% now and her BS is running around 170. I'll take it compared to the 300's. Her insulin bottle is fairly new and seems to be okay now that I have increased her basal so much. I did think about the insulin vial though myself and wondered if something could be wrong with it. Keep your fingers crossed for us for tonight!
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Hmmm....just to double check: when you previously said you had increased her basal by 60%, you set it at '160%' on the pump right? Because if you had set it at '60%', you were actually giving her 40-percent LESS insulin, not more. At least this is how it is on Minimed pumps. By setting it to 120% right now, you are giving her 20% more (not 120% more) than her usual basal rate.
Spaghettio- That's a good thought. I panicked a minute when I thought about the settings. But, with the Animas the normal basal setting is "0" you either go minus or plus from your usual basal. A temp basal of +20 is 20% above normal. Last night I gave up on the temp basal and made up an "other" basal program which we are running right now. She is at 120 to 150% above her usual. Even with this she is still running 200-300. I can't stand this. She seems fine. The diabetes educator in the endo's office didn't seem too excited about this so long as she doesn't have any ketones. Thanks for your thought though. I wish that had been the problem because it would have been an easy fix!
I haven't gone that high on insulin. When i'm sick. well i've had diabetes for 13 1/2 years but this year was the first time i've been sick with an insulin pump & i just did a 20 sometimes 30% increase. not higher then that because that worked for me.
I so love Juvenation! You have let me whine about my daughter's latest D challenge and took the time to answer my questions, give suggestions and wish us luck. My gut mommy feeling told me there was more going on here than just a cold. After reading so many of your posts about how much insulin you use durring an illness it just confirmed my gut feelings.
I was able to get in touch with my daughter's D nurse educator today (mind you I have already spoken to another D nurse educator and a physician about this present illness and high BS). I let my floodgates open and rattled off every BS, insulin dose, I:C ratio, ISF, and basal rate to her and concluded with "This CAN'T be due to a cold". Glory be, she agreed with me! Don't you love it when people agree with you?
After crunching some numbers and comparing a few other numbers our D nurse said she thought my daughter had dropped out of her honeymoon phase and that the cold may have just been the final blow to her limping beta cells. It seemed to make perfect sense to me except we are 1 year post diagnosis now and she had an increase in her insulin needs over the summer that her endo told me was the end of her honeymoon phase. All I can say is sometimes even the best doctor might get it wrong sometimes. We (the nurse and I) really think we have seen the end of my daughter's body producing any of it's own insulin. For now, it's the best explaination I have and I'm running with it! Thanks again for all your replies!