I am 54 and diagnosed T1 about 7 years ago. I’ve never had a Ketoacidosis episode or even flirted with one. An occasional spike that puts me over 300 is always knocked down quickly with Fiasp delivered by Omnipod.
Yesterday I came down with an acute sinus infection. I spent the night and today pumping enough insulin to kill an elephant (with bolus way up, basal up 25%) I could not knock BG down, seeing high 300s and 400 all night and today, peeing out everything, really dehydrated and a bit disoriented.
I’m in the process of moving so the afrezza I have and too rarely use lately was at my other place. I sent a runner and started inhaling 4 unit capsules. 400+ has been going down in 10 MG/dL increments to 304 and still on the diagnonal Dexcom arrow. Nice descent. Subcutaneous injection was doing little or nothing where inhalable works. I feel better already and think once I have it tamped down I can keep it there with fiasp. If not I’ll hit every cartridge and then get on my antibiotic. Clinic doc said to take those right away, but I know nothing was absorbing when I was at extended 400. Need to get BG down first, get water/food absorbing and then antibiotic. I have little doubt I was heading for the ER in miserable condition had I not taken afrezza.
I’ll be making sure to have afrezza around at all times just for this reason, avoiding DKA when ill. I also recommend highly as a supplemental treatment and will start using it more often in general.
Have you changed the pod? Got any Gatorade? Syringes?
Good questions. I used a syringe mid-am and that had no better effect. I’d had the pod on for 2 good days and I had come down sick before BG rise. I’ve had nothing but great results with pods and never a non-alarm failure but it probably would have been a good step to change it late last night. I figured the afreeza’s delivery method was able to break though, but even that with less dramatic effect than usual. I hit a bunch of 4 units capsules and one outdated 12 and still 250. I also have a decent sized spider bite on my leg that happened a couple of days ago. Looks ugly but has only been red and itchy. Maybe that’s a factor too. If my theory is correct I believe afrezza saved me the trip to hospital. I did just change the pod and took another afrezza so will wait and see what happens later when I know the afrezza is out of me. 242 after last afrezza cap 10 minutes ago…I have a grim but better understanding of what happens to a T1 without insulin.
I had a bad tooth infection about a 2 months ago? It took so much more insulin to bring down Bg’s, like you said enough insulin to kill an elephant. I didn’t eat much because it was just so hard to control, so abstaining from most everything was just easier. That lasted weeks of higher doses and spiking up and wanting to stay up BG’s. It was very aggravating. Finally it started acting more normal, plus a few days of mix and match, lets stay high, then lets drop fast, then maybe lets do what we usually do. Arrrgh.
I am becoming convinced the subcutaneous injection is not very effective when the body is fighting a bad infection. Afreeza much better but that’s short acting. I want to be prepared for this in the future. I’d considered injecting into a vein earlier to knock it down. I’ve read about people doing that and getting good results knocking down a big and persisten high. Now can’t find anything on it. Anyone have experience with doing that?
I also use Afrezza to knock down highs. Infections always put me in shades of rage bolus mentality.
When fighting elevated insulin resistance I like to use a combination of insulin delivery including Afrezza, bumping the basal rate up to double, and using an intra-muscular injection with a syringe. I also know that when I fast, even just missing one meal, my insulin sensitivity goes up. I would consider a short, <24 hour, fast if I felt otherwise well enough.
Then drink lots of water and try to get in some light exercise. I’ve read other member’s accounts of delivering insulin intravenously with a syringe. I see the Afrezza speed as a substitution for IV insulin. I think self-administered IV is unneeded and could be risky when Afrezza is the easy alternative.
I agree with terry on drinking lots of water, either one of my endos or I read somewhere that water and our high BG thirst is our body’s only way to naturally combat high blood sugar…similar to coughing when you are sick. I always bolused in my arm against a corner of a wall, or in the thigh, or an alternate place where the omnipod usually goes…sounds like a combination of the infection or bite and placement might have been working against you at the worst possible time…one reason I stopped using the pump. I’d also probably have a box of cereal ready in case you start to plummet I’d expect to see 2 down arrows soon
So, after getting into more normal but high ranges in the mid-200’s, I bumped basal from 25% to 60% increase and started using my normal bolus ratios with a couple of afreeza 4 units caps. I went overnight without going low which would normally not be the case with the basal increase. Woke up early at 104 stable and am going to try my normal basal program since I have some heavy work to do today. I’ll be checking my readings a lot.
Thanks for your thoughts on intravenous. Wasn’t nuts about the idea but was about to go for it. I do have some longer syringes bought by mistake that could work for intra-muscular which I had not considered. I need to get back on the afreeza program to always have a supply. Afreeza is impressively effective, but it is just one more thing to manage and tote around so I let it slip after I went on fiasp which is fast but not that fast. Now I have a new reason to keep it on hand I drank water throughout. At the worst stage it seemed to come run through me unfiltered and I still woke up very dehydrated. I could feel it absorbing once I got things a bit under control. Thanks to all for the comments. My advice for T1’s is if you can get afreeza, get it. If not for regular use then to have on hand as a recovery kit when things get out of control and subcutaneous isn’t working.
I also use Afreeza as another tool in my tool box to help with the management of my diabetes. It is fast, it is easy and unlike the rage bolus that I can get myself into, this is quick and easy.
I don’t use it a lot but it sure is nice to have when needed.
And anything to avoid an ER visit is worth keeping around! Glad you help avoid that nightmare!
I would do way more than a 25% basal increase when something like this happens. When I am heading to dka for whatever reason I immediately correct with inj, change everything out and raise basal to 180% or so for as long as needed. Also eat only lower carb if needed and you are eating. Drink water as well. I am glad afrezza saved the day.