Do you hyper-bolus when you're sick?

Hi friends,

I have a bad head cold and as expected, I've had high blood sugars for the past few days. I've doubled my bolus insulin and it has almost no effect. I've gained two pounds despite not eating much (from the extra insulin? lack of exercise? water retention? ) I'm a little afraid to bolus MUCH more. I went from 14-20 U/day to 26. What do you do when you're sick? Do you just let the high blood sugars go? Should I increase my basal? Should I keep bolusing until I'm back down?



Hi Maria

Call your Endo.

From my experience, I let my BG stay in the low 200s while I’m sick. I do end up stacking insulin and doubling my insulin intake even without eating and my BG still stays in the 200s. I drink lots and lots of water and Diet Green Tea. I eat cheese (digests slowly and has little carbs) and drink lots and lots of water.

Did I mention the water?

Hopefully it just lasts for a few days.

I would not double the bolus (only corrections of course). Your enemy is the higher need for background insulin. Thus I recommend to increase the basal rate of your pump. For example you could set a TBR of +30% or more for the next 3 hours. After these 3 hours you reevaluate the situation and set a new TBR for the next 3 hours. Step by step and increase by increase you should see the difference.

If I am sick I will increase my basal insulin (I am on MDI). In most cases I will have to increase by 40% or more when I have a cold - even more with fever.

I wish you a fast recovery.


Listen to Holger. He’s wicked smart. Try increasing ur basal a little at a time. I usually end up stacking while I’m sick and I know that’s not a good idea. Have never tried increasing my basal while I’m sick. But it makes sense.

Call ur Endo just to make sure, if that makes you more comfortable. :slight_smile:

I’ve been experiencing the same. I’ve just been chasing, more or less. If I can get below 200, I’m pretty happy. I wasn’t even feeling badly earlier in the week when my sugars started running high, then it hit me this morning, funny how my body gives me a hint but I was too dense to realize it.

When in doubt, maybe a call to the doc to see would help.

Good luck and feel better!