Help! I had a real bad night last night

Mary’s sugars were so good the other night, I thought, "great, tonight can finally get some sleep!"
All of a sudden @ 10:00 she felt low and it turned out to be 46 with over 1 unit on board. We gaver her full glass of OJ. We waited 15 min all the while she was complaining she did not fell well.
After we checked it again it still read 46. This time another glass of OJ, and a box of raisins, then a ring ding.
Finally it read 78. Then went up to 115 I suspended her pump for an hour… I set my alarm for 12:00 am and it read 348. And the whole night since she kept going higher. Her highest reading was over 500.
I gave a correction dose before the 500 reading. Once I got to the 500 I have her 3 units via a needle.
This morning she is still reading 368.
NO keytones, though. I cant figure that out because she is complaining of stomach pains.
The only thing I can figure is the insulin went bad.
We changed her set yesterday morning and her sugars were just fine during the day.
Her bottle of insulin was down to the very last drop.
Anyway, I just changed her set again this morning with a fresh bottle of insulin. It is still a bit high but is reading @ 268.

I am so tired, I probably dont even make sense, but I am so weary, any advise would be appreciated.
We are still new to the medtronic.

BTW I just opened another bottle of keytone strips. she does have keytones. But as of now her sugars are coming down . Its 196 now.

Ugh maybe u over ate to bring down the low? I tend to do that all the time. Or like u said maybe the insulin went bad. But I’m thinking that since u didn’t get a higher reading after 15 minutesand u gave her more stuff to bring up her bs that maybe she just over eat for a low. My guess anyway

Oh maybe her infusion site went bad. Since u changed it out and all maybe now she will see it come down.

I’m glad the BG is coming down this AM!

For the last couple of years, I’ve been trying to wait more like 20-30 minute to test to check how a low is doing as it seems to take that long for even faster acting stuff to work. Part of me doesn’t want to run high but I also want an accurate reading. Similarly, while I love the sort of carthartic buzz I get off of orange juice when I’m low, it also has a ton of carbs, usually about 36/ cup so 2 cups end up being almost as many carbs as a Big Mac!! Maybe the large helping of citric acid could cause some stomach pain?

Another thing I’ll do when I’m running that low is input a “fake” bolus that will tell me how much insulin-on-board there is? In my head I refer to this as “pinging” my pump. If I’m low and have insulin on board, I’ll consider that “oops, I undercounted whatever carbs I ate earlier” and eat some sort of bonus carb to “cover” the insulin on board. Also, if I get a 48-78-115 “chain” of BG, w/o any insulin on board, at that point, I’d conclude I’d overtreated and take a small correction bolus, or bolus to cover the extra food I ate. I totally know about low unchies. When I was in high school, I was defrosting ice cream with the broiler and wandered off and set it on fire…

At 115, I wouldn’t suspend it for an hour, because the “graph” is going up and, depending on what a ringding is, may go up for a while, if it’s like ‘food’ instead of ‘candy’?

Re the infusion sets, I would take the fact that it ran down to 46 as defacto evidence that the set was working fine.

Thanks so much for your reply.
Dont you think it should have come down pretty good after 3 units by needle and giving corrections?
That’s what threw me. Usually when we over eat with a low it comes down with a correction pretty nicely.
Also, we are new to medtronic, is there such thing as a pump not working right?

I am so tired, that I’m not thinking too clear.
Thanks again.

You don’t know what a Ring Ding is??? Probably better for you :slight_smile: This is what they are, with that yummy crappy sugary cream filling.

I have to agree with the others… definitely overtreated the low. I’m not sure what size glass of OJ it was, but between that, the raisins, and the ring-ding, you probably corrected with over 100 carbs, easily. Not counting the first glass. But it’s understandable… I do the same thing, there’s a tendency to want to eat and eat until I feel better.

When you saw her BG go from 78 to 115, the thing to do, as counterintuitive as it is, is to give a correction bolus, not to suspend for an hour. There are still a lot of carbs at work, and the BG has already reached a safe level. But don’t fault yourself for it … live and learn. (If it were me, I would probably have square-waved the correction bolus, so the bolus didn’t nullify the still-working carbs. Playing it safe).

As for the keytones, I’m not quite sure. It’s not consistent with what you said before (unless the BG of 46 was a result of correcting an earlier high which happened because of weakened insulin). It sounds like she takes relatively low doses – which tells me that the vial of insulin will probably expire before it’s empty. Going down to the last drop is certainly the most cost-effective, but may not be the best idea in terms of insulin effectiveness. You did the right thing in starting a new set, though. I’m often too stubborn (and cheap) to do that, and end up regretting it later.

I’d suggest writing the date you start a vial right on the bottle, and see if you can observe a correlation between the date and the time things start to go haywire, or when the vial is empty. The conventional wisdom is that it should only last 30 days. Anecdotally that date is spot on for Lantus (which you wouldn’t pump), you may get less time out of Apidra, and maybe 45 days for Humalog or Novolog.

At least she got to eat a Ring Ding. One of the “perks” of being low. I hope she was able to enjoy it!

AR I was thinking the samething but wanted to prepare her for that b/c we all know that can happen and make ur bs’s go up. Maybe I didn’t do it in the right way but I know I should have said more. Sometimes I drive myself crazy with my short answres LOL! Thank you for taking time to see my mistake!

Corrections, whether by needle or pump, still take a while to work, which I would presume would be torture with a small (?) Child at night. I’d blame it more on the different layers of food causing layers of curves to be bumping all night. Then, OTOH, you have different layers of insulin pushing it down. Then, a few hours later, you get dawn hormone waves too, all kinds of stuff.

My current favorite low thing are Starburst jelly beans since they are easier to do incrementally, like 10 g sevings of quick carbs instead of 30 like OJ? With a kid who doesn’t feel well, it might be worth it to have “pick the colors” as a diversion to make her feel better when she’s running low? This works with Skittles too but if the orange ones are you favorite, setting up a combo of 5 orange, 2 yellow and e pink can be more fun than just weighing them? I picked all the orange and yellow ones for the race I ran recently!

Nah, nothing’s a mistake. Well, maybe having RingDings in the house is a mistake? I could eat a box of those if I were zonked out of my gourd?

OMG Eat them like crazy if I had them here, exp if I were low. My hubby brings in the sweets here and hides them from me and only gives me those things if I’m low and only 1 b/c he knows that I will eat them like crazy even if I’m not low LOL!

I am looking at her records from last night to now.
I think she over bolused her supper. (she eats like a bird) I am sure this is what she did.
When you are in the thick of things its hard to tell whats going on. I fear going into the night with her on a lower side.
But looking at her numbers, you all sound like you make sense. We probably over did it.
Thanks everyone. Youv’e been a big help.
Just now checked her Bg its 94.

Very funny! Thanks for the humor!!! It makes me feel slightly better!

Great advice. Thanks!

Something that helped me more closely estimate how much carb to treat a low was the thread on “how much does 1 g of carb make your blood sugar go up”. After doing some experiments (eat 1 glucose tab) and seeing the response, I figured out that

1 g makes my blood sugar go up about 5.6 mg/dl. Then I just see how low I am and how far from where I want to be, divide that by the 5.6, and I get the number of grams I should eat to start with. Instead of eating 15 or 25, I can get away with 8 sometimes and avoid the overshoot.
If I were at 65, say, I know that eating 8 g (2 glucose tabs) would take me up about 45 mg/dl and I would be near 110.

You may be able to learn a ratio that works for your daughter.

If there is still a lot of insulin on board, as others have pointed out, it may take more.

I agree that you overtreated the low. We all do that sometimes. I also agree that it is hard to wait for a BG to come down. But if you don’t wait, you will stacking insulin, which can really be a mess.

When my BG gets really high, my ususal correction factor is too low. Usually, one units reduces my BG 65 points. But if I am over 200, it usually takes a 1 to 50 ratio. If I go over 300 (rarely…) I will usually take the correction and add one unit.

You would know if the pump was not working, unless the battery dies. My battery died suddenly overnight and Medtrqaonic sent me a new cap, and all has been well.

I stilll use juice to treat lows, as it works fast. Also carbonated beverages with sugar work really fast because of the fizz. Coke now makes a really small can of soda, and I wonder if that is for those of us with D? I have juice boxes everywhere–car, work, and I carry skittles in my purse. It is awful to be low and not have anything to treat it with.

Good luck.

how long do you wait to get your sugar up to figure out your ratio?

I was also told in classes that you are supposed to eat something with protein/fat to hold the sugar, which is why I gave her the ring ding. & I don’t give any bolus for that either. Perhaps I need to reeducate myself!

Thanks! This has been very helpful!