So, I keep going on and off pump, my endo and pump nurse both went out of town last week, blood sugars were all over the place and wasn't sure how to really adjust my basal rates on pump. I took off POD on Saturday and just thought I'd do MDI until I restarted POD this week. I've been messing around, still, with my Levemir, lowered a bit at night, changed to dinner dose and increased my AM levemir dose. Frankly, I don't know what I'm doing and I'm getting very concerned. I'm waking up to high 200's and going to bed at around 180's with doing corrections all day long.
Last night I was 189 before bed, got it down to 120, woke up at 6AM at 200 and within 30 minutes I was at 268 and rising...I took 5 units and finally drank some coffee and ate an egg. Threw up, ketones, drinking water, got it down to 147 for lunch, ate a little bit..and now I can't seem to get my blood sugars below 220, it just keeps going up. I HAVE TAKEN SO MUCH NOVOLOG, I even added another 1 unit Levemir.
At what point do we get concerned if we can't bring our blood sugars down. I don't know what is happening. I think I've messed up really badly with all these changes and my levemir doses. I feel just simply awful and I'm nervous, too.
Chill a bit. Are you spilling ketones, again? Great that you were initially able to eliminate them Do you know what your correction factor is and what basal rates you were started on? Are there any explanation of these concepts in your user manual for the Omnipod?There is one for the Minimed pumps I use. When you used shots did you know what to do to correct? Same type of process. You will have to learn to be your ownscientifc experiment.
For right now:Drink a lot of water. Do your overnight basal rates again, may be up it just a bit the hours before you wake uo. TEst Test Test.The overnight basal rate testing is tiresome, but it can be masterd. I personally need at least 25 to 30% more basal insulin the two hours before I get up.Also,if I do not eat within 30 minutes after I rise, my sugars will go up unless I take .50 to .65 units of insulin upon arisal. You have not "messed up really badly:. the punp just has a long learning curve. It is trial and error and trial and error until you find how your body responds. YOu will not know it all at once. I do not recommend going on and off the pump. You will make it through this..... Take small steps
When you get a chance, read two really good books: Think like a pancreas( Gary Shiener and Pumping insulin(John Walsh) They will help you when you do not have the doctor or pump nurse to rely on. And there are always wesweet, kind, and caring Tudiabetes folks.
yikes! I'm not sure what the answer to "at what point do we get concerned..." as I haven't run into sustained elevated BG like that. I prefer sticking to the pump. I've had a few odd situations and was like "is it working?" and I've been able to "make it work" but I dunno about Pods. I'd be concerned too w/ all the corrections. I know that some docs sort of "back off" on the dosing w/ a pump b/c they work better. If they did that and left you short, it might explain what you're seeing too. I don't think going back and forth between the pump and shots works very well. I think you have to pick one or the other.
You've been high for 24 hours and can't seem to get a handle on your blood sugar. I think you need more help than even Brunetta and Acid can provide (and they can provide a lot of help). I personally would either call my doctor or walk into the emergency room if I was in your situation. Diabetes is a do it yourself disease but sometimes we really do need help - especially when prolonged high numbers begin to take a mental toll so we're not even sure if we're thinking straight.
Sarah - I would continue to appeal to your doctor and pump nurse. If they're not available, they often have someone to back them up. It seems as if the medical types just throw us into the deep end of the pool and hope we learn how to swim!
Are you keeping a log? I would make the effort to write everything down: insulin doses (basal and bolus), food weight and carb values, and BG numbers. Try to simplify your meals to the ones that you've had good luck with in the past. As someone else said, test, test test. Be careful not to stack bolus inulin doses, especially before bedtime.
I know that you've said that you've not much weight to spare, but I've found cutting back on food quantity tended to settle the BG circus down.
If you have any suspicion of any infections including gall bladder and appendix, promptly see a doctor. When I've had various infections in the past, correction insulin doses seemed to have little or no effect.
Are you certain that your insulin is fresh and effective. Changing to a new bottle might be a good idea.
You've been struggling for a while now. If your doctor can't see you, find one who can.
Reading this again, I would suspect that "messing around, still with my Levemir" followed by rising BG overnight would indicate there wasn't enough Levemir. My objection to going back and forth between pods and shots are that it's difficult to track these sort of changes consistently. If you are taking tons of corrections, I think that you'd be better off to put some of that back into Levemir to get you the steady state where you want it and then worry about figuring out the food boluses.
The various weight-based rules for calculating approximate doses would be as good place as any to reboot your plan. That's probably what your doc would do when they give you a dose. Most of the time, they don't show their math although I had one doc who did it in front of me, making some sort of recalculation based on what I said I'd do and then cranked out a bunch of math and said "yup, that'll be fine".
I agree with Terry that a log should help you get there much faster. I did total winging it from like 1985-2008, when I got my pump. I survived ok but it was a lot more work than just doing the work. My pump has helped me a lot, partially because it's a great logger, BG, insulin, food, all in one spot. The Medtronic "pie charts" are an excellent shortcut to use. They show the %age of BG that are high, low and in range during different times of day (pre-breakfast, post-breakfast, pre-lunch, etc.) in a way that shows you "hmm, I'm having more lows after breakfast or highs after dinner, how can I fix those areas?" I think a lot of meters offer some sort of reporting that it would probably help make some progress.
Do you think you may have an infection? I have not been on a pump so I have no idea how to manage that, but if you don't have an infection maybe you need more levemir? Are you exercising too to try to bring down bg? Since you went off the pump maybe your body is reacting to that and to being back on a longer acting levemir? Maybe try a new vial of insulin, but save this one in the fridge in case it's good. I agree with drink tons of water as well as to do exercise also to bring yourself down. Whenever I go up too high: I first drink water, then correct with novolog, then go for a walk or stairstep or vacumn.But yes, I think I would call my doctor and then go to the covering doctor or to the er if these high bg don't come down soon because it could be an infection of some sort. Hope you feel better very soon and sorry this is happening :(
thanks, i'm not sick, other than high BG's. I've changed out both my novolog and levemir. I've called my doctor. I woke up at 231 at 4:30am and am getting very concerned and scared. something is wrong. yes, AR, not enough levemir I think...but corrections aren't bringing it down. I've already corrected and am at 189 still. I feel sick to my stomach, mouth so dry. thanks for the replies. i'm so nervous, ya know.
Did you correct with a pen, syringe, or the pod? I find that stubborn slow to diminish highs respond best to an injection. bBt you must be aware of the insulin on board that you got through the injection. I have no idea how you do that with as patch pump, such as the omnipod. While still attached to my MM 523 pump, I inject, by syringe,a certain number of units for a correction say, 4. Then I disconnect from the pump and bolus through the disconnected tubing, letting the 4 units just drop . Then I reconnect and the amount I have "on board" is thus reported on the pump, even though the pump was not the source of the correction. How do you do that, or are you able to do that with the Omnipod?
Did you check for ketones? If you are spilling some, I strongly suggest you correct with a syringe or pen, if you have not already done so.
thanks, brunetta. I did corrections with a syringe all day and night yesterday as I was still on MDI's. I talked to pump nurse this AM and put new POD back on but I'm still high - hovering close to 190, so I've done correction with syringe and just upped my basal rate. I don't know what is happening. last time I had the pod on (just last week) I had to go down to .30 basal rate because I was so insulin sensitive and kept dropping. I think because I've been high for so long it's just messing everything up and I'm running now a .50 basal rate. I don't have ketones now...hoping they don't come back. POD determines IOB too...but I'm just writing everything down right now, trying to just get my blood sugars to stabilize. That's the thing about this stupid relentless BEAST, it never lets up and when it's off it can be way off and a nightmare and often scary (at least for me), as I'm sure you know too. I haven't had blood sugars close to 300's, like I said, since diagnosis, really. I literally feel like I have morning sickness, like I'm frickin pregnant....I'm not. Just drinking water and hope within a couple hours I'll get a break and not drop too low, wondering what tonight, overnight has in store for me again. ugh! thanks for you kind responses. :)
ugh.. sounds horrible... I would be nervous too. I think you could still have some sort of infection brewing and not have symptoms maybe though so I would go to a doctor or er and have some blood work and an exam done, check for uti etc. that is good that you don't have ketones anymore. how is your bg now? Any better?
I was also thinking the stress you're feeling could be affecting the bg so maybe a tranquillizer or something like green tea may help too.
Ketones to no Ketones is good progress [wth, spellcheck doesn't know "Ketones"?] If a bit more basal got you there, I would maybe keep making progress in that direction. I don't remember what basal rate was crashing your BG out but I would speculate that the best BG would be between them somewhere? Unless there's no room.
Is there a way to get the settings to get smaller increments? My Medtronic 523 does .025u/hour increments but has a setting that needs to be adjusted to allow that. I have been suprised to find out that .025 will make a difference and thought the Pods did that too.
