How to bring down high BG's when sick with a cold or flu

I have been very sick since Wednesday with some sort of a cold or something. I plan to go to the Dr. in the morning, because its not going away. In the meantime, I haven’t been able to get my BG’s down for about the last 3 days. They want to stay in the 200 plus range. The lowest I have been able to get them down is about 174 and that’s it. I give a correction, check my BG 4 hours later-no food-and have to do another correction, and on and on. No matter the correction, it only drops about 30 points. I’m not sure if I need to change out the site or if its just due to my illness. So much for my good average. Any tips, or do I just wait until I see the Doc?

Drink a lot of water and keep a close eye on things. I am fighitng off a chest cold and had no choice but to go on steroids due to my asthma and I have went through 300 units of insulin between Friday and Sun morning.

Bobby, how comfortable are you with your pump settings? When I get sick and my bs is on the rise I use a 150% temporary basal setting ( I get 1.5X my normal basal at my regular basal pattern) or a special basal pattern. It keeps things regulated for me, but please do not mess with settings if you are uncomfortable or new or hypo unaware. work with the cde or endo. Most over-the-counter cold medicines have sugar and the stress of just being sick can raise your bs too.

test a lot and feel better.

I agree with Joe. I have a “sick day” basal pattern that’s about 115-150% of each of my normal basal rates. You have to play with it.

Hi Joe,
Do you set that under “set/edit Temp Basal”? I also find on my paradigm 722 a Max Basal Rate. I don’t remember if my cde set that up or what. She must have, but I don’t really know how it works. When I select it, it shows the basal rate at 3.25 units per hour. My regular Basal rate is 2.75. I’m not sure if I select that if it just changes it temporarily or what.
Well, I’m going to the Dr. in the morning and I’ll ask him. It makes sense though, if my basal rate was up maybe I wouldn’t be having to do so many corrections. I didn’t even think about that. I’ve only been on this pump for about 2 months now. I obviously have a lot to learn.
Thanks,
Bobby

Well, I don’t feel so bad about my 125% basal (on Cipro for a nasty infection) but the carb ratio seems off too…do you use the same carb ratio and just correct, or a sick day one and how the heck did ya figure that out? Had a hard time with the 125%, and am only doing it 24 hours at a time (have a CGMS --so shouldn’t get into too much trouble)

Thanks Melissa,
Which heading under Basal do you change that at? Do you have a Paradigm 722? I don’t remember. There are several headings under basal. I just don’t know which one to change. I didn’t even think about needing to change my basal rate or I would have called my cde. Well, Maybe I can find out tomorrow. I just hate that all my hard work getting these numbers down is blown in just a few days of high BG’s. Live and learn, I guess.
I guess it takes a good while before you really get to know everything you need to know about these pumps, where you can pretty much handle whatever comes your way. Thanks for the response.
Peace,
Bobby

I’m going to the Dr. in the morning, so maybe I will come away with some valuable info. Thanks for the response.

I have a stomach bug right now and I called the endo, they said temp increase to 115% for 4 hours.

Everyone is different though. if you dont know how to do it, call them up and ask. i’d rather hassle them than potentially be hospitalized :wink:

A temp basal is generally a short-duration change in your basal rate, like for a couple hours before/during/after a workout or when you’ve delayed eating and want to keep from dropping low. You could use this for a sick day, but you would be changing it every couple hours as the rates expire. It’s an option though.

Your max basal setting is a precautionary setting where your doctor or perhaps a parent of a child pumper can make sure the basal never goes over a certain max number per hour to prevent overdose. I wouldn’t recommend changing this on your own.

Your basal patterns (standard, pattern A, pattern B, etc.) are different 24-hour basal rate combinations. I used to use one pattern on weekends when I woke later and skipped breakfast, for instance, because I could change my dosages based on my routine and activity level. You could set one of these patterns up with a slightly higher basal rate during each block than you normally have them set to. Before you make any changes, make sure you write down your prescribed basal rates and time blocks. Or upload it all to Minimed’s Carelink.

I wish I could be more specific for you. I used a Paradigm for years, but I’ve been on a Cozmo for 4 months and have already forgotten the specific menus for the Paradigm. It’s going to be in your basal rate menu, but not max or temp basal. In basal setup, I think. You’ll have to turn on “Patterns” to be able to use more than one basal pattern. Then you’ll be able to change the rates.

Right now my basal is set at 195% due to being sick and being on steroids

I agree…try to talk to someone in your doc’s office.

I went to my Dr. this morning and he said the only time he recommends changing the basal rate is if your BG’s are running over 300 consistantly. He said anything below that you stand a chance of going hypo if you increase your basal. So…

Hi Bobby. I use a Pradigm Minimed 522 and have been on the pump for 5 years. ( Type 1 for 40 of my 53 years) It is very difficult to learn so much about the pump… I am still learning as I adjust my basal rates. You could increase your basal just a little bit, I go from the very small increments rather than the percentages. I have discovered a “sick day” basal that i use when I hae the rare cold or infection and I try to stay low carb when I am sick( about 35-40 grams per meal. I also find I have to give more manual boluses when I am sick as I really do not ever put in a “temporary” carb-insulin ratio. I just sneak in an extra .5 or single unit to my boluses if I am runinng High after a lowcarb meal as a standard correction. I hope this helps. Just test frequently so you know what is going on I know how diffculty blood-sugar management is when we are sick…Run run as fast as you can , you can’;t catch me, I’m the changing blood glucose man (LOL) We all go through this…

GOD
BLESS

Brunetta

Thanks Brunetta,
I did go see my Dr. this morning, and he said don’t worry about it if my readings aren’t 300 or higher. I was sort of shocked. My CDE called me this afternoon, and she said go ahead and increase my temporary basal rate to 110 to start with. Keep on eye on your readings and adjust accordingly. That sounded better than what my Dr. told me. I went an entire year with my BG’s being anywhere from 200 to 500 pretty consistently, and I believe that is why I have the slight kidney damage I have. It just doesn’t make sense to me to just tolerate high BG’s when I have the technology to bring them down.
Thanks for the info,
Peace and Good Tidings,
Bobby

I am with you. keep yopur blood sugar normal if you can… but the penalty for a analog insulin overdose is pretty severe, so that’s why most CDE’s and doctors for that matter tend to be high-sugar conservative, especially in sick-day stuff.

Your pump has 3 basal “patterns”: Standard, and then Pattern A and Pattern B. I have my pattern A set up for travel - higher basal during the day, but no dawn phenom in the 3AM. Pattern B is for anything I need - like being sick for 2-3 days. The patterns need to be set up for each hour, just like your standard pattern is set up now. If you go thru the menu Basal > Basal Review you can see what your standard pattern is set for. To switch between patterns go thru the menu Basal > Select Pattern.

If I am exercising, or have a “temporary” situation, I use a Temporary Basal, which allows me to set a basal for, say 4 hours during a workout. I use percentage because I want to follow my pattern, but I just want a percentage of my base- basal. I’ll drop to 25% for exhaustive workouts for 4+ hours.

It can be technical and confusing and no CDE wants to get you flustered, especially when you are sick, with pump buttons. Anyway I say Iif you are up to it… then go ahead!

Hope you are feeling better by now!

Thank you, Joe! These are the menu instructions I was trying to recall!

Using temp basal when sick is usually advised. Whenever I’m sick and have fever and high bgs I increase my basals temparily to 180. Years ago my CDE gave me a chart with info on when to increase basal rates for different situations like eating high fat foods, illness, stressful situations, etc. Each situation calls for different basal rates.

I had a sinus infection that was dx’d last week and my BG had been in the 350s for a couple of days prior to beginning antibiotics. 24 hours after starting them, my BG was SOOOOO much better. It was the BGs that finally drove me to the doctor. I was sticking with the “it’s just a cold” thing. I did change my site a couple of times to no avail. Your body is telling you it’s sick.

The simple answer is that you need more insulin than you are using for this situation. If you double your correction bolus, you should get some increase in action, probably not twice as much but close. Like others have mentioned, I also use a “sick” basal rate when I am laid out with some nasty bug. It is the same rate I use on long car trips and is about 160% of normal.