How to figure a manual shot when BG is high

I have had Bronchitis since Wednesday last week, and fighting high BG’s all week long. I started a Temporary Basal last night as per Medtronics, of 115% which is 3.15 units per hour for 24 hours. Medtronics told me to change my carb ratio from 6 to 5 which should bring my after meal readings down a little. Then this morning I had 1 & a half servings of Malt-O-Meal and half of a whole wheat Bagel. It figured 60 carbs. My starting BG was 192, so I bolused for that. Four hours later my BG is 311. It was as if I had taken no insulin at all. I called my Dr. but they are all out to lunch. I called Minimed and she told me to change everything out, so I did. I then rechecked my BG on the other hand–different finger and it was 301 so I did a correction for that. I’m sure if I had known how to figure a manual shot, my BG would come down much quicker, but now I have to wait to see if the site change, new vile of insulin, & new reservoir worked. This has really been a battle since I have been sick, and all my normal BG’s I worked so hard to get are out the window, and I suppose I’m really frustrated at this point. I was really counting on a “normal” A1C this month.
So I guess that’s the long version of: How do you figure units of insulin for a manual shot when your BG is rediculously high?

Again, I’m no doctor, but I pick between these two options generally.

  1. Use the same correction factor (sensitivity) you would use for a correction bolus. If you don’t know this, check your bolus wizard settings. It might be 1 unit for every 30 over your target range. Might be 1 for every 25, 40, 50, etc. Depends on your settings.


  1. Blindly take a giant 5 unit or 10 unit injection, cross your fingers, and hope you come down.

For either choice (calculated or blind), you MUST remember for the next 4-6 hours that your pump has no way of understanding that this insulin is on board. It is secret ninja insulin and you’ll have to consider it when taking any meal boluses or correction boluses later in the day. ***And as always with adjusting your treatment, monitor carefully afterward for possible hypos.

hi, Bobby, I’m sorry you’re not feeling well. It sounds like you’re doing the best you can. Don’t worry about your numbers “being out the window” right now - it’s normal to go wack-o when you’re sick. Sometimes when I’m 300 it takes me all day to get it down. It was a good thing that you changed it all out, including the vial of insulin. Remember to drink lots of water, too, when you are sick, and also when the bg is high. hope you’re feeling better soon!

I think I figured it out after calling Medtronics again. We were checking all the settings in the Bolus Wizard and the sensitivity is set at 20. So according to that if I needed to drop 200mg I would take 10 units of insulin. I didn’t realize that was how it worked.

Thanks Marie,
I was just looking at my average on my meter and for 30 days my before meal average is 120, so that hasn’t changed much. Its 168 after meal average for 30 days. All results average for 30 days now is 154. I guess I was overreacting.

Hi Bobby
Here is what I do when I take insulin thru a syringe. I do this a good deal of time because my sites last longer for me this way. In fact I do most of my up front bolus with a syringe. I disconnect and lets say I am going to take 5 units in a duel wave. For me that will cover 75 carbs with a mix of fast and complex. After I disconnect I use the wizard and it will say 5 units then I say I want 2 units now and 3 over 2 hours. I let it deliver the 2 units while disconnected and I inject that with a syringe then after the pump has finished with its delivery I hook back up so I can receive the rest. I do this so if I have to take a corrective dose the pump figures insulin on board correctly. My sites go bad fast I don’t have much real estate so this is how I can lengthen my site time.

I think you could use this method with your problems also without having to lose your data. It does waste some insulin which I don’t like to do but it is either that or I am changing sited everyday.

Hope you get it worked out
be loved

Wow. That’s quite a unique approach.

I am not good at math :slight_smile:

Hey Bobby, I hope you are doing better.
I know my reply is a little delayed, but I thought I should mention that it might be a good idea to check your urine for ketones when you’re battling a stubborn high bg while sick. I know that it takes a LOT more insulin to bring me down if I’m spilling ketones.
Hopefully your endo gave you some sick-day rules for these sorts of challenges? If not, you might ask for those next time you go.
Hope you get better soon,
Katie I.