Check your basal rates.
I’m on the Medtronic 670G, which in Auto Mode seems to be much more conservative on corrections so it brings me down more slowly. On every previous pump, I would feel terrible when I hit 300, always get exasperated and inject or over correct, and then have to deal with the rebound low. Our bodies are complicated and insulin activation varies day to day. IMHO, it much safer to do it slowly and avoid insulin stacking with a rebound low.
Whenever I go above 200 or so, it’s because my infusion site needs changing or it’s just been changed and the insulin is taking its sweet time getting into the bloodstream. At 300, I’ll switch back to manual mode, inject 2 units, and do a correction with the new infusion site. Injections start to work within 20 minutes, insulin through the new infusion site takes 1.5 hours to work. But I have to discipline myself to not over-react and be patient.
I haven’t yet had to deal with being sick with this new pump yet. Supposedly, it should automatically give me more insulin. If not, I’ll just flip it back to manual and do my “sick temp basal”.
I knock it down as quickly as possible. I rareley find myself that high on a lchf diet. The times when I’ve made a miscalculation and need to correct for a bg over 300, I’ll let my pump wizard give me a suggestion. I’ll add an extra 20 or so percent to counter for insensitivity and then using a syringe , inject in a couple different locations. I want to preserve my infusion site which i find has a limit to the total amount of insulin flow before it becomes ineffective and needs to be replaced. I’ll then closely monitor my dexcom. Only downside is I can’t rely on my pump to know the correct iob.
I try to get it down fast if it is over 240. My first step is to wash my hands and recheck. If the number is the same, I then figure out my correction using my pump’s wizard. I do the whole units with a shot into the muscle, noting the time and amount on paper. Then I pull the set. I check for insulin drops. If they are there, I assume it is an absorption problem and reset into a new site. (I use the sure-t which has a metal needle and it is possible to do this) If it is close to time to change it all out, I just go ahead and do that. Next, I give the number of partial units the pump suggested. For instance if the wizard said correction was 2.3 units, I would have already given 2 units by syringe and would do .3 by the pump. Everything gets written down. I figure 4 hours for insulin’s activity by the syringe and write down the expected insulin on board for the next 4 hoursl. The pump will keep track of the insulin given that way. Then the wait is on. I become a camel and drink, drink, drink., keeping track of ketones if I had any. I am prone to get them very easily over 240. It is very important to know your correction factor and override the pump very carefully if it has been a site problem, and the insulin IOB may not really be there at all. I check every hour and give small boluses accordingly until I come down to around 150. At 150 I begin to become insulin sensitive. This is where your diabetes may vary. Toward the end of this little adventure, I may need to eat a very small carb or two so as not to rebound to low. That’s where it is so important to write down what you have done insulin wise, know how much the insulin will work on your BG, and know how much 1 carb will raise your BG. By doing this I usually land pretty okay, but I am worn out.
I try to lower quickly now because I feel awful with a high and I start getting a lot of symptoms. I’m cautious because I can easily crash though. Last night we ate out for the second time in a few months. It was a disaster with going up to 200 straight up by the time I got home. It took hours to come down because I was more cautious having more iob. I’ve had some fast dropping lows lately again that have sprung up on me. I absolutely have to get my Bg at 120 or below to eat now. Sometimes at home I can manage it but not at a restaurant. I also just won’t eat out anymore for dinner maybe for a snack here and there if it’s gf. Last time I ate out here I crashed and had to eat a fruit bar while I was there. It’s not fun.
Today I woke up low and the when I ate Bg eventually went up to 125- I had a bad dizzy spell when it changed. I haven’t had that for a long time so I think it was due to the higher Bg and staying high too long. It’s kind of a crap shoot I can never tell what will happen.
Someone said if I’m not absorbing Levo and converting it to t3 that can cause insulin resistance. I wonder if that is playing any role in the times my Bg stats high for hours. I notice when I take Levo in the morning before I sleep my Bg tends to drop but not always.
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I always do that too.