Please HELP! First cold since diagnosed with LADA, high numbers, what to do?

Hi,

I m a recently diagnosed Lada diabetic, I have been honeymooning for the last 6-8 weeks, meaning my insulin requirements were very small and I was able to control my BG numbers very well, (fasting 80-100), post-prandial on low carb mostly under 130 mg/dl.

Yesterday I started to develop a light cold (no fever), and suddenly my numbers look very different. After eating a small breakfast which included around 1.5 KE), which I bolused for (1 unit Novorapid) my BG has rised after 2 h to 220! (I never have these numbers)
I m very scared because I m new to all this and since I dont use basal insuline yet I am worried that the BG will rise and rise until it gets dangerous! But I am not very form on correction insulin yet--

Can anybody give me some advice on what to do and how likely I will get into dangerous territory? Should I contact my doctor?

1: Don't worry about a number like 220 postprandial. No reason to panic. This is not DKA territory.

2: Insulin needs will likely go up while sick. In some cases I even have to double my doses. Although doubling a single unit doesn't sound extreme to me maybe it is to others.

3: Check bg often and correct as necessary. If you don't know how to do corrections... you may well learn how now. Since your meal doses are so tiny (one unit), corrections will have to start tiny too (one unit maybe smaller!).

4: Very unlikely to get into dangerous territory if you check bg often and correct as necessary. Reading up on DKA and having ketone test strips wouldn't hurt as general background knowledge.

5: My biggest worry would be that a correction could cause a hypo and maybe you don't have much experience with hypos. Again, tiny corrections to start. And maybe no corrections based on 1 hour numbers, but only on numbers further after a meal. Since your pancreas is making the bulk of your insulin needs still, it is very likely that you'd come down from a mildly elevated number like 220 on your own, no need to take extra insulin that might kick in at the same time. If it stays elevated, then it's time for a correction.
5: If your doses for a meal are as small as one unit and all your fasting numbers are spectacularly normal it's real hard to justify a basal.

Thank you so very much for your helpful advice. I guess I m just overly nervous because this is still all fairly new to me. I will follow your advice and keep measuring. So I guess its unlikely that this cold I m having will "jumpstart" me into full blown T1 Diabetes.../finish my honeymoon? it doesnt happen overnight?

Yes you should contact your doctor. How many units of insulin do you use each day? You may not use enough insulin to do a correction with a syringe. Just test again and see if it starts dropping. If you feel Ok go for a walk, exercise will lower your BG. 220 mg/dL is not a disaster 2 hours after a meal, what did you eat and what was your BG before the bolus?

I ate some soy yoghurt with linseed and a kiwifruit, 1 slice of LC bread, had a coffee with milk. I calculated and came to around 1.5 KH and since my "insulin-factor" in the morning is o.5 , I injected 1 unit of fast acting insulin. I measured before injecting and was at 122 mg/dl-

I have now dropped to 170 mg/dl, 3.5 hours after eating. I will try to walk around the block now.
Do you still recommend contacting my doctor?
Thank you for your reply!

ps: my problem seems to be that whenever I do inject bolus (not always necessary because of my LC diet and small insulin requirements) it doesnt seem to affect the post-prandial spike WHATSOEVER- it simply doesnt make a difference when I measure after my meal, whether I had injected a unit or two or not. Only 4 hours after eating I might drop lower with injection than without--in my personal position, I m beginning to ask myself- what good does injecting actually do??

i am type 1 and on the insulin pump. as accurate as it is in helping me control my BSs, there is always room for some unknown high BS. i am shouting out to EVERYBODY because i recently had a flu shot, and 2 days afterwards, my sugars went over 400. obviously i gave myself a correction bolus. but i called my doctor ight away and he was very helpful in making an adjustment to accomodate my D needs. now after a week of rediculously high BSs, i am bk 2 normal. PHEW! so, as U C, it can B the tiniest little thing that shakes your "norm" but certainly no worries over a 220 BS!!!! if i could B that lucky, i'd dance around the block naked. hope Ur cold goes away. as a D, i HATE being laid up and feeling like crap.(and, PS: when we Ds get sick, we tend to get sicker than the regular person. our immune systems R not as strong. so pamper Urself and ride it out. no worries.

I wasn't clear from your post, Julez, do you know how to correct?

thank you zoe for your question.
well, in the course I took at my hospital I kind of got taught how to correct and was given a "correction factor" (dont know if thats a european thing. Mine is 40, meaning that for every 40 mg/dl that I am over my target value (which is 100 BEFORE eating) I would inject one unit of fast acting insulin.
But since I have been having quite a bit of my own insulin production left, I havent really been having to do that..
As far as correcting for "special occasion" such as illness goes, I am quite in the dark. I am a bit confused on what to do there...

If 1:40 is your correction factor, (and you have tested it) that will work to correct whatever is the cause for high blood sugar. So, for example, when you were 220, and wanted to correct to 100 you were 120 over your target, so you would take 3 units to correct. You also can add corrections to your before meal boluses. However if that is just a general number the hospital picked and you have not tested it yet, you should be cautious. We are all different and have different ISF's. Some of us use different ones at different times of the day. For example mine is 1:35 for daytime but 1:60 for nighttime. Start with something more like 1:60 and see how that works a few times and then change it accordingly