Sick Day Help

I haven't been sick in over a year, and when I do get sick it never affects my blood glucose reading....
Now I have a cold. It skyrocketed my BG overnight. I have eaten about 20 carbs today--mostly chicken soup, and am still in the 200-250 range. No ketones. I have corrected with 6 units today so far and it never gets much lower. My average daily insulin totals are around 13-15, and I have already taken over 17 and still have 7 hours to go.

I entered a temp basal for 5 hours--from .325u to 1u, but am still not going down.

Ideas? New pump set up? I appreciate every idea. Thanks, as always

spck, sorry youre feeling rubbish. im not on a pump but have read around here that when they want their bg to come down fast they inject with a needle. possibility? hope you can get your bg down safely and feel better soon!

Thanks for the sympathy. I don't know how to inject 1 unit with a syringe--it is impossible! Sometimes to correction is do you do that? Seriously?

I am on MDI and routinely do single unit corrections. In fact, the very first thing I do in the morning (other than pee) is a 1 unit injection to combat my normal dawn phenomenon. I usually use syringes with half-unit markings, but even with 1-unit syringes there is no real trick to it. Where do you run into difficulty?

I do an intramuscular injection right into my quad. I have little bodyfat there and I just load up the correction and inject perpendicular, then you can just walk around a bit. You can do a 1 unit injection with a syringe, but from what you say, you probably need more. When you are sick, you become insulin resistant. Your normal ISF will not be enough.

A few times in the past I came down with a bad cold and a secondary sinus (bacterial) infection. I also had a large increase in insulin needs with substandard control. Do you have a fever? Even a low-grade one?

If it were me, I would change my infusion site and use a new bottle of insulin, just to be safe. In any case, I would test BGs more frequently. If you go over 300, test for ketones.

Yea, I am overtesting --9 Times so far today, and testing ketones-all negative- every time..well, you know.
Can you give me very specific info about the low dose syringes? I have a physical next week and can a scrip.<

Yes, I do IM injections in both quads and deltoids. No problem.

Depending on the nature of the injection, I use one of the following syringes.

BD stock number 328431 -- 12.7mm needle, 30G, 3/10 cc, 1 unit markings. This is what I normally use for IM.

BD stock number 324910 -- 6mm needle, 31G, 3/10 cc, half unit markings.

BD stock number 328440 -- same as 324910 but with 8mm needle.

Wow! Thanks. I haven't done injections in well over ten years--forget that the tech changes!

Do you find the longer needle is helpful?

Well, it mainly depends on where the injection is going. For subcutaneous injections, I use mostly the sixes because I don't have a lot of body fat. For IM, I use the twelves to make sure the injection goes where it's supposed to.

you don't do manual injections with high blood sugars while on pump? that's standard practice. was told over and over, if you're on pump and can't get BG's down after 2 hours with pump correction and BG's over give MANUAL injection and always carry syringes.

Been on a pump for 10+ years. High readings are unusual for me. I have only injected with a syringe twice in all my years of pumping.

Actually no doctor ever suggested that. I either change my pump set up or just bolus.

down yet?

Got down to 109 by 9:00. Used correction blouses a d a temp basal. Turned temp basal off at 10:00. Continued down until midnight and started to climb again. Woke at 211.

Changed out pump, took a correction and reset temp basal. No ketones.

I have never heard that, either. I can see where it would be beneficial as it certainly can save a pod full of insulin for OmniPod users. The biggest obstacle for me is that I never carry my vial with me unless I'm traveling and I don't see myself changing that habit.

I just accept that while I'm ill, my BG will be higher and save myself the stress that ultimately will raise my BG. Then again, I admit that I'm not an award-winning PWD.

so, you're on the pod, have a failed pod, occlusion..whatever and you don't carry a vial of insulin? at least carry a pen of insulin. if you're a type 1 diabetic, one needs to carry insulin, a vial with them at all times, to either give a manual injection or change out site or pod.

I hear what you're saying, but if I'm at work, I go home (it's happened once). If I'm out, I can go home. If I don't want to go home, I'll avoid eating or be high for a while (or have an adult beverage to bring levels down). Like I said, I'm not an award-winning PWD and I am not as diligent as some, for sure. I can say that I've never been in a situation where not carrying insulin has been particularly worrisome - knock on wood, right?

It isn't that I wouldn't like the comfort of carrying an insulin pen (it would be free for me), but if I always carried a pen of insulin with me, I would have thrown away about 18 unused pens by now. To me, that's just wrong on so many levels.

I appreciate the wisdom and advice, but until something that I don't like happens to me, I'm unlikely to change.

I have a MM pump. If I go out of town and am within 2 hours of home, I go with the current equipment. I have never (10 years) had to make an emergency run home, even though I traveled the state extensively for 17 years, 10 on a pump. I will carry a backup kit and cartridge on business.

I am OCD about my control, but never carry a vial or insulin pen. All that would happen is the pen or the vial expire and I have wasted money. Guess I am too frugal... And have rarely seen a real need to step away from the beauty and wonder that is my insulin pump.

I have given a manual injection, maybe one or two times in the last ten years.... Never saw a need.

I just got over a similar situation, where illness caused high BGs. When my pump correction didn't work as expected, I corrected with syringe, and got similar results. In both cases, BG came down, but I found it to be about 50% effective.
So I set my basal to 175%, for 6 hours, and that helped get back into range. Over the next couple days was able to use 125-150% basal, and bolused about 1.5-2 times normal. Today is the first day I was back to my normal basals/bolus.

I always have syringes on-hand, and carry with me (in my meter case), 'just in case'. I often find corrections to my stomach work faster, compared to pump, and do that when BG is very high, without even trying a pump correction. I use the 30 unit syringes, and use with corrections of 1-2 units. (With my pump, I usually do .2 - .8 unit corrections.)
The only disadvantage of correction by syringe is that IOB is not recognized. So I disconnect and do equivalent bolus from pump to keep track.

I like having a fall back plan of being able to buy Regular insulin just about anywhere (w/o Rx), and having a syringe on-hand if needed. I don't carry insulin with me, other than what is in my pump, so no waste of insulin / pens. In case of pump failure, I've heard you can remove the reservoir, and with syringe get insulin from reservoir. Fortunately, in 15 years of pumping, I've never needed it, but gives me a peace of mind.