Sick-day infections, the power of temp basal rates

Two days ago, I came down with a nasty viral infection. I had been having a great trend of overnight BG control. I use a CGM so I'm able to monitor this. Two nights ago, my Dex alarms woke me up to 200+ BGs. Even though I made three high BG corrections during the night, this persistent 200+ high greeted me in the morning.

Since the BG correction insulin doses did not seem to matter, I decided to set a +200% temp basal and see what happened. Over two to three hours my BG flattened out at about 110 and proceeded to travel sideways.

After about 4 hours of this temp basal, I let it time out. What I observed was a slowly climbing CGM line. I decided to forego my usual late morning meal in the interest of keeping my BGs in a good range. That evening, I was able to eat and the post-meal BG line was normal.

Today is day three of this illness and I've been alternating between +200%, +100%, and normal basals, with the majority of time under some temp +basal % rate. My BGs have been controlled very well.

Another TuD member, acidrock, has mentioned his use of temp basals in his bag of tricks. I would have been timid to try the +200% without his experience. I caution anyone interested in trying this out to be extra vigilant monitoring their BGs with a CGM or at least an hourly fingerstick. This includes setting multiple alarms if you run them overnight without a CGM.

It's kind of amazing to me that the elevated temp basal can pull down a high BG when the correction dose doesn't seem to have any effect.

Good job, Terry! Now if you could just push some buttons and cure the nasty virus!

The doc told me last night that I probably wouldn't feel better for six days. Oh well, at least I can expect to feel better in the not-too-distant future. People with a working pancreas have no idea the advantages they have!

Terry, I have been seeing the same effect with carb miss counts for meals as well. I get a better response to a temp basal then a correction.

I'm using a t:slim and a Dex G4, I'm only 8 months into pumping and a year plus from dx but I find the micro delivery helps tremendously with control. It may be because I'm still making some insulin, so I don't need as much to help out, but the slow trickle works better/absorbs better than the big bolus.

Had to drop my rates by around 50% when I changed from MDI to the t:slim.

I have done the basal testing so I know my basal rates are good when I do not eat. And my carb factors are good if I have accurate carb data, and my correction factor checks out as well with defined situations. But when the meal time carbs are a guesstimate a temp basal works so much better than bolusing for additional carbs.
If your pump lets you dial in a percentage and a time frame then go for it for mealtime corrections as well. Especially if you have a reliable CGM that lets you see what your trends are.
I've been able to get my A1C down to 5.5 without lows using this approach, granted YMMV.

When I changed to a lower carb diet almost two years ago, I started to bolus for fat and protein as well as carbs. The fat and protein bolus is always delivered over time with a max delivery rate of 1.2 units/hour. I've had great luck with this regimen.

If I need to make a correction post meal, which is not often, I still use the single correction dose and that works well for me.

You're so smart to make strategic use of the partial help you get from your pancreas. I wish I knew some of these techniques when I was at one year post diagnosis. I suspect that your techniques will extend your honeymoon period. Good for you!