I just tested at 29.9 (538 mg/dl) after dinner. I tested about four times, including once on a different meter, to make sure I really was that high. (Unfortunately, I was.) I haven't been that high in over a year, I don't think.
I was 16.7 (300 mg/dl) before dinner, and I have ketones, and being this high is just not right, so I think it's pretty likely a bad site. One of those sites that looks perfectly fine (I just changed sites) and has only been in a day. I get those a LOT and it's so, SO annoying. I wish I knew what caused it.
My pump recommended a 13.8 unit bolus, but I bolused 10 units because I'm scared to do 13.8, that's a massive bolus! I bolused with my pump so it would count the IOB but took the insulin with an injection.
One of the few times I don't have much to say other than this disease sucks! I just felt like posting and complaining somewhere. :) I feel weird doing it Facebook because my family and friends wouldn't get it and would probably freak out.
What are we here for if not to be a sounding board when no one else would understand. I was taught to correct with the greater of 25% of my total daily dose or the calculated correction.
Yikes! That's got to be frustrating! I have sort of laid off my usual, center abdomen sites as it seemed they weren't working all that well [although part of that seems to have been my pump blowing up...]. It's sort of awkward but I prefer the easier-to-manage-numbers even though it means dealing with a wierd tube here and there.
I agree that your suspicions of the site are probably the culprit. I would skip eating @ 300. The only time I had to deal with that lately was a trip to LA last spring, I had close, but what I thought was plenty of insulin so I was like "well, this should be ok..." but ran into massive spiking that wouldn't go away *and* ate more insulin than I planned so, by the end of the day, I didn't eat much, like a piece of salami and (black) coffee for dinner. Yuck. That's crafty to do the bolusing and then injecting trick. I would never have thought of that.
I changed sites (the old one looked totally fine, *sigh*) and took a correction with an insulin pen. I will probably test in about an hour to see if it's moving in the right direction. Hopefully it's not one of those nights where diabetes keeps me up till all hours!
I had a pretty low-ish carb dinner (chicken, veggies and dip, cheese) which is part of the reason I think it's ridiculous I'm so high!
The weird part is I actually have moved away from my abdomen as I wondered if that's partly why I've had so many weird highs and site issues (allergies, etc.), but obviously it wasn't that ... My new site is on my arm so we'll see how that works. I think different sites absorb differently which make it even more confusing to figure out. I think I'll ask my endocrinologist about it (sites just failing for no reason, site allergies, etc.) when I see him in January.
Yes it sucks !! I am not sure, if I have done it correctly when HI , called a intramuscular injection .I use upper arm . My choice is not to eat, when over 12 ( x 18 ) and that sucks too till I come down http://www.wisegeek.com/what-are-the-different-types-of-intramuscul... . I think Dr. Bernstein refers to intramuscular injections ? Do I understand as well , to split the shots when needing about 10 correction units ??
The problem is if I didn't eat when over 12 I'd probably be skipping at least one meal per day, if not two. I don't think that would be good ... I think if I could get to the point where I didn't hit 14 on almost a daily basis, not eating when high would be more do-able.
I have heard of IM injections but haven't tried it yet. I only have 8 mm pen needles and I think I might need longer ones. Also, I'm not sure how I'd tell where the muscle was.
I don't eat with highs either, Nel. Just exacerbates the problem. Dr. Bernstein suggests splitting doses when over 5 units to avoid the problem with variable absorption at larger doses.
You don't even eat something low-carb? Tonight I had about 15g of carbs, though tonight I don't think it would have made much difference either way ... no way 15g of carbs should have made me rise by 13.2 (238 mg/dl) points, even if I didn't bolus for them at all.
Two hours later I'm down to 17.8 (320 mg/dl) and just bolused 3 units through my new set (pump recommended 5.8 units but I'm heading to bed as soon as my blood sugar gets down a bit more and don't want to end up crashing).
Nope, I don't eat anything with high BG because it exaggerates the problem. Seems that if we cover the correction & the bolus, it should work. But, we know from experience it doesn't. Large doses are variable in action. BG may be heading even higher, so the correction may not be enough. Add food to the mix & it's a bigger mess. I correct, wait for it to come down & then eat. If it's still persistently high, I pass on the meal.
That makes sense. Unfortunately for me I can't really delay meals and eat later on weekdays, so if I delay a meal it would mean skipping it entirely. I think if this wasn't likely to happen every day I would probably be more motivated to do it when it did happen (even eating a low-carb meal when high is an improvement over what I used to do). I have tried picking a number like 17 (300 mg/dl) that I don't hit as often (maybe a few times a week), and saying I won't eat if I'm that high or higher, but I am usually starving when I'm that high, so skipping a meal entirely and eating hours later is sooooo hard to do, hence eating something low-carb.
I'm so sorry to hear about this, I know you really struggle with these swings. I think taking a manual correction was exactly the right thing to do. Even though the site may look fine, it may be scar tissue or something blocking the insulin and you won't ever see it.
I tried the Contact-Detach sets (same as Sure-T) about a year ago, but for some reason about 50% of them hurt and bled for me. So I went back to Comforts, changing them every two days. It works sometimes, but sometimes my sites still give out early and sometimes they still get really red/itchy by the end of two days. I haven't had as many problems with allergies lately, probably because my other seasonal/environmental allergies aren't acting up as much since it's winter (I think they are all related). I should probably give Contact-Detach another try, though. I think I'll probably ask my endocrinologist about this in January.
My vote is bad site. Bad sites can be caused by a lot of things-scar tissue, the angle of insertion, the absorbsion ability in that area, etc. My very first line of defense for "unexplained" high glucose is changing my pump set without fail.
Someone asked this before and I did not see an answer--did you check for air bubbles? No matter what anyone says about the "O" rings in the insulin cartridge, I ocassionally get bubles large enough to effect my glucose readings, especially since I take really small amount of insulin.
Also, the correction with a syringe is a great thing to do. Let the pump calculate,fill the syringe and inject, clearing the calculation on the pump.
Additionally, if I am over 200, I always bolus more than an normal correction. It just seems to work better for me.
Luckily, after about four corrections I woke up this morning at 7.4 (133 mg/dl). Hopefully I can avoid spending half of today high!
I did check for air bubbles and didn't have any, so I think it was probably the site. I was trying a new location, so perhaps it didn't like that (although it worked fine for the first 12 hours before failing). I already change my sites every two days due to allergy issues (they don't last three days), and I feel like if I changed sites for every random high I'd be changing them every day. I have tried to get in the habit of using an injection if I randomly test really high, though.
I go over 200 almost every day. Sometimes I find I stay high for hours and don't come down, but sometimes I correct and I drop really fast and end up low with IOB remaining. So I don't like giving myself extra insulin, especially before bed, because in the past I've gone to bed still high and woke up an hour or two later in the 30s. Not fun.
I will eat some protein , when HI , to get rid of the hunger pangs ( PB , cheese , left over meat ) .Medtronic pump's instructions are : if BG is over 13.9 ( 250 ) take an injection ..not through pump .I don't wait that long and use a needle ( BD Ultra-Fine 11 , 1/2 unit markings ) correction at around 11 ( x 18 ) . And do what I had suggested some time ago : disconnect infusion set,use act button to let insulin drop freely " anywhere " , deliver correction by needle ; this way a record of IOB is in pump ...I think I read , that's what you do now too ?? ( PS I may be a little behind in following your discussion )
