My son has his first illness since being on the pump and I’m wondering how frequently it’s prudent to increase his temp basal to deal with the accompanying high. For general changes, we like to give a change 2-3 days before evaluating whether it worked, but, obviously, with an illness, that doesn’t make sense. He’s not sick enough to stay home from school - it’s just a cold - no fever, just feeling a bit crummy.
He ran around 200 all day yesterday at his normal basal rate. He did corrections throughout the school day but didn’t adjust his basal. We increased to +20% last night and he ran around 130-140 through the night and this morning before school. We bumped his basal up to +30% before school this morning and we’ll see how that goes.
So, for a minor illness, with what frequency does it make sense to adjust the basal? When you recover, do your basal needs generally go back to normal gradually or rather quickly? Do you tend to have a similar response from illness to illness, i.e. do you know “I’m catching a cold, I need to increase my basal by 50%” or is it different for you every time?
If I am running BGs like you describe, I will generally up my basal to keep the BG stable. I take less than 20 units per day, so small changes (.7 to.9) make a big difference. I think the answer lies in his total daily basal amount.
The only time I have run high while on the pump (about ten years) is when the doctor gave me steroids. Within an hour of the first dose, my BG skyrocketed. I usually do not have much of a problem with a minor illness, but we are all different.
I had a horrible flu a few years ago. Could not eat, even drinking water, etc was hard. With my pump I stayed steady through the illness. Good basal testing, I guess.
My experience with colds in other PWD is that the need for upping the basal drops as suddenly as it came. So hopefully, he has hypo awareness, or tell the school nurse to monitor FREQUENTLY. It's different every time, no similar response. I personally don't like living with an upped basal.
For a minor illness, such as a cold, it doesn't make sense to increase basal except for a day or two. Then decrease the percent.
The only time I have seen it possible to know that one must increase basal is for prednisone, and I always recommend doubling the basal for two weeks, then pulling it down gradually til 4 weeks. Then dropping to normal.
I was hoping more people would reply to this as I am having my first cold since diagnosis now and was looking to hear about other people's experiences.
I've had to increase my basal rates by about 15% or so (I used temp basal). It seemed like my BG started going up the day before I felt the cold symptoms. Now as it is starting to resolve I am not having to use the temp basal increase.
We’re up +50 on my son’s basal rates and seeing how that goes today. He was at +40 last night and this morning and still running about 130 fasting. He was at +30 at school yesterday and ran about 200 all day. His needs went up the day he started feeling sick.
I heard back from our CDE and she said typically +10-30% works to keep the bg numbers in range. She said generally, the needs return to normal as quickly as the increased needs came on. So, my son is testing a lot, we’re testing him during the night, and we’re letting him run a little higher over night than what we’d normally like to see. He feels his hypos, so we’re not too worried about being more aggressive during the daytime hours.
