Very sticky high blood sugars - I'd love some advice

awesome! glad things are back to normal!

Running hot would be my way of thinking about running basal up. Sometimes when I correct with insulin on board (particularly "bad insulin" like Maurie is mentioning...which sometimes seems to deploy slowly but sometimes seems to still work...), I'll get a big crash in a while. The basal seems easier to catch, as I can watch the CGM for the BG to start to level out...120-125-132-134-135....and just turn the basal back to normal which, depending on where exactly it is in the basal cycle, generally doesn't seem leave as much new IOB floating around as a correction bolus would. It's sort of "gentler". I probably do these corrections often due to being a lazy carb counter and being off by 5 G of carbs or so so it's not a huge deficit in insulin.

I'd try to use my pump to see what it would calculate but, unfortunately, my BG is 79 right now so I am not "correctable" but a unit bolused vs. a basal adjustment of .7U for an hour, if I kill it at 45 minutes has probably pumpedd maybe .4-.5U so it's slightly finer dosing.

My problem with injections is that I need such a small amount, sometimes less than 1 unit. It is impossible to dose that little with a syringe.

I actually think it was the reservoir rather than the insulin itself but I won't be using the vial again to test the theory. The clue was when my wife smelled insulin and I remembered that in pump training the CDE mentioned in passing that it was important to learn the smell of insulin to catch bad sites. I had already switched out the site and had tested negative for ketones so I was confident that the site itself was OK. The reservoir/insulin was the only other piece. I didn't switch out the reservoir when I had changed the site because I had just started it and had about 5 days of insulin left. Sometimes it doesn't pay to be frugal with supplies.

I am glad things turned out well. However a small point, using a pen or a syringe it is really the very same. The pen is dial insulin, the syringe is pull from the vial. It is six one half a dozen another.

at any rate i am glad it worked out for you.

Rick Phillips

Sorry I did not see your original post until now. I follow a "protocol" when I have stubborn highs. So far, my last step is changing the reservoir and cartridge. I was going to suggest that, but see you already figured it out - good job!

FWIW, do you have an insulin syringe that you could test the insulin with? Eat something that you need to bolus just a few units for, use the insulin from the "bad" vial and a syringe and see what the results are. My experience has mainly been the insulin in the reservoir has gone bad, but not in the vial.

Ug, after replying to this, I'm finding myself in a similar situation. BGs of about 280-300 all day without eating. A 400 overnight. I've got bronchitis and a sinus infection, a nasty bug all week long. I'm on cipro. Confirmed with the doc and pharmacy that cipro should't affect the BG. I just had some light yogurt for breakfast and then a salad for lunch. I thought the sugar was coming down, but checked after the salad and it went from 270 to 300. I've lost about 3.5 lb this week from just not being hungry. But now I'm worried it's the fat burning. I sure hope not. My endo's advice is to test every 4 hours. I'm having moderate ketones when I check. The last time I checked looked slightly better than before. I keep upping the basal and bolusing--I know I shouldn't stack but this is worrisome.

Sometimes when you are ill, there is no cure until the illness is gone. Being a sick diabetic is the worst.

A major cause of problems can be dehydration and low electrolights. They sell no cal "gatorade" which might really help. Flushing your system with helpful liquids and testing all the time (every 4 hours, 24 hours per day) and ketone testing is imperative.

Get a really good book, set you glucose montior and always full glass of helpful liquid beside you, bundle up in warm blanket and relax. Keep checking ketones and relax. Hope you feel better soon, Paul.

Thanks a lot. I changed my pod (omnipod) and a new bottle of Humalog. It's coming down quick now. Appreciate the advice!

Long-term diabetic Brunetta answer to persistent highs: First steps 1) change out the entire infusion set and the resevoir- check blood sugats frequently every 30-45 minutes or so, for two hours.I correct through the pump.Drink a lot of water. Some times like acidrock, I will up the basal, but only to 130% and just for an hour. I do like quick corrections. Need energy and I am not energized at 250+.I am hungry but I fast for AT LEAST TWO hours. Check to see if you are dropping. You may not be in range in two hours, but you should be dropping.;2)Check blood sugar at 3 hours post correction( this is a long process to do safely, that is why I sometimes tend to over-correct, because it takes a loong time to safely correct a high, and I cannot afford the swings back and forth if I am working, busy,3) I correct with the syringe if it is more than 3 hours post correction and I am still very high or rising. I check for ketones.
4) If spilling ketones at a high number, the Last resort is to call the dr. I only have had to do this once when I had a crimped cannula for several hours and wasn't able to change out the set nor inject, as I was away from home without suplies. I was able to get to MY DR'S other office, though sick as a dog, and the MM rep had left an infusion set for me, I changed out and gavE myself an injection there, as thEy had syringes and extra insulin.I will never do that again( leave the house without back-up supplies)

HOPE THIS WORKS. I do have a sick day basal that works most of the time, as well

God bless,