I've been dealing with a cold the last couple days with modest success. I've managed to keep my bg readings under 180 for the most part although I haven't yet managed to break under 120.
I've bumped my basal up to 140%. Do you recommend adjusting your insulin :carb ratio and correction ratio at the same time? If you do, how aggressive are you? I'm not sick often enough to have much experience.
Thanks,
Maurie
Maurie - Like you, I don't face these situations very often and my tactics are hit and miss. I've had good success with raising my basal rate to +100% and then watching my BG closely. I use a CGM but if I didn't have one, I would fingerstick about every half hour. Needless to say, if you get distracted by other events, it could be dangerous to lose attention.
In these instances my BG is usually resistant to coming down so it doesn't drop soon or quickly. Once it starts to come down I back down the temp basal rates to +50%, then +20%, then return to normal. For some reason I have better results with the basal insulin than I do just adding insulin corrections or boosting meal doses.
I don't feel ill and yet my numbers are also consistantly in the 8.6 ( x 18 ) area .I am not wearing a CGMS at the moment , hence upping my basal ( I only use , not the carb ratio ) seems a bit scary ..If I up the basal ( on my Medtronic pump ) I start out with 165 percent ...I have gone as high as 200 percent ...hoping this helps you Maurie and get better soon !
PS giving corrections is not lowering ...I have to do more homework as to " why "
Thanks Terry and Nel. I guess starting basal at 120% and bumping to 130% and finally to 140% was probably a bit slow. However, I changed my site today and about 3 hours later started back to normal. The old site looked fine, didn't bleed and the cannula was nice and straight but it may have punked out after about 36 hours. That's what makes this such a challenge. We may have a problem and it might be medical, might be mechanical and it might be that the diabetes fairy is angry at us.
Good luck with getting a handle on what's going on Nel.
Maurie
Devil's advocate here...
You have lots of germs messing around with you and it affects BG levels. As far as radical basal/bolus changes, I would ask "WHY?" If you were landing at 300 or so, yes, worry. But is under "180 for the most part" really ALL that bad? If you up basals, increase boluses you could easily get low without the usual warning signs.
I know it is a bit frightening when we control strictly, but is it really that big a deal for a few days?
What is the time period for a cold? Seven days, but only the first ones have the germ fest that makes problems. My advice: eat lots of chicken broth and give yourself a hiatus on the BG readings. You know your stuff, Maurie, and you will be fine in a few days.
No advice to give as I never get sick (I always say, "I just get conditions"). Just feel better soon!
Hi Spock -
Thanks for the other view from the other shore - and from long experience. Staying mostly under 180 was OK but staying under 180 for the most part took an increase of my basal to 140% and lots of corrections. Yesterday my total daily dose of 26.95 units consisted of 14.25 units of basal (normal is about 11), 7.60 units of corrections and only 5.10 units with food. I'm pretty sure I would have been close to 300 without all those finger sticks and corrections.
The finger sticks were the most maddening. My accucheck meter seemed incapable of giving me readings with less than a 15% spread. I probably poked myself close to 30 times to get 10-12 readings.
I wish you a happy and healthy new year,
Maurie
Good to read you're back to normal.
I don't get sick a lot but had a bizarro flu situation yesterday, or maybe 10:00 PM the night before and most of the day yesterday. Junior threw up the night before last and Mrs was so horrified I cleaned it up, without my Walter White saftey gear. Big mistake. 2 hours later, my own GI "eek" started for 5-6 hours.
The next AM, my BG was pretty elevated but I was totally wiped out, laid in bed until 10:00, could tell from CGM I was running up and did correction boluses and redlined my basal at 200% but, when I got up and went downstairs, was still like 220 or 250 or something horrible so I corrected again and felt like crap and went back to bed for another couple of hours. Then I woke up at 2:00, still miserable, maybe 220 or so, so the correction was working but not very well, I'd shot maybe a correction+ 15 G of carbs too, as Mrsacidrock left 1/2 a cheese sandwich for me. The achyness was in my knees and elbows, which was weird as while my knees are sore w/ the running and stuff, I never have had any elbow issues so I figured "what the hell..." and dropped a Celebrex and went back to bed, again correcting and maybe 15-25U bolus or something, perhaps risky but I was feeling hungry. By 4:00ish, the Celebrex had made me feel much better, I went down and was still up, like 140-150 but I had like 3U on board and still redlining so I ate the sandwich and was relieved I didn't throw up immediately. BG stayed around 140 and I kept bolusing and ignoring IOB while doing to to try to get it down, it finally dropped and I ate another cheese sandwich, figuring I didn't want to take chances. Things have been fine today but yesterday was "ugh". I shot like 47U whereas normally I run maybe 37-42 but I also usually eat 100-140G of carbs and had about 30 yesterday which was very unpleasant.
Yeah, I do both, but it's sort of a guessing game.
and what is up with Tu D ?? ..I had to " sign in " and remember all the stuff ...not impressed !!!
Maurie a challenge it is !!! , I go through this roller coaster thing ...keep thinking : " it's the insulin , site of infusion set etc. " and without doing anything next BG is around 3.8 ( x 18 ) ...and then HI again ...poking finger very regularly is the only way for me to keep this life's balance .
Let us all not give in and up !!!
I had another up and down after I wrote my last post. Started a dinner that I eat often at 86, tested at 4 hours and was 180. Corrected and walked up and down the stairs for half an hour. Of course, I didn't back off on the correction which was a mistake. Ended up at 54.. glucose tabs etc. and was fine over night.
That last HI after getting back to normal is a kicker. You can't quite tell what to think.
Glad you're feeling better. Just remember this story so you can tell it to Junior when she says that you're not good to her :-)
Maurie
I really am an alien: "the other view from the other shore." :D Missed all the preliminaries.
As an alien..who is trying to adjust a bit..I understand the concern. Hope you are much better, Maurie.
I tend to crash after a full blown assault on high readings. Hope you do better! Happy New Year!
I always get nervous about doing that. Usually I cross my fingers and make about a 10% adjustment at most. Beyond that I watch what I eat / drink and try to keep BG within "reasonable" numbers. In the short-term I worry more about getting better than diabetes. Probably not the best approach but I don't get sick too often and the doc signs off on the approach.
Mike
"Hoping this will help with this discussion too ...I posted it in our friend Jen's discussion http://insulinnation.com/treatment2/cure-insight/research-corner-no-longer-playing-the-a1c-blame-game/" it gave me comfort !!
Ever since I've been diagnosed since 2000, I have never been sick, even when I intentionally bypass flu shots....