Covid and type 1 (type 1.5)

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DennyG

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Hi. I am Type 1 and have Covid. I am on Basal Bolus. This morning, I went to A & E, because my B S was 20 (I am normally 7 - 8 and controlled).
My Ketons were at a safe level. I was put on a saline drip.
I was told to increase my insulin, so.before my.dinner, I increased by '4 units'. (150gm Quorn Mince, 3 carbs, 1 unit insulin. 1 Jacket potato 52 carbs, 5 units insulin. Plus 4 units insulin, as instructed. Total 10 units.
I have just read as 19 . Really scared and health care team are so.hard to get hold of.
 
DennyG said:
I have just read as 19 . Really scared and health care team are so.hard to get hold of.
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There are guidelines for how to manage sickness (and I don't think COVID-19 is different except that ketones can occur at lower BG levels than usual): https://www.t1resources.uk/resources/item/sickday-rules-pdf/

(There are lots of very similar flowcharts and things. This is just the one linked from the Useful links for people new to diabetes thread in the Newbies say hello here forum!)
 
Thank you Bruce. I was also only just getting used to a Basal Bolus regime, when I got struck.with Covid. So I could have done without that on top. I also haven't been introduced to any Sick Day Rules by my team, so this is extremely useful. Spent last night scouring Google for answers (no.sleep at all). This forum is worth its weight in gold. Thank you so much again
 
Hi there @DennyG it is most confusing when you are new to T1 and something like this hits you. I had a set of sick day rules a long time ago, which suggested increasing basal (long acting) rather than bolus insulin. I've always found it works for me. I had covid recently and just increased basal by 10%, which kept BGs to mid-teens. To be honest I had been terrified of getting Covid, but in the event it amounted to be not a lot more than a mild cold for a few days and extreme tiredness which lasted a while longer. Here are the DAFNE sick-day rules which are a teeny bit simpler to understand. DAFNE stands for "Dose Adjusted for Normal Eating" - a structured education course in carb counting. Hopefully you will be offered a similar course in the near future.
 
Hi @DennyG , a slight note of caution. If you are on a flexible basal insulin, such as Levermir, then increasing your basal dose temporarily should help; say a 20% increase. But on an inflexible insulin such as Tresiba (taken once daily) then you have to use your bolus insulin to get the adjustment; Tresiba changes take around 3 days to respond. What insulins do you now have?
 
Pattidevans said:
Here are the DAFNE sick-day rules which are a teeny bit simpler to understand.
Click to expand...
Yes, those look much easier to understand, and much more like the ones I was given (at a not-quite-DAFNE course).

There's another list of links to advice here: https://mytype1diabetes.nhs.uk/coronavirus/

(I'm sure some will be "get vaccinated" which is fine advice but not useful while you have it. It's good to see the NHS sick day rules, and those look straightforward.)
 
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Proud to be erratic said:
Hi @DennyG , a slight note of caution. If you are on a flexible basal insulin, such as Levermir, then increasing your basal dose temporarily should help; say a 20% increase. But on an inflexible insulin such as Tresiba (taken once daily) then you have to use your bolus insulin to get the adjustment; Tresiba changes take around 3 days to respond. What insulins do you now have?
Click to expand...
Oops.. I forgot about Tresiba... It wasn't around when I was on MDI (on Levemir) and I have been on a pump now for over 8 years, so even easier to adjust.
 
Well Lantus is nearly as bad Patti.
 
I was on
trophywench said:
Well Lantus is nearly as bad Patti.
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I used Lantus for 12 years and changed it a few times each week due to exercise, seeing the impact the next day.
It's not as flexible as pumping but still worth making the adjustment if you are unwell.
 
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