Illness whilst on the pump

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AJLang

AJLang

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Relationship to Diabetes
Type 1
I started going high on Monday night (up to 20) and thought it was the pump although I felt very nauseous and last night I went up to 20 despite not having eaten anything since 3pm yesterday. Today I woke up at 10 after correcting the 20 but despite corrections, which would normally work I can't get the bgs down as easily as I would expect. I do feel very sick and I'm relying on my anti nausea medication much more than normal. I've now had my temporary basal rate at 150% for four hours and that has got BG down to 7. I have set the TBR for another two hours but wasn't sure whether to continue with it during the night. Any suggestions as to what you would do please?
 
During illness I tend to either run a TBR overnight (and wake to test if I'm unsure as to whether the level might not be right in either direction)

Or...

Since Artoo bleeps and warbles Every. Single. Hour. during a TBR (and I value not only my sleep but also Mrs Eduad's sanity) I often calculate the insulin which would be delivered by the whatever% during those hours and administer it as an 8 hour square wave bolus when I go to bed.

Hope you feel better soon. Sounds like you are coping admirably with your first post-pump illness. With all these things the learning curve is always steep until you've been through it a few times - just like it was on jabs 🙄
 
Hi Mike thank you for your comments🙂 I will go with the TBR option because mine doesn't alarm until the set time for the TBR runs out - but when that does happen it is all singing and dancing. Due to the gastroparesis I will already be using the multiwave option so I'm bit cautious about increasing that for overnight because if I have to turn it off for a low BG then it will affect the insulin that I've given for my meal. This is fun🙄 I'm reassured that you also increase your doses overnight when I'll, thank you for the reassurance
 
Hi Amanda,

I would set a TBR for four hours or so - and then test and be guided by the numbers I find. I know its not ideal when your feeling ill - but as I am the one who does it all for Alex (when he is asleep) its a bit different.🙂 Eduad - thats a good tip - I never thought of doing a square to stop the beeping - but then I dont really hear it as Alex is in his room and he doesnt notice it - but worth knowing for future as it does sometimes get annoying. Also - dont be afraid to increase to a higher %. We were quite worried about doing this until one time when Alex was quite ill and we ended up doing an 800% TBR!😱🙂Bev
 
Thanks Bev. I guess it is a trade off between getting a good night's sleep to aid recovery and keeping the bgs ok. What a dilemma. 800% TBR sounds very scary. I managed to get my BG down to 4.2 after three morning bolus shotsfollloeedd by 6 hours of TBR at 150% this afternoon so I'm now not sure what to do to keep it at a reasonable level tonight. I guess it will be increased TBR and a midnight and 3am blood test😱
 
Hi Amanda,

Do remember that if your basals are different then you need to keep a close watch on TBR's as 150% of a higher basal can make a significant difference if the 'normal' basal is a lot higher in the first place. Not sure I have explained that very well! I just mean if your basals differ a lot then keep an eye on things!🙂Bev
 
800% is awesome. I am testing all the time when I hit 130%
 
Temporary Basal Rate on a pump, when you need more or less basal insulin temporarily for a specific reason but don't wish to make a permanent change.
 
bev said:
Hi Amanda,

Do remember that if your basals are different then you need to keep a close watch on TBR's as 150% of a higher basal can make a significant difference if the 'normal' basal is a lot higher in the first place. Not sure I have explained that very well! I just mean if your basals differ a lot then keep an eye on things!🙂Bev
Click to expand...

Thanks Bev I've done a midnight test - and despite the TBR have gone up to 12.4 - the bolus wizard suggested 1.4 units so I've had that - hope that it will now get lower with the bolus, TBR and multiwave!!!
 
Something is definitely wrong 3am 16.4so had more bolus. 8.9 this morning. Still feel Ill so have increased the temporary basal rate to 200%
 
AJLang said:
Something is definitely wrong 3am 16.4so had more bolus. 8.9 this morning. Still feel Ill so have increased the temporary basal rate to 200%
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Hi Amanda,

Well done!:D I know it takes a bit of courage to increase the TBR - but you are getting the hang of things quickly. I know 200% sounds a lot - but if you work out the 'actual' amount of extra insulin your having it isnt really that much - I think it just sounds more when you think of it in terms of %'s. Although its annoying for you - all this practice at TBR's means that you are getting more and more familiar with your own body and pump and that is priceless.🙂Bev
 
Thanks Bev. You're right the practice is good and thank goodness that I'm doing it now rather than at Christmas. I'm also seeing the pump nurse on Monday so I will have a good range of experiences to discuss with her! TBR of 200% plus a bolus correction has got me down to 5.2 - hooray - that certainly gives me the confidence that I am doing it right and the confidence to alter things during the day if it climbs again - but yes it was scary to begin with, especially during the night. Thank you very much for all of your help,.
 
AJLang said:
Thanks Bev. You're right the practice is good and thank goodness that I'm doing it now rather than at Christmas. I'm also seeing the pump nurse on Monday so I will have a good range of experiences to discuss with her! TBR of 200% plus a bolus correction has got me down to 5.2 - hooray - that certainly gives me the confidence that I am doing it right and the confidence to alter things during the day if it climbs again - but yes it was scary to begin with, especially during the night. Thank you very much for all of your help,.
Click to expand...

Good that you got it back in range and had the confidence to try new methods...well done! 🙂 Wondering though if you need much more basal generally, it might also help with your gastro probs?...maybe worth trying and if you get hypos change it back again?
 
Hi Phil

Thanks for the suggestions. The BGs were running smoothly over the weekend and on Monday I went 20 hours without eating to check the basals - overall they were good but I needed to do some increases from 12-3pm but it then started going up after that - but I've also been feeling unwell. As soon as I start to feel better I'm going to check the night time basal, hopefully on Monday
 
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