sick day rules.

[pippaandben]

I started insulin injections last Friday ( 10 units Humalog mix 25 before breakfast and dinner). Had first follow up last night. She could not answer my question about sick day rules eg what do I do if I am sick after injecting and having breakfast and/or diarrohea. She looked on her computer and then just said contact surgery or emergency number if out of hours.

She is on holiday now for 2 weeks and I can't help feeling it would be sods law for me to get sick now!!

I am obviously still getting used to what effect the insulin is having but I have already found that I have to have carbs 4 hours after breakfast - if I wait then Bg goes into the 4s, and then 4 hours after that. Also have to be careful about doing anything that I wouldn't normally think of as strenuous but makes me slightly out of breath - like carrying heavy shopping. Light gardening . So far wobbly legs and a shaky feeling inside my chest have prompted me to test and found in the mid 4s and once 3.6 which I am now not so panicky about and can rectify with jelly babies or glucose tablet.

Any advice please - just so I know exactly what to do for myself and when to call for help. (My first low reading over the weekend I called emergency number and Dr called back over 2 hours later - by which time I think I could have been in a coma if I had not taken glucose tablets - too many cos I went up to late teens but I am still here!! - so not too happy about relying on them)

 

[everydayupsanddowns]

Hi p&b

Maybe this will help? http://www.diabetes-support.org.uk/info/?page_id=141

Or this? http://www.diabetes-healthnet.ac.uk...ype 2 Patients on Insulin - update Jul 10.pdf

 

[PattiEvans]

I am obviously still getting used to what effect the insulin is having but I have already found that I have to have carbs 4 hours after breakfast - if I wait then Bg goes into the 4s, and then 4 hours after that. Also have to be careful about doing anything that I wouldn't normally think of as strenuous but makes me slightly out of breath - like carrying heavy shopping. Light gardening . So far wobbly legs and a shaky feeling inside my chest have prompted me to test and found in the mid 4s and once 3.6 which I am now not so panicky about and can rectify with jelly babies or glucose tablet.

It sounds like you are on a dose which is just slightly too high for you. Having said that, mixed insulin is a pig to titrate and you do have to have snacks between mealsand eat meals at set times with a fixed amount of carb. I was on it for 9 months right after diagnosis, couldn't wait to get onto MDI.

Rule for hypos is 15g fast carb, wait 15 minutes and test again. If over 4 and a meal is imminent then that's fine, if still under 4 have another 15g fast carb. In my experience I always had to have a snack of slower acting carbs unless a meal was going to be in the next 15 mins.

The first link Mike has given you only deals with basal/bolus regime but the 2nd one is quite helpful. There's not a lot you can do on mixed insulin except keep on taking it and drink full sugar drinks to replace food. I had a nasty case of sickness and diahorrea whilst on mixed insulin and got through it fine by drinking full sugar coke. Evidently I digested enough to not go hypo, but it was scarey.