T Slim/Dexcom Advise

[Adam 48]

Hi all, just after a little advise. My daughter has a chest infection and has been diagnosed steroids. Our GP said they may raise her BG...last night they went up to 22!
To bring them down, we had her inject 2 units with her pen. Then she input 2 units into her pump, but put that bolus down the sink.
Is this the best way while she is on the steroids?
Thank You

 

[Inka]

Hi @Adam 48 Steroids often raise blood sugar. Why did you do the correction with a pen? Is that something her team have told you to do rather than use the pump?

 

[Pumper_Sue]

Why did you use the pen just put the blood sugar reading in the pump and it will work out the bolus for you. The rule of thumb when that high is to increase the bolus/correction even more due to insulin resistance.

You will also find whilst on steroids basal and bolus will increase so set a temp basal and work from there.

 

[Adam 48]

Yes, we remembered that we were told to do this during the Tandem trainin

 

[Adam 48]

Should we have left it to the Dexcom and pump?

 

[Sally71]

The only reason we ever inject with a pen is if we are having cannula problems and want to make sure the bolus is definitely going in. If you are having no issues with the infusion set then you might as well let the pump get on with it. I think you can manually enter extra units into the pump if you need them, my daughter does it all the time, I couldn’t tell you how to do it though!

 

[Lucyr]

I don’t use a pump but I think the difference is, when you are high and it is unexpected or persistent and you think the pump insulin might not be going in then you use a pen to make sure the insulin gets into you. If you are high but the pump is all working fine, eg you are on steroids and know that’s why you’re high, then you can use the pump?

 

[Thebearcametoo]

Are you checking for ketones?

The advice if there are ketones is to treat the ketones according to the weight of the person & amount of ketones (we get given a chart - speak to your team for the info and for support) and to use a pen injection rather than pump so you know exactly what’s gone in and there’s no cannula issue etc. If no ketones are present then putting a correction in via the pump is fine and as has been said it’s likely that increasing the basal is a good idea too. Please get hold of your diabetes team’s out of hours people today though for specific support as both illness and steroids can mess with levels.