very high - please help

[Natalie123]

I am now 20.8. I went up to 15.1 after breakfast because my ratios have been dropped when I started the pump from 1 unit to 1 g carbs to 1 unit to 10g carbs. This is a 90% decrease and obviously didn't cover my food. I have corrected twice with the pump, but they reduced my correction dose too so that isn't working.

I have given a correction with my old pen now to try to bring it down and have left a message on my nurse's answering machine. I haven't had luch yet because my dose at lunch has been dropped too so I will only get higher.

I feel really unwell and don't know what to do. If I eat a salad and some tuna or cheese for lunch ie no carbs will that be better than eating a normal lunch?

Any suggestions of what I should be doing? I have changed my canular although I don't think it is that

Sorry for the long post and for posting rather a lot at the moment! Thanks for reading

Natalie x

 

[Northerner]

Goodness, those do seem to be drastic changes. I am sorry you are having problems - I hope the DSN calls back soon! I don't know about pumps, but can you put a temporary basal on that is higher than normal? I've heard others talk about TBR of (for example) 200% when they are high?

 

[everydayupsanddowns]

Hi Natalie

Sorry to hear you're going through this in the first few days of pumping

These were the guidelines my DSN gave me when I started:

First test over 14 - test for ketones,

If no ketones correct via pump

If ketones correct via pen, full set change, take fluids etc.

If next test still over 14 - test for ketones again and full set change if you haven't already. Assess whether additional correction will be needed based on timing of correction (remember that if you have injected with pen your pump's 'Insulin on Board' will not be accurate).

Not sure whether that's standard advice or just what she likes her pumpers to do.

Just to reassure you I also had all my doses/ratios/sensitivities adjusted in the early days (by about 50% in some cases) and they did work with just a little tweaking.

If your bolus rates have been altered as much as you suggest I would steer clear of any significant carbs until you've had a chance to talk to your DSN. Or (if it were me) I'd go for a mid-point ratio and keep an eye out for hypos.

M

 

[Copepod]

While you're waiting for DSN to phone back, you could try phoning NHS Direct on 0845 4647 - while they may not be experts on insulin pumps, they might be able to point you in the right direction towards sources of specific help in your area.

 

[Natalie123]

Thanks Mike. I am going to copy your guidelines onto my desktop for now as I haven't been given any guidelines! I don't have ketone strips for a blood meter but I do have the ones you wee on, are they ok?

 

[everydayupsanddowns]

Thanks Mike. I am going to copy your guidelines onto my desktop for now as I haven't been given any guidelines! I don't have ketone strips for a blood meter but I do have the ones you wee on, are they ok?

Those are the ones I was given. They react more slowly of course, but should do fine.

 

[trophywench]

Natalie - if DSN doesn't call back very soon, I can put you in touch with the ones at Rugby if you want.

I'd do what Mike said incidentally. In the meantime go 1u to 5g.

You can get into a pickle where you take too much insulin and it's all counter-productive, and this might be what your DSN thought with your ratio being 1u to 1g and decided to correct it in one fell swoop. But she's making you do the equivalent of going 'cold turkey' for a crack addict!

Hope you feel a bit better soon.

 

[Natalie123]

Thanks Jenny, I'm now down to 14.4 and she normally phones back quickly. If I don't hear back I will have to change the ratio tomorrow morning, I can probably get by this evening because my old ratio was 1 unit for 3 g so not so much of a change