Stomach flu, lantus vs pump

[twodoor2]

If you get the stomach flu with lantus, are you less likely to get ketones than with the pump? Sorry, more pump vs lantus questions again!!

[Amy C.]

Ketones are caused by the sickness and more insulin is needed. The pump doesn't stop giving the basal with the flu stops any more than the Lantus stops being effective.

On Lantus, the insulin comes in more shots of short acting. I never raised the Lantus because I didn't know when the sickness would ned.

With the pump, I can give high temp basal and end it when he is healthy, in addition to the extra bolus insulin to get rid of the ketones.

[Momof4gr8kids]

Ketones are not from a lack of insulin only. Ketone levels happen when your body is burning fat for fuel instead of carbs. If you have high bg and a high ketone level that usually means you need more insulin.
With the stomach flu most people tend to go low, specially when vomiting is involved. These ketone levels are from lack of carbohydrate to burn. They require carbs, and the right amount of insulin (not more, or extra).

I think ANY illness is easier with the pump. You can easily increase basal rates, or reduce them at the drop of a hat as needed for illness, exercise or anything else that would cause a basal issue.

The only reason people do not go into DKA as often with lantus is because the set can't fail. Here's the thing though. Most people catch failed sites long before DKA hits, and are able to reverse because they check bg often. If you're not checking bg, then yeah, DKA is a risk, but it's pretty risky not checking your bg with either. Also, Julia has not went into DKA once from a failed site. She's only ever even been near DKA once, and it had nothing to do with the pump.

It sounds like Lantus is working well for you, and that youhave a lot of concerns/fears with the pump. The fears/concerns are pretty common, but if you're not ready you can always put it on hold.

[momtojess]

When we had the stomach flu on lantus we ended up in the hospital for 2 days. The time she had the stomach flu on the pump, we got through at home.

Ketones are caused by the illness and require more insulin. With the pump, you can raise it by 10% for a few hours. With lantus, you can give an extra 1/2 unit, but that is gonna work for 24 hrs regardless if the ketones are gone before then.

Even colds, fevers, etc seem easier to me on the pump mainly cuz if you chang the basals, you can change them back after just a few hrs, vs lantus being for the whole 24 hrs

[Kaylee's Mommy]

I'm sure it depends ON the kid but when Kaylee was on lantus we hardly ever saw ketones, we do see them more now.. but it may also be that when she was on lantus she was honeymooning and by the time she went to the pump she wasn't honeymooning much if not at all.. the one thing with the pump is that if a child is throwing up and you disconnect the pump to help with the bg.. if they are lantus, you can't take that lantus back and you may have additional problems with lows.. you obviously wouldn't want to go without the pump very long.. but in the short term you can quickly stop the pump..we had to do this when K was 32 and wouldn't come up.. we disconnected the pump so all insulin was stopped.. except for what was already active.. she wasn't reconnect to the pump until her BG got above 100.. with Lantus that would have been hard to do..

[Lee]

I think that the pump is better with the stomach flu. The scenario is you gave your daughter Lantus with supper. It is 3 am and she is vomiting non-stop and keep anything down.

So now, you have this long term Lantus acting to keep her BS down, when all you want to do is get it up so you can give insulin for the ketones caused by the stomach flu.

With the pump - you just take it off and there is no basal (long acting) fighting against you trying to get those #'s up.

Oh, and in the summer, there isn't much talk of stomach flus - this is just the average kid getting sick during the winter thing...

[funnygrl]

If the pump is working properly, I don't see why you would be though. If it isn't though, watch out.

[Nancy in VA]

Emma seems to easily get starvation ketones - not from a bad site but from the illness. She seems to need a LOT more energy to fight the bug. I don't really know if she had them while on Lantus because, honestly, I rarely checked ketones. Since you aren't concerned about a "bad" site, you usually just treat the high and be done with it. And how many people check ketones with a LOW - but often that's when you see starvation ketones.

I don't know how much more you are prone to ketones when you are sick - but I think your pump protocols help you find them easier and quicker.

I honestly couldn't have imagined going through Emma's sickness in Oct without a pump. We were feeding her and dosing her with insulin every 3 hours all night for 5 days because she needed the food for the extra energy and she needed the insulin because of the food. At one point I think she had 9 or 10 boluses in one day - nightmare with injections.

Like others have said, I personally think if your big fear of the pump is ketones then you need to just give it a shot and try it out - try everything the pump has to offer before you jump to the "Untethered" approach - you can always "back off" to Untethered. But, like others have said here - if you cannot get your child to eat and you are running consistent lows with ketones - the ONLY way to clear the ketones is with insulin and you can't give insulin with the Lantus already in the background if you can't keep food in.

[Twinklet]

That probably depends on the child. It seems that the smaller ones on this board get ketones frequently. Emily is a bit older, but she has never had ketones--not even at diagnosis. Yet (I know it will happen someday!:rolleyes:).

If you stay on top of checking BG, ketones shouldn't be a huge problem.

I can't really speak for GI illness because we haven't faced that since diagnosis yet, either. I'm hoping the pump will actually help with it--I can raise or lower basal rates to accomodate whatever we need.

[miss_behave]

Illness is so much easier with the pump. You can increase/decrease basals, set temporary basals and even stop basals altogether. Using the untethered method whilst on the pump decreases the benefits pumping has over injections IMO.