I have a sick day question too. Lows, lg ketones,highs this is truly the flu season,

[fortristan]

Tristan (8 yrs) has had db for about a year and a half and we have been sick with one thing or another since. Out of all of the sickies I would have to say this one has been my biggest learning experience. So far I haven't really figured any of it out. We're on mdi humolog and lantus at night. First was the lows like mom of 3 princesses was talking about. We reduced some but I knew what would come next from past experiences (the highs) before those came the large ketones decided to make their appearence (that always makes things fun). So cookies, cake and junk it is. Now I have something new. We're now stage 2 or 3 of this yuk, its more bronchial and fatigue. His bs are erratic. I thought they were starting to stablize but instead the premeal will be a little high, I'll dose him they'll be in target or a little low (70-90) an hour-two hours after he eats. Then it's seems almost exactly 4 hours later he is high 200-300s. Example,
5pm 177bs - 6:59pm 102bs - 9:19pm 253bs. I gave an estimated correcting dose at this point still trying to find what works. Do you have any tips that might help this swing and any other sick day tips or stories I would love to hear. I learn a great deal from all of you.

[Mary Lou]

Hi there --

Call your endo!! They are the ones in the best place to help with specific sick-day care. Here are the protocols outlined for us by our endo:

We've gone through more than the usual amounts of sicknesses this season, many of them with low BGs and large ketones. We are pumpers, but the protocols we're following (that seem to work) are:

reduce basals and all meal/snack boluses by 50% (this was the starting rate, we adjusted it either way, depending on who was sick and how it was going).

Frequent regular-sugar sodas, popsicles, vitamin water, whatever could be tolerated. If there is a choice between eating and drinking -- DRINK! Agian, bolus at 50%. You need to get something into them so that you can give him insulin to resolve the ketones.

Good luck. Stay in touch with your endo/CDE.

[My_Dana]

Hi -

My Dana had a bout of a minor chest infections. This was the first time she has been sick in nearly 2yrs since her dx'd, so not real sure what to expect.

Could have been a viral infection to chest but not sure.

Her only minor symptom was a "crouping" cough, and not too frequent.

But her bg numbers went to the high 200s and some 300s. No lows. We increased insulin to nearly twice her normal daily intake.
As I have read, this is what I would expect when the body is stressed and fighting an infection.

My question is how long have you seen crazy highs? How many days?
We have had such highs for around 14 days, and half that time Dana had no symptoms at all.

Then we suspected the fast acting insulin may be losing potency. Things just didn't ad up. Got a new bottle and her numbers came down to near normal again. Anyone see this before?

Thanks,
Dana's dad
Ed

[wilf]

Tristan (8 yrs) has had db for about a year and a half and we have been sick with one thing or another since. Out of all of the sickies I would have to say this one has been my biggest learning experience. So far I haven't really figured any of it out. We're on mdi humolog and lantus at night. First was the lows like mom of 3 princesses was talking about. We reduced some but I knew what would come next from past experiences (the highs) before those came the large ketones decided to make their appearence (that always makes things fun). So cookies, cake and junk it is. Now I have something new. We're now stage 2 or 3 of this yuk, its more bronchial and fatigue. His bs are erratic. I thought they were starting to stablize but instead the premeal will be a little high, I'll dose him they'll be in target or a little low (70-90) an hour-two hours after he eats. Then it's seems almost exactly 4 hours later he is high 200-300s. Example,
5pm 177bs - 6:59pm 102bs - 9:19pm 253bs. I gave an estimated correcting dose at this point still trying to find what works. Do you have any tips that might help this swing and any other sick day tips or stories I would love to hear. I learn a great deal from all of you.

When BG starts getting erratic, we measure more often to make sure there's not any lows happening.

The pattern you're seeing could be a number of things, but one thing it could be is postmeal lows followed by rebound highs. So next meal try measuring hourly afterwards (step up to every 1/2 hour if he goes below 70) and see what turns up..