- advertisement -

Stuck high - any ideas?

Discussion in 'Parents of Children with Type 1' started by dqmomof3, Jun 30, 2009.

  1. dqmomof3

    dqmomof3 Approved members

    Joined:
    Dec 29, 2007
    Messages:
    2,778
    I know the obvious answer...duh, you need more insulin. But I'm in a quandry over this one. I can't get her bg below 300. We've been there close to 18 hours now with no end in sight. I have changed reservoirs, tubing, pump site, given four units of Humalog by injection, doubled basal, no change.

    What would cause this resistance?
     
  2. Adinsmom

    Adinsmom Approved members

    Joined:
    Sep 12, 2006
    Messages:
    2,995
    We were just caught in one of those. :( I just couldn't get Adin's bg to go below 275 for anything. I finally decreased his Lantus a half unit and it broke the cycle. It has gotten hot here and between the extra activity and heat his basal was too much. Weird but true.
     
  3. hawkeyegirl

    hawkeyegirl Approved members

    Joined:
    Nov 15, 2007
    Messages:
    13,157
    Have you tried a new bottle of insulin?
     
  4. StillMamamia

    StillMamamia Approved members

    Joined:
    Nov 21, 2007
    Messages:
    13,195
    Have you checked for ketones?

    I would ramp up a temp basal for as long as it takes. Maybe do another injection correction as well.

    If all else fails, change the site with a new vial of insulin.
     
  5. dqmomof3

    dqmomof3 Approved members

    Joined:
    Dec 29, 2007
    Messages:
    2,778
    Negative for ketones, and I'm using a brand new, just opened bottle of insulin. Gave last injection at 3:15, so I'm waiting until around 6 to do it again. I have her basal set at 200%...150% didn't work.
     
  6. Scribe

    Scribe Approved members

    Joined:
    May 26, 2009
    Messages:
    178
    sometimes it just happens and you have to ride it out. there are all kinds of subtle things that influence BGs and even when you do absolutely everything right you get these anomalies.
    but it's frustrating.
    it happens to me about once a year (last two times when i was at my inlaws. i'll refrain from offering any theory beyond, go figure) and when it does, i lay a heavy thumb on my pump and get very aggressive; bolus like crazy, eat very carefully, test more than usual and see what happens.
    it usually plays out after a day.
     
  7. Becky Stevens mom

    Becky Stevens mom Approved members

    Joined:
    Oct 14, 2008
    Messages:
    8,719
    Those stubborn highs! the poor kids become so insulin resistant when they are high for a long time it seems to take gallons to get em back down again I would just keep giving her shots every few hours to see if itll come down and lots of water too that may help. Any signs of illness?
     
  8. dqmomof3

    dqmomof3 Approved members

    Joined:
    Dec 29, 2007
    Messages:
    2,778
    No signs of illness that I can see.

    Thanks for all the suggestions...don't mean to sound unappreciative! :)
     
  9. GAmom

    GAmom Approved members

    Joined:
    Jul 12, 2008
    Messages:
    787
    FWIW my dd gets extremely high BG's a couple of days before she becomes ill, it can be a little cold or nasty virus. She seems fine until a few days later when the "bug" shows up.
     
  10. 2type1s

    2type1s Approved members

    Joined:
    Nov 23, 2008
    Messages:
    1,438
    I hear ya! Zoe's been in the 400's since 3:00. I have changed 2 sets, corrected 3 times, increased basal...now I'm waiting for the next check so we can go to bed...hence, that's why I'm up!
     
  11. Sorcha

    Sorcha Approved members

    Joined:
    Jun 30, 2009
    Messages:
    14
    We've been there a time or two - once I've checked EVERYTHING (like it seems you have already), and know it's not the site, the insulin, etc., I found it did just take a LOT of insulin to bring the numbers down. It was scary, because it seemed like so much insulin, but surprisingly it took the whole lot to finally get back to target.

    Wish I knew why it happened, but there are just so many variables it can be impossible to tell. Thank goodness it's a rare occurrence!
     
  12. carrie1berrie2

    carrie1berrie2 Approved members

    Joined:
    May 14, 2009
    Messages:
    56
    Tylors was like that last week and I made just a few basal changes and it seemed to work a little better than was super high for like 3 days so I increased ALL his basals .05 and for 3 days his sugars were all perfectly on target except 1 I think, they are high again so will see how tomorrow goes and maybe make some more change. Since he was high ALL the time it just made more sense to increase all the basals and was so glad it worked. Good luck!
     
  13. Heather(CA)

    Heather(CA) Approved members

    Joined:
    Jun 18, 2007
    Messages:
    10,153
    If this happens to us I do one of two things...If I think it's a rebound, I either just stop correcting and he comes down eventually, or I stop giving full corrections and just give a partial correction. That will bring him down too, but you have to watch them so they don't crash when the body takes the glucose back. If it's a meal I add everything up then subtract 1 unit. If she's still high at breakfast I suggest you try this, It can't hurt to try it since she's not coming down the way it is now...:(

    If I don't think it's a rebound I give a bit of a super correction, like whatever I would normally give plus an extra 1 to 1 1/2 units. Then watch to make sure he doesn't go low. :cwds:
     
  14. StillMamamia

    StillMamamia Approved members

    Joined:
    Nov 21, 2007
    Messages:
    13,195
    A couple of more thoughts.

    Sometimes the basal just needs to be increased all around, so we just have to go with flow on that.

    And....p.u.b.e.r.t.y. knocking???:eek:

    In either case, just keeping increasing the basals until you find BGs are better.
     
  15. Darryl

    Darryl Approved members

    Joined:
    May 8, 2008
    Messages:
    4,313
    Jen,

    What amount of bolus and basal have you been giving?

    For us, it takes up to 1.75u/hour for 2 to 6 hours (typically) plus several 1u boluses
    to keep persistent high's down where we want them. Just asking because a 200% temp
    basal would be nothing for us - a 1.75u/hour temp is 700% the normal basal.
     
  16. saxmaniac

    saxmaniac Approved members

    Joined:
    Jun 1, 2007
    Messages:
    4,057
    200% might not be enough. I agree with Darryl.

    Alex's night basal is around .25u. Just the other night I needed to hit 0.8u/h to break out of a stubborn high.

    Our protocol is this: for stubborn highs, if they don't begin working obviously after 2 hours, then I move up the basal one more increment, and reissue any correction. Check again in 2 hours.

    Fortunately, the omnipod has temp basals that can be set in fixed (u/h) or percentage. When things get bad I move over to the fixed.
     

Share This Page

- advertisement -

  1. This site uses cookies to help personalise content, tailor your experience and to keep you logged in if you register.
    By continuing to use this site, you are consenting to our use of cookies.
    Dismiss Notice