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Increasing bolus with illness

Discussion in 'Parents of Children with Type 1' started by momofone, Jan 25, 2013.

  1. momofone

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    We have this issue every time he's sick, which is fortunately not very often. Sometimes he needs a small basal increase but all bets are off when he eats - he skyrockets and then it is really hard to get him back in range. How much do you increase their bolus amount by when your CWD is sick? I know YDMV but at least it would give me a starting point.:cwds:
     
  2. sooz

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    I'm not sure I understand your question. For us, with the Omnipod, if their bloodsugar had skyrocketed, the pump would automatically give more insulin when it bolused to account for the high. Then the same wold hold true when doing a correction. We have never given more insulin with a bolus than required at the time to anticipate a possible potential future high. It will be interesting to hear other responses to learn more about this kind of situation. I must be having a seniior moment. The more I think about it, the more confused I am getting lol.
     
  3. Heather(CA)

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    Why not increase his bolus if it's worse when he eats :)
     
  4. momofone

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    That was my question - how much do you typically have to increase their bolus when sick? Between meals he's fine but when he eats he shoots up into the 300 range, maybe in part related to the fact that he's still honeymooning a little. I had to just kind of take a guess at how much to increase it but 40% worked. I just took whatever amount the the Omnipod suggested and x it by 40% and override the bolus. I was surprised it was that much. My goal was to prevent him from spiking rather than correcting on the back end. Maybe no one else has this issue, but it is definitely real for us. It's not with every cold but if he's really fighting something off it's a pattern that we've noticed - it's not his basals that need to be increased (for now), it's his bolus. Maybe that's why no one initially answered - no one else sees this?
     
    Last edited: Jan 27, 2013
  5. Sarah Maddie's Mom

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    I just think it's really hard to tease out what is going on when they are sick. They could be high from the illness, the meds, the lack of exercise, or perhaps they are eating differently. When mine is sick ( and she doesn't get sick much so it's not much of a sample) she doesn't eat meals - just some tea here, and bit of toast or crackers, maybe some soup - nothing like a meal so I would probably be inclined to look at it as a basal issue not a bolus one, but if that;s what you are seeing then that's what you are seeing. YDMV
     
  6. Heather(CA)

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    I'm sorry, I realized that then changed my post (On my phone) then I must not have submitted it :/ Let me try this again...

    This works VERY well for us. I only do this for illness because I know why he is running high. I test before meals then 3 hours after. If he is high after breakfast. I will add a unit to lunch.

    So, that is his normal carb ratio plus 1 unit. If he is still high 3 hours after lunch...I give his normal carb ratio plus 1.5 or 2 units depending on how high he still is.... If he is still high after dinner...In the morning I will add another 1 1.5 units depending on whats going on. I do this until he his good at the 3 hours after the meal mark.

    So, if he was high after breakfast AND lunch the first day, he would be getting betweem 2.5 to 3 extra units. Does that make sense?

    Then, and this is very important...At the FIRST low. Put everything back to where it was. Kids get well suddenly as far as D is concerned. Regardless of outside symptoms :cwds:
     
  7. hawkeyegirl

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    We don't really see it. More often when he's sick, he needs less insulin for food, not more. Sometimes when he's sick, he needs more basal, but I can't think of a time when his basal needs were "normal" but he needed larger boluses. I have heard of it though.
     
  8. momofone

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    It's really interesting... He had a cold that didn't affect his numbers at all. He seemed to get better but then all of a sudden got worse and what we noticed first was that he spiked really high after lunch and dinner and woke up the next morning with a fever and a cough that you know just isn't good and said his face hurt. Started on antibiotics and he's otherwise totally fine. The only time he's high is after he eats. Three days later and he's still needing 40% more bolus to keep him from spiking. It will be interesting to see if this totally kicks him out if his honeymoon. We have noticed this a couple of times in the past so I was trying to keep on top of it. Interesting that it seems to be fairly uncommon. I thought it was the norm.
     
  9. momofone

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    We also use a dexcom so we can see the spikes and the normal levels between meals and overnight.
     
  10. Heather(CA)

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    Everyone is different, but it is common to go high with illness. It's also common to have lows with illness. Depending on what's going on, which kid, and which illness lol :)
     
  11. MomofSweetOne

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    We've had illness that caused much higher post-meal spikes than normal, as well as illness that has caused no bolus to be needed. I believe both occurred because of different ways digestion can be affected during illness.
     

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