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[IP] The basal dose flew over the flu-koo's nest



Hello,

I've been a Type 1 for over 33 years and I've been pumping for almost
5 years. IOW, I'm not a rookie. I'm also fairly well controlled, with
A1C's in the upper part of the normal range.

I live in France, where there was no shortage of flu vaccine. I
received the vaccine, in fact, for free (all diabetics are eligible)
and took it at the end of September.

Nevertheless, I contacted the flu (or a flu-like illness) last week. I
had the classic symptoms: high fever (> 102 0F), stomach upset,
extreme fatigue, cough, aching muscles. The symptoms are now ebbing.

One aspect of this infection surprised me -- the soaring basal dose.
I've seen my basal dose change repeatedly, both before and after I
started using the pump ( see http://tinyurl.com/6ybal ), but my basal
dosage typically ranged between 0.5-1.5 u/hr.

This flu was a *very* different animal. My basal doses peaked at over
9 u/hr. I took over 110 units of insulin today, 10 of which was bolus;
my normal TDD is 35 u, of which roughly half is bolus. My bg was
fairly well controlled today, all things considered. It occasionally
dipped as the basal requirement dropped, and I adjusted the basal
accordingly.

I opted to increase the basal dose after I obtained an excessively
elevated post-prandial bg. Not sure what the problem was, I verified
that the pump was working normally. I changed the catheter, but found
nothing wrong with the site I'd been using. I injected 10 units via
the pen, waited an hour, measured the same thing, repeated the pen
injection, and continued to feel the effects of hyperglycemia. Since
the boluses had no effect, I changed the basal maximum setting and set
the pump to work. I then stayed up most of the night, since I couldn't
be sure how long the basal would remain elevated. (It started
dropping, though quite gradually, at about 5 a.m.)

My theory is that something in this virus reminded my body of what it
was fighting when it first started attacking my beta cells over 30
years ago and my body attacked the insulin in self-defense. As the
virus ebbs, so does the anti-immune response and my basal dose returns
to normal. I admit, it's a flimsy hypothesis, but it's the best I've
got.

IAC, had I not been able to act quickly, I would have certainly
suffered from hyperglycemia for two days, rather than sporadic hypos
that were easily treated.

I don't know if anyone else will see this phenomenon due to the flu
this year. If you do, please consult with your doctor about the best
procedure to take.

And Happy New Year to you all.

regards, Andy
.
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