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Re[IP]Problems with My Pump

David W. said...

<<Recovery from that extended (presumed) ketosis
will require more insulin than calculated for
correcting a usual "ate too much" high.
Somebody here (Barb?) suggested fully half(?)
of one's "daily total dose",
plus both fluid and carbohydrate.>>

Actually, you might need about 20% more than you would use for a usual 
correction dose. Always check with your endo/CDE team about what to do and 
how much insulin to correct for a stubborn high. 
Basic rules: If BG >240-250, times two consecutive BG tests, and you know of 
no other reason for the high (underbolus/miscalculated, set/site absorption 
problem, illness), test urine for ketones (or blood, if you have a meter can 
check the blood ketones), correct for the high BG by syringe dose using your 
correction formula, increase fluids...2 LARGE glasses on non-calorie fluid... 
and check BG and ketones in 2-3 hours. You will likely need more insulin.  
Assume it is a set/delivery problem and CHANGE IT!  If you have to change the 
set at bedtime, set your alarm and check BG in 2-3 hours to make sure 
everything is working fine.  It is much better to make small corrections 
every 2-3 hours in THIS situation, than to overbolus and have a WHOPPING BIG 
low BG later.

If you have an illness, the directions are basically the same, but there is a 
lot more to add. Again, YMMV, so ask your team for "Plan B" and "Plan C", for 
potential problem situations. 

Hopefully, your problem situations will be small, infrequent ones.

Happy pumping!

Barbara A.
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