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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.
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