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Re: [IPk] infusion sets, and low carbs

Date: Tue, 26 Aug 2003 11:14:30 +0100
From: "Abigail King" <email @ redacted>
Subject: [IPk] infusion sets

>I had very high BGs threough the day, for 2 days last week ( !4 to 22)

>intermittantly showing ketones. I changed cannulae twice, also whole 
new line
>and fresh batch of insulin. Both discarded cannulae appeared fine and
>up increasing basals to 180 percent. Oddly overnight BGs were fine
>percent of normal. As soon as BGs normalised I cut basal to 150 then 
>percent, then down to "normal", and am currently using 80 to 90 % 
during the
day, 100 to 110 in the evening and night.
>To add to the confusion it seems for me  that ketones don't always
a pump
>specific problem like bad set/ leakage. I wonder whether the upset was

>related" or hormonal or a minor infection ( no symptoms) Bizzare
- ----------------------------------------------------------

I find that at least 9 times out of 10, if not more, high BGs for me do
not mean a bad set, but some sort of "stress-related" or hormonal (less
now that I am 54!!) or minor infection. I would waste huge numbers of
sets, and have to stick myself so many extra times, if my first
assumption was a set problem - it almost never is, though of course I
do always try to remember to consider the possibility and examine the
set carefully. Mostly minor infections, some not bad enough that I
would otherwise be aware of them. This happened to me a couple of weeks
ago, had high BGs for several days, and was not sleeping as well as
usual, waking up several times in the night not feeling 100%, but no
clear symptoms. After a few days it finally dawned on me that I had a
urinary tract infection (and I wondered why it had taken me so long to
realize), and after a few days of some antibiotic/antiseptic
medication, BGs returned to normal, and I felt fine. But more often in
my case these undefined minor infections go away without them ever
being identified - in that case my approach is simply pragmatic - just
raise basal rates by 30-40% or more during evening/night (because that
is clearly when it is most needed at times of infections), monitor BG
more frequently if needed, and wait for it to pass.

Regarding low carbs, I must admit, sadly, having started out believing
that with the pump one really should be able to eat anything one likes
and still control BG, and also as a currently ex-chocoholic (I don't
think I am capable of restricting myself a little occasional chocolate,
for me it is either regular chocolate or none at all), that I also seem
to have better control with lower carbs generally. Since I love fruit,
and where I live, the fruit is truly wonderful, apart from a bowl of
breakfast cereal with milk in the morning, I eat most of my carbs as
fruit, which I figure probably also gives me for vitamins etc than
bread or pasta. 
However unlike what other people have written, for me, if I am going to
eat a high carb meal, it is much easier for me to emerge with
reasonable BG if I eat it all at once, and take a large bolus - up to 6
units, possibly with a second smaller bolus after half an hour - if I
eat high carbs spread over several hours that is what is really
disastrous for me.


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