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Re: [IPk] high BGs, ketones etc very long



----- Original Message -----
From: <email @ redacted>
To: <email @ redacted>
Sent: Thursday, June 19, 2003 9:23 PM
Subject: Re: [IPk] high BGs, ketones etc very long


> In a message dated 6/18/2003 10:03:38 PM GMT Daylight Time,
> email @ redacted writes:
>
> > high bg ( 18-20) in the past 2 months, vvith
> > moderate to high ketones
>
> Hi Abi,
>
and lots of exercise on top of a high bg is another
> cause.  I have particular problems over lateral abdomen but I have to use
it
> because I have so few usable sites).

The most frustrating thing is tha tBG came dovvn vvith a bolus and excerices
but  up again and ketones 2 hrs later, so there as  obviously some insulin
getting through after I changed cannula unless I still had just enough left
in me form the old faulty site to reduce BG on excercising and then it ran
out. I checked for ketones b4 simming and obviously vvould not have svvum if
ketones present. . As it initially reduced I assumed Id sorted it
but then I suppose that's the unpredictable nature of DM
>
> The real problem is knowing if you need to change the set, I guess - yes,
it
> can muck up a day/evening/night, I do sympathise.  You can always give an
>  injection if you're pretty sure the site is OK (if not then it mucks up
your
> pump
> assessment but hey, you might get some sleep).
I think my protocol vvill no be change site ( unless other obvious reason
for high BG) and bolus a couple of units through site to get it vvorking and
give rest of " correction" bolus via injection, hich ould only be 3 to 4
units if no ketones  for a BG of 18 but tice this dose if ketrones present

I had a discussion vvith DSN from pump centre and her suggestion : change
every 2 days instead of 3. I ill try this but vvhen this has happned b4, on
a t least 1 occasion it as only day 2 of nevv cannula
>
> .
>
> If you think absorption is the problem and you'd use different sites for
> injections, then a pump holiday might be a good idea.  I tend to do that
>  occasionally anyway to "rest" my crucial pump sites (I have terrible
absorption
> in most
> parts of my body after 30+ years of IDDM).
>
Do you use insulatard of glargi ne or just inject at v. short intervals
vvith humalog. and ho long are the "pump breaks"
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