Comments on: To bolus or give injection? http://www.diabetic.netslonguirado.com/2006/07/28/to-bolus-or-give-injection/ Blog for the diabetics who use an insulin pump to control diabetes Fri, 29 Aug 2008 05:26:42 +0000 http://wordpress.org/?v=2.2.1 By: Randolph Fawn http://www.diabetic.netslonguirado.com/2006/07/28/to-bolus-or-give-injection/#comment-25219 Randolph Fawn Fri, 04 Aug 2006 06:58:03 +0000 http://www.diabetic.netslonguirado.com/2006/07/28/to-bolus-or-give-injection/#comment-25219 > >About 2 hours later we were out for lunch when I tested and came up with the 526. I bolus about 10 after eating lunch I check bg and it was down to 269. What has worked for those of you that have this high of bg bolusing or giving yourself a shot? > > If I have no symptoms of a BG that high, I wash my hands and retest. There could have been some wine residue or any number of things that could give a false reading. Sometimes even a third test with a new poke site will confirm one of the first two when in doubt. > >About 2 hours later we were out for lunch when I tested and came up with
the 526. I bolus about 10 after eating lunch I check bg and it was down to
269. What has worked for those of you that have this high of bg bolusing or
giving yourself a shot? > >

If I have no symptoms of a BG that high, I wash my hands and retest. There
could have been some wine residue or any number of things that could give a
false reading. Sometimes even a third test with a new poke site will confirm
one of the first two when in doubt.

]]> By: elvira_14 http://www.diabetic.netslonguirado.com/2006/07/28/to-bolus-or-give-injection/#comment-25218 elvira_14 Thu, 03 Aug 2006 23:48:21 +0000 http://www.diabetic.netslonguirado.com/2006/07/28/to-bolus-or-give-injection/#comment-25218 No there wer no error missages or alarms that I was aware of? No there wer no error missages or alarms that I was aware of?

]]> By: Olin Ok http://www.diabetic.netslonguirado.com/2006/07/28/to-bolus-or-give-injection/#comment-25215 Olin Ok Wed, 02 Aug 2006 18:32:46 +0000 http://www.diabetic.netslonguirado.com/2006/07/28/to-bolus-or-give-injection/#comment-25215 Barbara, You make good points; I was aware of what you say. But this rapid decent only happened once, and it worked just fine. Next time wait a bit more, I guess....hopefully, there will not be a next time! David Barbara,
You make good points; I was aware of what you say. But this rapid decent only
happened once, and it worked just fine. Next time wait a bit more, I
guess….hopefully, there will not be a next time!

David

]]> By: Leif Karrie http://www.diabetic.netslonguirado.com/2006/07/28/to-bolus-or-give-injection/#comment-25214 Leif Karrie Wed, 02 Aug 2006 10:40:21 +0000 http://www.diabetic.netslonguirado.com/2006/07/28/to-bolus-or-give-injection/#comment-25214 >>I have had 500 readings from infusion set failure several times. At 500, instead of using the rule above, which would result in a bolus of 16, I used a bolus of 32. This brought the number down to less than 200 in an hour or so (using Humilog), and I never experienced an overreaction from doing so. << It is not recommended to have your BG fall more than 50 - 75 points an hour. It can cause a rebound and symptoms of a low when you aren't really low. When someone has DKA, the IV insulin has to be controlled very carefully to prevent these symptoms, and avoid going much lower. There can also be some fluid shifts in your brain if the BG falls to fast. When the BG is in these high ranges, and, if there are also ketones in the urine, it causes more insulin resistance, so more <!--more--> insulin will be needed. please be cautious when lowering the BG. It is not a good idea to go from 500-600 mg/dl to 200 in less than an hour. Someone with heart and kidney complications could get into BIG trouble. Drink more water when you are this high, as some of the high BG seen on the meter is a reflection of dehydration and a higher concentration of glucose in solution. BarbaraB. >>I have had 500 readings from infusion set failure several
times. At 500, instead of using the rule above, which
would result in a bolus of 16, I used a bolus of 32. This
brought the number down to less than 200 in an hour or so
(using Humilog), and I never experienced an overreaction
from doing so. <<

It is not recommended to have your BG fall more than 50 - 75
points an hour. It can cause a rebound and symptoms of a low
when you aren’t really low. When someone has DKA, the IV
insulin has to be controlled very carefully to prevent these
symptoms, and avoid going much lower. There can also be some
fluid shifts in your brain if the BG falls to fast. When the
BG is in these high ranges, and, if there are also ketones
in the urine, it causes more insulin resistance, so more

insulin will be needed. please be cautious when lowering the
BG. It is not a good idea to go from 500-600 mg/dl to 200 in
less than an hour. Someone with heart and kidney
complications could get into BIG trouble. Drink more water
when you are this high, as some of the high BG seen on the
meter is a reflection of dehydration and a higher
concentration of glucose in solution.

BarbaraB.

]]> By: Olin Ok http://www.diabetic.netslonguirado.com/2006/07/28/to-bolus-or-give-injection/#comment-25208 Olin Ok Mon, 31 Jul 2006 01:31:22 +0000 http://www.diabetic.netslonguirado.com/2006/07/28/to-bolus-or-give-injection/#comment-25208 I have had a few similar experiences. What I find is that the rule for bringing down a high reading (I use 1 unit for each 25 points above a norm), does not work well above 250 or so. So I have tried doubling these numbers for extreme values. Since this has only happened a few times over the past 10 years, this is not a guide of any value, but it seems to work for these exceptional situations. I have had 500 readings from infusion set failure several times. At 500, instead of using the rule above, which would result in a bolus of 16, I used a bolus of 32. This brought the number down to less than 200 in an hour or so (using Humilog), and I never experienced an overreaction from doing so. But, this is a personal observation only, and only a guide for others to <!--more--> consider. David I have had a few similar experiences. What I find is that the rule for bringing
down a high reading (I use 1 unit for each 25 points above a norm), does not
work well above 250 or so.

So I have tried doubling these numbers for extreme values.

Since this has only happened a few times over the past 10 years, this is not a
guide of any value, but it seems to work for these exceptional situations.

I have had 500 readings from infusion set failure several times. At 500,
instead of using the rule above, which would result in a bolus of 16, I used a
bolus of 32. This brought the number down to less than 200 in an hour or so
(using Humilog), and I never experienced an overreaction from doing so.

But, this is a personal observation only, and only a guide for others to

consider.

David

]]> By: Jeannette Kaley http://www.diabetic.netslonguirado.com/2006/07/28/to-bolus-or-give-injection/#comment-25204 Jeannette Kaley Sat, 29 Jul 2006 21:25:10 +0000 http://www.diabetic.netslonguirado.com/2006/07/28/to-bolus-or-give-injection/#comment-25204 I have had problems like that when there is a problem with my set (crinkled catheter) were there any error messages or alarms that you were aware of? I have had problems like that when there is a problem with my set (crinkled
catheter) were there any error messages or alarms that you were aware of?

]]> By: colin_140 http://www.diabetic.netslonguirado.com/2006/07/28/to-bolus-or-give-injection/#comment-25202 colin_140 Fri, 28 Jul 2006 20:33:18 +0000 http://www.diabetic.netslonguirado.com/2006/07/28/to-bolus-or-give-injection/#comment-25202 << Yesterday I had a bg of 526. - First off I could not figuer what I had that would cause my bg to be that high- the only thing I came up with was I helped our priest comsume for of the communion wine, and I had a small glass of lemonaid (it normaly is sugar-free, maybe it was not.) I gave my self a bolus of 4 to cover for the wine ( since I was not sure of the amount I had). About 2 hours later we were out for lunch when I tested and came up with the 526. I bolus about 10 after eating lunch I check bg and it was down to 269. What has worked for those of you that have this high of bg bolusing or giving yourself a shot? Thanks for your information. >> Hi Mary: It might not have been the wine and lemonade....sometimes your site can fail, you might have gotten some occlusion in your tubing which slowed down how much insulin you were getting. I would suggest you troubleshoot your pump to make sure it's working correctly. When in doubt, <!--more--> change your set and site. And do gradual bolusing so that you don't overcompensate. Better slightly higher bg than too low. And rechecking , which you did, which is good. If you are using Humalog in your pump, remember your insulin sensitivity. It's a good idea to carry a small emergency kit....I keep extra batteries, infusion set with site prep and dressing and a couple of packs of Life savers or Gummy Bears....they keep a long time in the pocketbook, and can take care of a low episode. Can always reset your pump and use the existing insulin still left in the syringe. Just remember to replenish when you get home. Joan :)) << Yesterday I had a bg of 526. - First off I could not figuer what I
had that would cause my bg to be that high- the only thing I came up
with was I helped our priest comsume for of the communion wine, and I
had a small glass of lemonaid (it normaly is sugar-free, maybe it was
not.) I gave my self a bolus of 4 to cover for the wine ( since I was
not sure of the amount I had). About 2 hours later we were out for
lunch when I tested and came up with the 526. I bolus about 10 after
eating lunch I check bg and it was down to 269. What has worked for
those of you that have this high of bg bolusing or giving yourself a
shot? Thanks for your information.
>>
Hi Mary: It might not have been the wine and lemonade….sometimes your
site can fail, you might have gotten some occlusion in your tubing which
slowed down how much insulin you were getting. I would suggest you
troubleshoot your pump to make sure it’s working correctly. When in doubt,

change your set and site.
And do gradual bolusing so that you don’t overcompensate. Better slightly
higher bg than too low.
And rechecking , which you did, which is good. If you are using Humalog in
your pump, remember your insulin sensitivity.
It’s a good idea to carry a small emergency kit….I keep extra batteries,
infusion set with site prep and dressing and a couple of packs of Life
savers or Gummy Bears….they keep a long time in the pocketbook, and can
take care of a low episode. Can always reset your pump and use the existing
insulin still left in the syringe. Just remember to replenish when you get
home. Joan :))

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