Today isn’t the best diabetes day.
For those of you who do not read loop: glucose of 364 mg/dL, 5.24 units of active insulin, 56 units of insulin delivered on the day, as of 3pm. I’m writing this at 19:45 and I’m exhausted. As you know, failed pump sites (or not receiving insulin) make for such a long, miserable day.
Disclaimer: This is my personal experience. This is not a guide of how you should deal with a similar situation. I am not a medical professional and this is not medical advice.
Since there is no fix-a-flat can of magic for this kind of predicament, we do what we can do make sure we are taking care of ourselves.
My blood sugar was fine when I got home from work at 6am. I ate a meal, and went to sleep. When I woke up, I noticed my Dexcom had been alarming high glucose for hours (side note, I have NEVER woken up to Dexcom alarms).
Here are the steps I took when I woke up:
- Checked my blood sugar on a glucometer. I don’t even usually carry one anymore since I have the Dexcom, but It’s still here and I still use it to back up strange readings. After confirming the HIGH reading from Dex was the same as my meter, I checked Ketones.
- I have a blood ketone meter – they are going to be far more accurate than urine strips, which can be up to 4 hours delayed with their readings. And thanks to the keto diet, they are super cheap to purchase online. I honestly grab those supplies on Ebay because my insurance company refuses to cover them. Anyway, blood Ketones read 1.8 mmol/L. That’s high enough that I could have made a trip to the ER for fluids, but I also have other options based on a plan my doctor and I came up with.
- After confirming the sad status of my body, I replaced my Pod. I filled it with insulin and put it in a different area than it had been before. The site of the old Pod is most certainly infected. I put some bacitracin on it and I’ll check it again tomorrow.
- INSULIN! I took more insulin. Based on my personal insulin needs, I had about 10 units of correction (1:50 insulin sensitivity factor correcting down to 100 mg/d). Additionally, I ate a 15g carb snack and took insulin for that as well. When ketones are involved, it’s better for me to have a little more insulin on board and babysit the Dexcom.
- Next, I downed about 40oz of electrolytes in an hour. I found powder sticks of electrolytes at Costco. They taste awful, but holy crap do they work! I just water them down a bit more than advised – for taste.
- Finally, I went back to bed. My body was MAD! So I turned on Game Show Network, snuggled my doggies, and set an alarm so I would remember to check my blood sugar every hour.
I woke up at 7pm at 75 mg/dL and dropping. Had a small spoonful of icing, and now getting ready for work. No, I don’t feel great. Yes, I could use my Intermittent FMLA. But I’m feeling far better and honestly want to go to work. It’s nice having people around, and I’m lucky enough that my supervisor is T1D and totally gets it. If I start to feel bad again, I’ll go home without it becoming an issue.
How do you deal with bad blood sugar days? Have you set up a plan of action with your doctor? Tell me about it in the comments, on twitter, or email me at email@example.com.