Pump question

So we’re traveling and doing family stuff and my BG is all out of whack! Meal times and content have been erratic and I have obviously been underestimating carb/fat content. I hate hanging in the 200s (!!!) and am wondering if It’s appropriate to increase my basal when correction shots alone aren’t doing the job. Thanks!

The best way to do it depends on whether the high BG is from food or your circumstances and a change in your basal needs.

Yes, you can correct a high with a basal change. Your body does not care if you call the insulin “basal” or “bolus”. But really, if it is from too many carbs or from food, it is best to correct it with a bolus. It’s faster, and then you don’t mess up your basal rates.

But traveling can also cause other changes that mean you need more basal. Time zones, stress, lack of sleep, all kinds of things. If your high BG is from a change in circumstances and you need a higher basal, then it is probably best to do it that way.

So the answer depends on the cause. I think the best way is to address the reason, whether it was caused by a food issue or a change in your basal needs.

Thanks, @Eric, that helps a lot. There have been changes in circumstances (5000 ft altitude to sea level, temperatures in the 60s here compared to 90s at home, less physical activity) as well as food issues (richer food than I generally eat and carb counting/timing issues especially in restaurants). I will make some careful adjustments.

Sounds like both bolus and basal! Changes in altitude can make your heart beat faster to compensate for thinner air which can raise endorphins and increase your BG. Colder temps slow insulin absorption, and of course less activity will also require higher basal.

And of course, restaurants and different foods will be bolus issues.

So hit 'em both!

But the most important thing…enjoy your vacation and travels!

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Can your pump do temp basals? And can it have separate “basal profiles?” For us, we find that increasing basal has a more powerful effect than doing more frequent corrections or strengthening ISF. You could issue a +X% temp basal for the hours when your’e eating a bunch of random stuff – so maybe from 9am o 6pm or whenever you eat during the day. That could maybe counteract all the SWAG-ing from the carbs. You could also issue an extended bolus for a few hours after each meal and just cancel if you start trending low.

For our kid (who’s still little), we find that eating high fat, high carb foods like mac and cheese and pizza have an effect for 6 to eight hours on his BG, so a basal increase would be more appropriate than a higher bolus. But probably best of all is an extended bolus for those kinds of foods.

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