Just start small. Maybe take 1 unit while you are at home, surrounded by food and not planning on doing anything for a few hours to learn how it affects you. Remember it’s the insulin almost everyone used until the late 1990s, so it’s nothing too radical!
5 Likes
@Scotteric and @mike_g, sorry to bother you, but I am reading what you guys are writing surrounding mealtime boluses, but as you can see, I’m struggling with my overnight and fasting. So out of frustration, I added novolin to my repertoire of shots this morning hoping it would give me a kind of temp basal effect. I would’ve added more to my Levemir, but I’m still not sure what that effect would be…which is not much different from my not knowing what THIS effect would be, but this is more immediate. Maybe. So I have done about double my regular novolog, 13 units of Levemir (which I did increase a couple of days ago but not since), and 3 units of novolin. Am I in the ballpark with this? I had just commented a couple of weeks ago about how I have never had a “sick day” plan, and here I am sicker than I’ve been in years. I’m not sure if it’s the being sick, the antibiotic, or all of this being horizontal that’s causing this, but I’d like to get my blood sugar down…
What do you mean? Your nighttime basal is not enough? Is it because you are sick?
1 Like
Being sick can intensify everything, so it’s hard to say what the cause of this is if you aren’t feeling well unfortunately. I usually just take ~2 more units of Levemir, but I’ve read people who say they run 100% temp basal increases just to keep BG around 250! I see your rise starts around midnight to 1am and then steadily continues, so it likely isn’t DP causing your problems (but it could be keeping your BG from ever going back down without intervention). When did you last eat before going to bed and what did you eat? I think that’s the first place to start.
1 Like
I don’t have any idea. I went with 9 units of levemir last night, but I forgot to do it on time… so maybe an hour and 20 minutes late. (Didn’t forget actually- was asleep). I hadn’t eaten anything almost all day, and my sugar ran about a 200-240 most of the day with nothing but intermittent boluses. I started Augmentin yesterday, and my head was the worst, and I was really nauseous. I tried to eat a little cheese, hoping it would settle my stomach, but that was no help. There were tortilla chips, so I ate about 6 of them, which was probably about 12g of carbs. I did twice the insulin plus correction plus a bonus bolus in anticipation of the rise I get from chips, but in reality I was too sick to care. I was up every couple of hours over night and did 1-2 units every time I woke.
I’m repeating myself with the same information I just provided Eric, but to answer your question, I had about 6 chips at around 10. I did a very generous bolus, plus correction and then some, as I had been running high all day. I knew the chips were a bad idea, but I didn’t eat almost anything yesterday, and I was taking an antibiotic, inhaler, Tylenol, and ibuprofen, and was with a very bad headache and nausea and needed something.
This is the second night I’ve run high like that, but last night’s was higher. I wanted to do extra levemir last night but was worried that it would send me plummeting, and without my pump, I have nothing to catch me. Turns out I didn’t need to worry about crashing last night. 
I’m crashing now though. That’s for sure. I’m not sure if it’s the addition of the Novolin, but it’s a cliff. And I even got my coffee without hitting a 400.
It sounds like you need to ramp up the Levemir. It’s always a risk with MDI, but worst case scenario just eat a few glucose tablets with peanut butter and you should be okay!
Unfortunately this can cause huge problems, especially if you’re sick. Sometimes what I will do is take a unit or 2 of R if I take Levemir late to cover the gap. Again, if you’re sick, it’s not going to be easy to get anything close to right though.
Just to reiterate it - all of this stuff now is just damage control until you get better.
If you are able to eat without throwing up, and eating does not offend you, bump up your basal doses morning and night. From your CGM pic last night, it looks like you have a lot of room still left!
And when this is all over, don’t hold a grudge against MDI and Levi. This is just sick stuff, so it’s totally different.
1 Like
I hope this is damage control… I started off so strong with a few isolated times that needed an adjustment, and now I feel like a train wreck. I took out my log and pen and am going to make myself write my numbers down. I haven’t been keeping track of the insulin I’ve been doing, and that uncertainty, and my long history of hypo anxiety, might not be helping. I feel like I’m doing a ton of insulin, but that doesn’t mean I’m doing all I’m due.
No grudge. Just am looking forward to feeling well enough to accept the challenge… rather then just sitting here taking the whooping.
I’m up today. So there’s light. 
And either I really hit the novolog harder than I thought this morning, or the Novolin is a beast. Something showed up. I hit 40.
Oh no Nicky…
Can you post a picture of your Novolin please?
I’d definitely write every dose down, or get an app to track IOB and BGs, etc. This helps me a bunch, since my memory for routine stuff like injections, BGs, etc, is very poor…
1 Like
Sorry for butting in, but it sounds to me like you are changing WAY too many things at once. Going pumpless plus trying two brand-new-to-you types of insulin, and all of this happening when you are sick and eating weird.
Feel free to ignore, but I would go back to what you are used to until you are well, and then try your experiment again, this time one new insulin at a time. You have lots of past experience handling being sick while managing with your pump, and your pump will keep track of all your insulin for you just like it always has. I think it would be best to go back to what you know until this storm passes and you are able to try again on calmer waters (no mixed metaphor there).
7 Likes
I agree with @jag1. Let’s pick it up in a few days when you are better.
I was thinking yesterday that you should just manage the sickness and try to simply get through it, and then pick it back up.
But the only reason I didn’t say to go back on the pump is because that thing seems really horrible, and doesn’t necessarily get you through it any better.
But adding a bunch of things at once - even if you are healthy - is not the best way to do this. Just do one thing at a time.
Part of the reason you may have been seeing the BG spikes a few days ago might have been the onset of the sickness, not the wearing out of the Levi.
1 Like
I need an actual keyboard to respond, but I wanted to give you the pic first, and to thank @jag1 for the thoughts. I think I just got blindsided by whatever this illness is. Yesterday I was really too sick to do anything for myself, and then this morning, with that in mind, I overdid it.
Here’s my Novolin:
Which I will not do another 3 units of (I DID ignore advice to start with 1 because I just wasn’t really feeling all that reasonable this morning)…
And here IS why I get so frustrated with my pump situation… and it would be suspending itself right now even though that is not a real blood sugar…
I will be back with keyboard if I feel that’s necessary (and didn’t respond to something that needed it), but I will actually try to stay away while I sort it out. I’m better today and can. I didn’t mean to create a fuss… honestly.
1 Like
Great!!
The reason I asked is because they also make a Novolin mix, called Novolin 70/30, which is 70% NPH and 30% Regular.
And if you had been taking that instead of Novolin R, without knowing it, it could have added a whole other bunch of confusion to all of this.
Just poke through this the best way you think you can, either pump or Levi, and then we can press on.
Please try to stay reasonable. I am supposed to be the unreasonable one in this relationship, not you.
1 Like
Well… that might be a problem. 
2 Likes
Okay. I wanted to give you a proper thank you for your observation. It is dead on. I jumped in last Friday, and things went unexpectedly well for the first few days, and then I started to get sick which was a major problem because 1. I was getting sick, and 2. I’ve never done anything any differently when I’ve gotten sick… which is how I was all of a sudden injecting myself with whatever I could get my hands on. I’d like to say that this was just panic mode, but I think this is just my hard-headed mode, and I’m likely to frequent that many, many times a week (or day). So I might actually need a “sick day” plan as well as a “sick in the head” plan because both are a guaranteed part of my future.
Sound advice. It really is. And I think I can definitely do better than yesterday and today but maybe stop short of pulling the plug entirely. I’m feeling better today and have been up to tracking my insulin and writing everything down. I think it was @mike_g that recommended an app for keeping track of IOB. Once I’m done in here, I’ll go look for it. And although I DID just do another novolin R bolus, it was a unit instead of three, and I’m doing it at a time I’ve found myself needing it for the last 4 days. I hope you don’t mind my explaining myself to you. Just felt like I should. 
Yes, one would think. In reality, I have lots of experience handling my pump when sick but none handling my sickness while pumping. Trying to handle sickness is new. I probably would’ve made as many mistakes this time while pumping… In fact, I may have button-mashed myself into oblivion.
Unnecessary explanation #1 done. Onto Eric’s. So I don’t scare him into not talking to me anymore.
2 Likes
Poking on. Just adding testing and recording. I’ve been really sick this last couple of days, but I’m getting better. I was doing well when I was feeling well, and then it all kind of fell apart. It was a mix of physical ailment and personality flaw. S. Flaws. But one seems to bring out the other, and maybe I’m on the other side.
I don’t think I want to go back to my pump just yet. If today were going equally as badly, I maybe would make that choice, but I have gotten things to settle. I’d like to go back on a good note.
I had been sick for about 2 days before it really hit. So there’s certainly a chance. I also noticed that when it stopped doing it at 7 pm, it did it twice over night, which wouldn’t have been the Levemir. So definitely maybe. 
So hard to do…
I do wonder what I would’ve done on my pump… and can almost guarantee it wouldn’t have been pretty. This would’ve been my first time sick since having discovered the extended bolus… And although, in theory, my pump would catch a fall, it couldn’t with this accuracy. It would’ve spent half the day suspending me unnecessarily. It really is easier on my mental well being when it’s doing it while it’s already suspended. Almost worthy of a little laugh. If, in fact, there were any humor in it.
Not my most impressive couple of days, but don’t bail on me. I would’ve done three times worse if I didn’t know you, OR I would’ve just stayed at 400 and not bothered with any of it at all. I tried WARNING you what you were dealing with when we first talked…
It’s all good! You are doing fine. Just hang with it, but don’t get crazy with the eating or injecing or adding 10 different things.
Keep It Simple…uh…um…Sweetie
In a few days you will be back on the victory train.
3 Likes