Sick day rules

I’ve got a bad respiratory virus, and am having trouble keeping BG down. Anyone have “rules of thumb” for changing I:C ratios and correction factors? I’m MDI with Humalog and Lantus.

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We use a pump so our rules of thumb are a bit on the high side, since the tech and manual intervention can change course mid-way through the day.

We generally go up 25% in our basal when sick days or high stress days are upon us. If we were MDI it would be more like 15% day one, if still high add 10% etc. Equally important that you back off at the right first sign that your BS is coming back into control.


A very general rule I suggest is to increase both mealtime bolus insulin and basal. And as a starting point, I’d suggest increasing them both the same amount. Like if you do 15% more for meals, do it the same for the Lantus.


I never have changed anything, not when on MDI and not now when pumping. I’ll correct with boluses as required. I’ve just spent 10 days with flu (my doctor’s best guess), symptoms started (rapidly) on Jan 21 and the infection was apparently defeated 1-2 days ago, though I still have the nose/phlegm symptoms; that’s normal for me.

During that period I significantly reduced my food intake and my alcohol intake dropped almost to zero; not by design, I just didn’t feel like it. The only time I had a serious high was after I started eating again yesterday, but that was a can of Campbells soup and it apparently had way more carbs than the label suggested. Fast Food.

The way I look at it is, “If I don’t feel hungry I don’t eat”. I figure my body is doing something which causes it to decide to stop me feeling hungry and I’m not going to argue with 6000 years of evolution, well, not when I’m sick :wink:

I don’t increase my basal because I don’t want to have to deal with **** low blood sugars when I’m sick. That gets a double plus **** in this case because my wife got the same bug from me two days later, my potential carer was actually in a far worse state than me. (We both did a damn good zombie movie for a few days, from the little I remember.)

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I don’t know there is a rule of thumb, but when I’m I’ll I use trial and error, but I’m on a pump. I usually don’t have an appetite so I’m use temp basal. I can increase as much as 4 times my normal basal but I still remain high.

I think if you are on MDI though it might be safer to increase your bolus rather than basal. I hope you are feeling better.

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I always get a flu shot, and I haven’t had the flu in years. Guess the vaccine was the wrong virus this year. Or could be because I’m taking a new disease- modifying-anti-rheumatic drug which suppresses my immune system. So I don’t really have much experience being sick, at least not since I was a child (pre-Type 1).
I don’t have much of an appetite generally, but after taking R and NPH for so many years, I’ve got a programmed meal schedule that I feel like I have to follow. I’ve never skipped a meal, maybe after learning from you guys, I’ll develop the courage to try that. :grin:
I increased my bolus this morning about 20% and I’ve basically flat lined. Thanks for that suggestion.
@jbowler I hope you and your wife are feeling much better now. Being sick sucks! :face_with_thermometer:


Me too. In fact I don’t think I’ve ever had flu before. I don’t know about my wife, she probably has. I figure we probably caught it off her sister in law, who was on the couch totally wiped out a day after my wife started showing the symptoms. She (sister-in-law) also had the vaccine.

Different countries take different vaccine mixes based on assessed local risks. Sister-in-law is in Taiwan but Taiwan follows the US. We either contracted the virus on an international flight to Taipei (quite likely, I frequently get something off those) or when we got to Taipei. The CDC apparently had this to say about the 2019/2020 season.

If you google this take care; a lot of the references are to 2018/2019, that’s another year, another time.

The CDC comment on the virus component states they have not updated the B vaccine.

It might be that we got vaccinated too early; CDC was recommending against July/August vaccinations, we were vaccinated in September. Given the seriousness of the disease I would think it it might be better to have two vaccinations during the season.

Anyway, the page I quoted gives a very specific list of the viruses protected against. I have a different one :stuck_out_tongue:.