Managing illness - A pumper’s perspective
Be Prepared- Each illness is different, and often unpredictable. Some will have no effect on my blood glucose, others will cause massive changes, sometimes before I know that I am coming down with anything. My first tip is (despite having never been a girl guide) to be prepared.
The Highs and the Lows- While this is often higher glucose readings, I have had odd occasions where my blood glucose dips too. Remember not just your Sick Day Rules, but also ABCC for highs, and The 15 Rule for lows.
Learn From Experience- I always make sure that I have my diabetes teams’ guidance for managing illness on an insulin pump close by. I have also learnt as the years have gone on how to manage different illnesses in different ways. Using CareLink™ Personal to have a good look at my patterns after a period of illness can be so useful to see what worked, and what didn’t. On any Medtronic pump, giving corrections is easy with Bolus Wizard™, and I have certainly found that often, once I am on top of things again, the 2 hourly recommended testing can be relaxed a little as ketones clear, and my blood glucose levels start to settle.
Use Basal Patterns- Setting different Basal Patterns, in line with your diabetes team’s guidance, while you are feeling fit and healthy is really useful. On a MiniMed™ Veo™, make sure that in the Basal menu, you have Patterns turned on, and then choose an unused Basal Pattern to make the appropriate changes. On my MiniMed™ 640G I have set Sick Day for when my blood sugars are running high, and I have had to correct a couple of times already and/or have tested positive for ketones while I am ill. I have set another that I have called Day Off in case I am under the weather but have found my blood sugars are dipping.
Temporary Basals- I have also used Temporary Basal increases. If I set these for 2 hours, this ties in nicely with the next time I need to test my blood glucose, and decide whether to continue using more basal insulin. I have also set the Bolus Blood Glucose (BG) Check on the Minimed™ 640G, or BG Reminderon a MiniMed™ Veo™ as an additional reminder, whether I am using Temporary Basals or not.
Use Your Pump’s Features- On the MiniMed™ 640G, you can also set a Preset Temporary Basal for sickness too, so you can be fully prepared. I have mine set for an additional 50%, in case the 20% I have chosen to set in my Sick Day basal pattern isn’t quite getting me there.
Help Your Sensor to Help You- For those of you using sensors, some additional tips… Remember to keep up the frequent BG checks. I don’t use them all to calibrate, but because my blood glucose can change really quickly while I am ill, the sensor may be tracking a few minutes behind, which can change the decision that the pump makes regarding boluses. It is so useful to make sure that Suspend Before Low is on, so that as my blood glucose levels start to come down I have reduced the risk of a hypo. Usually I keep the alerts off, but during illness I would turn them all on to help me. On a MiniMed™ Veo™, of course, you can set the Low Glucose Suspend feature to help out too, but I would be tempted to set this a bit higher than usual just in case. Having to sip Lucozade while poorly is not my favourite thing!
Get Well Soon- And finally, of course, make sure you treat your illness. Everyone gets ill, and it is so much harder when you have diabetes too. If you need to see your GP to help, get an appointment sooner rather than later. The sooner the illness clears up, the sooner you will be back on top of your diabetes.