Big mistake with pump

Don’t know if anyone else has been this silly. I was at 110 and gave a small bolus in the middle of the night and then removed my pump until I was able to replace. I was able to apply a new pump 2 hours later (without eating anything for 10 hours). My glucose reading was then 250 and rising and took some time to come down. I had no idea 2 hours on an empty stomach with no insulin would cause that rise! Obviously from no background insulin. Boy did I learn my lesson.

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Cindy @T1c, you have just learned another “little bit” about Autoimmune diabetes [T1D] which emphasizes that human bodies - with or without diabetes - constantly need a presence of insulin. Think back to when you were diagnosed with diabetes, a pump was not attached to you and you hadn’t recently had an injection of insulin, and your BGL was way up.

Another bit to remember, that engaging in any activity, including sleep without having sufficient insulin present can and will elevate BGL. I use Control IQ to assist my diabetes management and when reviewing my graphs on-line, I often see a sharp increase in basal delivered from my 0.25 uph Profile setting to as as high as 1.25 uph for about 15 - 20 minutes - I can only guess that I have wild dreams that I never remember.

A take-away from what you observed, if at some time you have been unable to take insulin, avoid exercise - the exercise without insulin present could cause hyperglycemia and almost always ketoacidosis.

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Hi @T1c . No judgment here - just wondering why you took a bolus at 110? Whatever the reason - someone on the forum (wish I could remember who to credit) reminded us to take each experience as a learning opportunity. One time I left the house without my pump - drove about a half mile, went to check something and… From that point on I’ve always checked before walking out the door - and occasionally even if I’m not going anywhere😊. It can take a frustrating amount of time for numbers to come back down - be sure to follow your doctor’s orders about how much to take and how long to wait, so your don’t end up stacking insulin and going low.

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The bolus is a fair question. I didn’t have any IOB and took .2 thinking that would cover for background in the next couple hours. Not a good decision but surprisingly my glucose just kept rising from that point (CGM reading) until I woke again.
Like I said, I’m new to all this and I learned “another “ important lesson.

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If you don’t mind my asking, what pump are you on, and are you using a loop system such as Tandem control IQ?
Depending on what pump you use, IOB may refer to bolus insulin only, or it may include basal insulin as well. Keep in mind a pump always has some background insulin running, based on the basal rates you programmed in. You will need to bolus for meals and snacks, and perhaps for exercise; but the loop system should do a good job of keeping you in range when things are otherwise “steady.” Your doctor can help you determine when you should take a correction.
If no one has mentioned it before, I highly recommend you check out the book Think Like a Pancreas by Gary Scheiner. He has diabetes and works in the field so has a unique personal perspective that is particularly helpful.

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I use OmniiPod and Dexcom. But I removed the pump because it was near time for the end and loud alarm and it was 4 am. I thought I could do a small .2 bolus to get me 2 hours. I deactivated and removed the pump until 6am wake up. Normally the background insulin with active pump is fine.
It was just a big fail trial.

I did read “Think like a Pancreas “. Excellent helpful book!

I use Omnipod too - I switched to the Omnipod5 from Tandem almost a year ago. It’s annoying with any pump to get a “feed me” alert in the middle of the night, that’s for sure!

I recall how surprised I was when I went from MDI and left behind having that long acting background insulin. It’s scary how fast my BG goes up, if I’m disconnected. It’s really the only thing I liked about MDI.

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Nighttime for me is a very strange time period. If I have reloaded my pump the evening I do not know if the new site is a really good site or just an OK site. Love my pump. Have been on one for about 20 years. But I’m still learning.

The impact of this depends on the amount of insulin the pancreas produces by itself. A lack of background insulin would lead to elevated glucose numbers similar to yours, unless you are in the honeymoon phase of your diabetes (in which case there would be a smaller rise in glucose).

Likely stress related or you ate something that took forever to affect you.

Been there. Done that. Sometimes good sleep is worth the hassle of bringing down high BG later… This could happen at any point in A Day in the Life of T1D by not bolusing correctly for ______ (insert food here). .2 was a safe bolus hoping to get to 6am, although there is that morning phenomenon of rising BG in order to have energy to start your day. You had the Dexcom still on and activated, so it would alert too. All-in-all, a good “knowledge is power” thing for your T1D toolbelt.

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