# Probably a common title but "not sure how this works"



## bigdan1404 (Oct 11, 2014)

Hello, I need some help please, i'm 23 and was only diagnosed 3 years ago with type 1 diabetes, i've had a chest infection for the last four or five days that I'm taking antibiotics for, but for the last 4 days I'm able to control my blood sugars and I've had readings between 15 and 29 mmol for the last 4 days and I can't bring it down, i'm starting to worry, I have been ketone testing and they are zero so I see that as positive but can't see my sugar levels been so high for so long been very positive for me, is there anything you can suggest? Thank you for your time.


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## HOBIE (Oct 11, 2014)

Hi Big dan & welcome. Are you keeping yourself hydrated ? Just what you have said I would be on the side of thinking about a visit to Drs. Good luck


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## bigdan1404 (Oct 11, 2014)

Hi hobie, thanks for replying. Yeah, I'm generally a big drinker anyway, i've always got a water bottle with me. I think I will be going to the Dr's first thing Monday but was just wondering if this had maybe happened to others.


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## Northerner (Oct 11, 2014)

Hi Dan, welcome to the forum  Sorry to hear about your illness  What insulin are you on? Are you eating OK? Have you been taught about 'Sick Day Rules'? Sorry for all the questions! Illness will push your levels up usually and you may therefore need more insulin than you would normally take for your food. If you're not sure how much extra insulin you need then you do need to speak to a doctor for advice. It's good that the ketones are zero, which suggests that your body is happy enough using the energy from the food you are eating. 

Hopefully, the antibiotics will get to work on the illness soon and your levels will start getting back to normal. Although not great, a few days of elevated levels won't harm you, as long as your ketones remain low. How are you testing for ketones, blood strips or urine strips?


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## HOBIE (Oct 11, 2014)

Its that time of year when lots of infections are going around. Dr is the best thing. Good luck & let us know how it goes.


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## bigdan1404 (Oct 11, 2014)

Hi northerner,  fortunately for myself this is the first time I've been ill in the 3 years since been diagnosed so I've never been told anything about my insulin or anything when I'm ill. Generally i'm eating ok, my insulin got swapped about 5 months ago to levemir and novorapid and I've recently got the adjustments to dosage right to suit my new job aswell so was a stressful time with all the changes but in the last month I've had healthy readings with the occasional low or high to be expected. I test for ketones with blood strips. No problem about all the questions lol I'm hear to learn


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## Northerner (Oct 11, 2014)

What they should have told you then is how to 'correct' your blood sugar levels when they get too high - this is taking extra injections of novorapid on top of what you would have for your food. How much to take will vary from person to person though, so I'm afraid I can't tell you how much! For me, I find that one unit of novorapid will drop my levels about 3 mmol/l, so to bring them down from, say, 15 mmol/l to 6 mmol/l I would inject an extra 3 units. Good to hear you have blood ketone strips, much more accurate and informative than the urine ones 

When I have been ill I tend to just increase my mealtime insulin to keep my post meal levels reasonable, but it can be a bit hit and miss and it's best to be cautious


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## Redkite (Oct 11, 2014)

Hi Dan, this document is quite useful (scroll down to the tables showing what to do at different BG levels and ketone levels):

https://www.uclh.nhs.uk/PandV/PIL/P...ick day rules – multiple daily injections.pdf

Hope you're better soon!


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## bigdan1404 (Oct 11, 2014)

Unfortunately I haven't been told about that,  I was on novomix before and only did 2 injections a day and was fine at first but then went wrong so needed changing but after the change there seems to of been a lack of follow up care from my DR's and my health care team at the hospital. The only thing I've done in the past few months since the insulin swap was a blood test for my average blood sugars. I'm going to go to the doctors on Monday so I'm going to say something then.


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## bigdan1404 (Oct 11, 2014)

Hi redkite,  thank you for your help I will have a look through it now  I hope so too


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## Northerner (Oct 11, 2014)

Dan, it seems you haven't been given the best of information in the past. It's good that you are on levemir and novorapid now, it is a much more flexible regime than the mixed insulins, but you ought to have been taught the ins and outs of it. Have you been on a carb counting course, like DAFNE or XPert? If not, ask your doctor what is available for you. I'd also recommend getting a copy of Type 1 Diabetes in Children, Adolescents and Young People by Ragnar Hanas. It's a really excellent reference guide to all things Type 1


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