[beleive]

sugar got up to 390 today,have took bolus to bring down,my question is what is fastest way to get it down??I do have symlin but my understanding is wont do anything unless you eat??Just want hear some opinions.thanks

[Funnygrl]

I would just bolus normally, and wait for it to come down, testing again in an hour and changing the set and re-bolusing if it hadn't come down.

Some people may do a super bolus.

[BlueSky]

Symlin won't bring a high blood glucose down. You need to get some insulin working as quickly as possible. The best way to do that is to inject the bolus into a muscle, and then exercise the muscle. The most accessible muscle is the deltoid, a couple of inches below the shoulder.

[MinimedPumper07]

I've heard its bad to do exercise when you are super high like that. Just do insulin and then you can exercise when you are under around 200.

[kgm0612]

Although it's not recommened to do any exercise if your BS is over 250...........I always take a walk when my sugars are high. Whether it's the full 3-mile walk, or a mile jog on the treadmill, this works for me!

Karen

Also..........drink plenty of water!

[Scratch]

Originally Posted by BlueSky

Symlin won't bring a high blood glucose down. You need to get some insulin working as quickly as possible. The best way to do that is to inject the bolus into a muscle, and then exercise the muscle. The most accessible muscle is the deltoid, a couple of inches below the shoulder.

Yeah, injecting into a muscle is the fastest way. I've also used the biceps a couple of times although I find getting the needle in the bicep results in a somewhat more uncomfortable sensation than the deltoids.

[NoelD]

Bingo Scratch. I was wondering if someone was going to say that. It worked faster for me that way too when I was doing MDI.

[xMenace]

Originally Posted by BlueSky

Symlin won't bring a high blood glucose down. You need to get some insulin working as quickly as possible. The best way to do that is to inject the bolus into a muscle, and then exercise the muscle. The most accessible muscle is the deltoid, a couple of inches below the shoulder.

This is what I do with a syringe. Generally if I'm very high it is due to set problems. A syringe in the deltoids removes all the doubt about it working.

[notme]

I also use the deltoid muscle when I need to lower my blood sugar in a hurry. Exercise when I am extremely high drives my blood sugar up higher and takes a lot longer to lower my blood sugar. Don't exercise if you are over 200.

[Subby]

Just another possible consideration: I think depending on what range of BG your body is used to, you might find that coming down very quickly can have some unpleasant effects.

I found at one stage when MDIing when my general BG was tending high, and my novorapid shots would sometimes defer for a few hours and then rush right in, that the act of dropping very quick (not necessarily low, just fast), say 6 mmol/l over 30 min, would leave me disorientated and confused.

Certainly not saying it will happen, or that it commonly happens. Just a heads up for unpleasant effects, if you do use some super quick way to get down from on high.

[Funnygrl]

Originally Posted by MinimedPumper07

I've heard its bad to do exercise when you are super high like that. Just do insulin and then you can exercise when you are under around 200.

It's bad if you have ketones, but I believe it's okay if you don't.

[Emm]

I'm with the others - inject in the arm.

This isn't something to take lightly - you need to be willing to keep an eye on your BGs. Depending on whether you hit muscle or not (and which way you held your tongue when you injected!) your BG can drop a lot faster than you're used to.

Sometimes I find the insulin is stronger too - so a 2u injection that would usually drop me roughly 5mmol over 3 - 5 hours, instead drops me 5mmol in the first hour and I still have some active insulin left to keep an eye on.

A very handy trick, but not one to try if you're about to drive / exercise / or do anything that requires you to be away from your testing supplies.

I'm yet to figure out if there's any danger in dropping so fast...(apart from the obvious risk of a low) so be careful and consider all options before you try this.

[pumpman]

Originally Posted by Scratch

Yeah, injecting into a muscle is the fastest way.

Yeah this is working great for me... I had breakfast this morning and put in the required amount of insulin (8 units for spaghetti on toast), BGL was about 8mmol/l

Two hours on and my BGL is 17mmol/l !!!!!!! WTF

I tried this muscle thing and put 5 units of novorapid into my tricep (using a syringe). 30min later and my BGL is 19mmol/l...great.

What is going on?

[iDream]

Originally Posted by Funnygrl

It's bad if you have ketones, but I believe it's okay if you don't.

This is what I thought too. I've never been that high (390), but when I'm 170-200 ish I'll be running or whatever, it'll be down in five minutes.

[BlueSky]

Originally Posted by pumpman

.... I had breakfast this morning and put in the required amount of insulin (8 units for spaghetti on toast), BGL was about 8mmol/l

Two hours on and my BGL is 17mmol/l !!!!!!! WTF

I tried this muscle thing and put 5 units of novorapid into my tricep (using a syringe). 30min later and my BGL is 19mmol/l...great.

What is going on?

As the amount of carbohydrate and insulin increases, the blood glucose outcome becomes more and more unpredictable. After injecting so much insulin, variation in the action and/or absorption can have a major effect on the blood glucose level. It looks like this happened to you, assuming that you got the carb-counting and dosage calculation right. Also, when blood glucose gets as high as 17mmol/l, the rules of the game change. Insulin resistance increases and the amount of insulin required to bring blood glucose down again increases exponentially. This is probably why your 5 unit correction bolus didn't seem to work, and blood glucose kept on going up.

I find that, after injecting into a muscle, it takes about an hour for blood glucose to start coming down. This is a big improvement, as with sub-cutaneous injections it takes more like 2 hours. I would be wary of injecting 5 units into a muscle. If you breach that tipping point, that much insulin could cause your blood glucose to come down very quickly, causing a severe hypo. The trick, of course is to avoid blood glucose going so high in the first place.

For what it is worth, I keep right away from foods like that. Especially in the morning. Ingesting all that carbohydrate makes managing blood glucose levels too difficult. The Dawn Phenomenon effect makes covering breakfast and controlling blood sugar in the morning even more difficult. The best way to avoid problems in the morning is to eat low-carb food for breakfast.