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Blood glucose levels and the common cold

December 13, 2010 | 7:42 pm

Sam’s rollercoaster of BM levels last week seems to have been the precursor to him actually getting a cold.

Not that complicated you might think. And so would I, having not encountered the common cold colliding with Diabetes until now.

Nikki read up a few facts in our Diabetes Bible. Most importantly is the fact that Samuel’s insulin sensitivity will be changed by the cold virus. A cold leads to increased insulin resistance. Which in turn leads to an increased insulin requirement. If we don’t up his insulin, his BM levels will go up. And all week they have been doing just that. Dr Hanas recommends increasing insulin by 25-50% but up until Samuel caught this cold, we have been reducing his insulin, as he as been going low all the time.

Wtih hindsight, perhaps we should have increased the insulin earlier but through the week, he has crept up and up to the point where he peaked at 18.9 at 1am this morning.

So, to get it under control, I spent the night testing him every couple of hours and letting the pump calculate a correction, until he finally came down to 7.4 at 6.30am this morning. He has still been a little higher during today but never above 10.

I couldn’t have done it without his new pump though. When you test his BM, the pump automatically calculates how much insulin to give to bring him back to 5.5, and gives him the dose. Easy you might say. Well, to a point. The complication comes if he is rising or falling at the point when we test his blood. The lag time of the insulin being given coupled with the direction his BM was going means that it can take a couple of hours to see the effect of the dose. And he might need another dose then. So testing him an hour or two later and giving another correction requires you to work out the correction dose, but in the context of the previous test and how much active insulin will be left in him. Two or three in a row, and it gets very hard to keep track of in your head. And imagine trying to do this at 4 in the morning.

That’s where the pump comes into its own. Doing these calculations automatically means we just test and dose, knowing he will get the right amount to continue bringing the curve back to 5.5.

Which leads me onto the next thought. The more regularly we test, the tighter we can control that curve. And nothing is more regular than Continuous Glucose Monitoring (CGM). Something I think we need to explore in more detail.

Samuel’s pump is made by Roche and they don’t have a CGM system. But if they did, and it talked to the pump, that would effectively be a closed loop system. Doing what mine and your Pancreas does automatically in micro-adjustments. An artificial Pancreas, if you like.

Surely that’s not rocket science. Or perhaps it is. Because Roche have had pumps out for years but haven’t got anything on the CGM front.

Posted by Gareth

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