Sick for the first time

Hello everyone,
My sister was diagnosed with type one exactly a year ago. She’s never gotten any colds, flu, strep, etc. The most she’s ever gotten is a stomach bug that to our luck only lasted for a day. Today my sister has been coughing, throat feels weird and it’s VERY likely that she’s going to end up with a cold. We are hoping it’s not Covid… but so far she’s not showing any other symptoms and she’s breathing fine, she’s not in huge pain when she swallows, minimal fever.

I’ve read that when you get sick it makes your blood glucose rise? I also read that when you are sick and your glucose is high, physical activity makes your glucose rise even more?

As I said this is the first time my sister gets sick which has caused us all to be worried for her. Please share your tips, and experiences. We know that we might have to check for ketones and possibly give her doctor a call to adjust insulin intake.

We are scared and quite nervous for her. As of right now she’s only been coughing and felt her throat hurt and her glucose spiked to 300 when she did some physical activity. We just gave her a correction, low carb meal and at this point it’s just a matter of waiting. Please help us out with your tips, thank you!

Don’t forget to give her sugar free fluids to help wash out any ketones. I find insulin some won’t bring my numbers down if I don’t get rid of them.
Illness often includes loss of appetite. Crackers and ginger ale are usually easy to keep down, and I find fruit easy to say because it’s so light on the stomach. That said, I used to sip some juice or a sweet drink periodically to keep my numbers up if I couldn’t easy or keep down solid foods.
Hopefully it’s just a cold and she’ll be up and around soon - in the meantime get doctor can provide sick day guidelines. You’re a great sibling - how old is your sister, if you don’t mind me asking?

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Calling the doctor isn’t a bad idea if you can. You can talk about how to handle it, how much insulin to give, whether she should be on an antibiotic (which won’t help if it’s a virus, but should help if it’s bacterial), etc.

Hopefully this is a mild cold that will be over soon.

Being sick does indeed raise your BG levels. It’s a side effect of the body fighting off the infection. Correct for it as you can. Keep an eye on her BGs. Give her liquid to help flush it out. Give her what food she can comfortably tolerate.

Try not to stress too much. Focus on letting her rest and heal. Running higher than usual BGs for a few days isn’t going to hurt her in the long run. Just correct as best you can. The hardest part is when she throws up after a meal for which she’s bolused. You have to estimate what you think she’s got left and then figure out what you can do to keep her sugar in a safe range. Sometimes giving regular soda is necessary. They used to advise keeping some on hand for when you get sick and can’t keep down actual food.

Like I said, though, hopefully it’ll pass soon. Weather storm as you’re able, and she’ll be okay in time.

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Hi Alexa. I’m sorry your sister is not feeling well. As you have stated, when her body is experiencing some type of illness like a cold, strep, bronchitis, etc., the early warning sign is commonly erratic high BGL’s and feeling tired, along with the symptoms of what illness she has. The mild fever is something to keep a vigilant eye on. The BGL’s rise due to the battle waging inside of her with white blood cells fighting what is attacking her body causing keytones and BGL’s to rise. Keeping her BGL’s as low as possible is important to help her body heal. High BGL’s will slow the healing process down and cause infections to last longer. Adequate hydration is extremely important also to help flush toxins and keep the body’s organ systems functioning as normal as possible. If you, her, and family feel things are getting serious by all means call the hospital and see if she should be seen ASAP possibly at the ER. COVID is a serious issue for Diabetics and a test maybe needed if symptoms continue to worsen, so the earlier a diagnosis the better. I have drank Gatorade Zero without added sugar to replenish fluids that are lost however, always follow guidelines for insulin boluses if needed. Using fast acting insulin boluses under advise of her doctor or if she uses a sliding scale to bring down BGL’s is important to employ. Also over the counter med’s can cause BGL’s to rise also. Please keep us informed on her progress and we hope she starts feeling better quickly. Remember if you feel something isn’t right that means something isn’t right and get her looked at immediately because you know her better than anyone. You’re a great sister, good job caring for her.

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Thank you so much for your tips it really helps. My sister is 12 years old, she recently turned 12. Unfortunately though, last year she was diagnosed 15 days after her 11th birthday. Interesting but sad. (I also have permission from my parents to talk about her age)

Regarding the foods, as of right now she’s eating well and her stomach is keeping the foods. Hopefully we don’t reach a point where she’s unable to eat the foods she usually has but it’s important to be prepared. We are going to look into buying foods or snacks just in case. Thank you! We really appreciate it!

Thanks so much for taking the time to share your tips. We are going to keep an eye on her sugars. But in fact right now we are having terrible luck. She uses the Dexcom g6 and particularly today out of all days it’s decided to give sensor errors and basically stopped working. We are using finger pokes right now and will probably have to replace her sensor later.

Anyways, thank you for the clarification about blood sugars rising. We are going to watch for ketones but either way we are going to make sure she stays hydrated so hopefully she’ll get over this cold soon.

Hopefully she does not get to a point where her stomach is rejecting foods. Like I’ve mentioned before as of now she is just experiencing a minor cough, a very minor fever and a very minor sore throat. She’s eating just fine, and hopefully it remains that way.

Again thank you for the tips! We appreciate it!

Thank you very much. As I’ve mentioned before my sister has never experienced an illness so we don’t know much and this post helped us a lot!! Thank you greatly for all the tips and information, it helps us a lot.

We are going to keep an eye on her symptoms, as of right now nothing has changed. She is still feeling a minor cough, and a minor sore throat. She does seem to have less energy but other than that she’s doing fine. We are hoping there is no need to go to the hospital but if we get to that point we will definitely seek help.

In your post you mentioned you drink sugar free Gatorade; do you take insulin for that? Or can she just have it without worrying about her glucose rising?

Thanks for your kind words and calling me a good sister. I try to help out my sister and my parents as much as possible especially now when we are all a bit stressed and overall anxious about what the future holds. I will keep you updated and see how she wakes up tomorrow morning. Thank you!

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Odd. My Dexcom G6 has been giving me errors all day today, too. Going to replace it a couple of days early. But, yeah, worst time for it to do that to you.

I don’t suppose she’s been taking Tylenol/acetaminophen? Supposedly it doesn’t affect the G6, but it’s been known to affect readings on other CGMs and when I had trouble with my Dexcom not reading properly, it was the first thing tech support asked me about. Medtronic (back when I was using their sensor) also said that dehydration and lack of sleep can throw off CGM values, since they can affect the chemistry of the interstitial fluid that the sensor is reading.

Sounds like you’re doing the best you can. Hang in there. It’s stressful, but you’ll get through it, and then you’ll have a better grasp on how to deal with it next time (which hopefully won’t be anytime soon).

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Hi again Alexa. Excellent job young lady. I couldn’t tell if the Gatorade Zero made that much of a difference in my BGL’s because they were spiking like crazy due to an infection, 275 to 350. I advise looking at the label and see carbs and calorie info then monitor her BGL’s to see if a bolus is required. There’s more pros than cons in regards to benefits from drinking it, but use in moderation until you see if she has any issues with her BGL’s for a period of time like 6 to 12 hours then let her decide if it makes her feel better and adjust from there. Good luck and let us know how she’s doing. Tell her she’s a warrior and she’s got this.

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It’s definitely been stressful. She’s been getting proper sleep and hasn’t been on medications except her insulin of course. So the sensor error is not because of Tylenol. This will definitely be an experience but at least we will be prepared for next time! Thanks for your help! And good luck with your sensor!

Hello again,
Thanks for the information about the Gatorade and such. We all tell her she’s a warrior! Thank you for your words!

As of right now we are dealing with high blood sugars. Checked her glucose at 6:00 pm and it measured around 290. We gave her a correction. We just checked her glucose at 9:00 and it read 308. We are definitely dealing with high blood sugars but hopefully this won’t last long. Thank you!

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Hi Alexa, Is she using a sliding scale for dosages for high BGL’s?

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Yes, she is currently using a scale.

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Ok, what was her dosage at 290 BGL? It’s different for each of us when it comes to time for insulin to take effect after injection but for me when I took Novalog it took within 3 hours there was some change starting to be seen. After 5 hours it would be working to where I could start to see a marked difference, but that is from my experience and others may have different results. This also would depend on if she has eaten anything additional during that time. There is something else you may want to consider for her to hydrate that she might like for her throat is Pedia lyte freezer pops. They say they have only 15 calories and they’re cold.

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Valid morning. First of all, I’m checking in to see how your sister is doing - of course I hope she’s feeling better.
I know you all were anxiously waiting to see what happened with her numbers after dosing for her high and I wanted to see how things went. I should have mentioned this before but hopefully you know, it can be tempting to give additional insulin because the numbers aren’t coming down as quickly as we would like - it’s called stacking and can cause a severe drop in numbers once the insulin does start to do its work. Depending on insulin type it can take 3-4 hours before the numbers start to go down even a tiny bit, so be patient and again be sure she gets sugar free fluids to help wash out ketones Caffeine can raise glucose so be careful with SF coffee, tea, and soda if she drinks those.
Don’t forget to contact Dexcom (or remind your parents to) to get a replacement for the sensor. I don’t get many sensor issues but I had problems with not one but two over three days recently - and am waiting on replacements. BTW, I usually keep a Freestyle Libre as a backup CGM. The Freestyle 2 has alerts - the original one does not. You have to swipe the Freestyles periodically to get readings - they keep continuous track of numbers but swiping shows the current one and a graph since the previous swipe. A nice alternative to fingersticks. They are available by prescription at local pharmacies but insurance might require additional authorization since she already uses Dexcom - her doctor will know how to handle that.
Tell her I hope she’s feeling 100% soon!
PS - menstrual cycles may affect blood sugar as well. I haven’t had to deal with that for years now so I don’t recall how it affected my numbers, but some women know their cycle is getting ready to start because of the change in their numbers and they may have a special pump profile or injection settings for those days😉. Something to keep in mind.

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Thank you so much for checking in this morning. Thanks for mentioning the insulin stacking. That’s not something I knew about but maybe my parents know; regardless she received the proper amount of insulin. She needs 3 units if it’s at 300 and she never received more than that. Either way after having her glucose at 300 for almost 6 hours it started to drop. It went to 250 when 6 hours passed so she received another correction. As of right now, her Dexcom which has decided to work now says her blood glucose is at 164 steady. Her normal level is 200 or lower when she’s sleeping so she’s in her range right now. Hopefully her glucose doesn’t spike again but it will most likely after her breakfast.

Regarding the freestyle it’s definitely an option. The insurance authorized Dexcom only but it could be she could switch in the future since she tends to have many sensor errors. Thank you for mentioning that.

I am aware about the cycles but that’s not something that has happened to her yet. However I think she’s mentally prepared since she’s 12 now and a cycle could take place at any time now. At this point, she a absolutely refuses to use a pump. We will just have to wait and see! :slight_smile:

Thank you so much for your concern for her and hopefully she’ll recover quickly. We will just have to wait and see how she feels when she wakes up but early in the morning she woke up and said she felt the same. Either way, thanks!

Thank you for your concern. When her glucose was at 290 it was 5pm which is when she has her dinner. She ate a meal with low carbs- fish, vegetables, corn, sugar free lemonade. So when it was time to have a correction (she uses humalog )she is instructed to take one unit for every 50ml over 150. So she received 3 units for correction and one extra unit for her meal. After that it was around 9pm. At that point 4 hours passed. When we checked her glucose it said 308. So she just had 3 more units.

When it was 1:00 three hours had passed and she received 2 units since she was reading 254. As of right now, it’s 5:00 and her Dexcom reads 164 and steady. Hopefully it’s true since it’s been experiencing lots of sensor issues.

About the popsicles those sound great. We are always trying to find some good sugar free treats. I’ll definitely look into seeing how I can obtain them.

Anyways, thank you for your concern. We will just have to wait and see how she feels when she wakes up.

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Good morning Alexa. How’s your sister feeling today? Is her throat feeling any better? I read Dorie’s post and she has given some valuable advise about insulin stacking and hormone issues. It’s so common for people to get frustrated and patience will be put on the back burner when wanting our BGL’s to come down or up when needed because it feels like an eternity when actually it’s only been a few hours. That can cause us to insulin stack during highs or over eat during a low. There’s one thing to consider between Dexcom and freestyle CGM’s. Her G6 has the transmitter that monitors her as she sleeps and will alert from several feet away but the freestyle does not so if she has lows during sleep she may need the G6. This is what I was told by CCS when deciding between the 2 systems because of my 22’s BGL’s during sleep. Let us know how princess warrior is during today, and make sure you take care of yourself also.

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Thank you for the additional info on Freestyle. I Google Freestyle’s manual and found this:

IMPORTANT: How to prevent missed alarms

• Alarms must be kept on for you to receive them and you should ensure that your Reader is within 20 feet of you at all times. The Sensor itself will not issue alarms.
• If the Sensor is not communicating with the Reader,
you will not receive glucose alarms, and you may miss detecting low glucose or high glucose episodes. You will see the symbol on the Home screen when the Sensor is not communicating with the Reader. Make sure the Signal Loss Alarm is on so you will be notified if your Sensor has not communicated with the Reader for 20 minutes.

As I understand it, the alerts will sound if the sensor and reader are within 20 feet of one another even without swiping - it’s worth verifying with Freestyle to be sure. There are some things I prefer about the Freestyle although I do think Dexcom is the better device, in large part because of its interface with my pump. Even for those who take shots it’s probably more convenient than doing fingersticks, particularly in the middle of the night, but sticks are fine too for those who prefer them.

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This is very interesting info Dorie. When I got into a discussion with the outside medical equipment provider for my insurance, it got very nasty. I was wanting the Freestyle 2 and was determined to get it, even had the script sent for it. The company carried all brands of CGM’s and when they questioned my reason for why I wanted the Freestyle 2, I told them about my 22’s at night and wanted the alarm to wake me up before things went south. I was strongly advised that the Freestyle 2 did not alert because of not having the transmitter and would not serve my needs. This was going to be my first CGM so I had to redo the entire process and now the Dexcom has saved me more times than I can count. They told me that Freestyle had to be scanned by the monitor to get a reading, so your info is very interesting because my copay’s for Dexcom are really high, so I may switch since it sounds like it does what I originally thought it would and would be much cheaper. Thanks for the info.