Hello! It’s been awhile since I’ve had a true stomach bug and I guess I was due.
Last night I woke up and started puking my guts out. Followed by sharp pain in my lower right side. I called a nurse care line, did the right thing and went to the ER to get tested for appendicitis.
Good news is I don’t have it. Bad news is the only thing I know for sure is I have a little stomach bug.
I don’t really have an appetite but seem to be keeping stuff down. When I left the ER this morning, my blood sugar was 181. Not horrible considering I’m under the weather. I just checked again and now I’m at 264. My endo is advising caution with my insulin so that I don’t go too low and then I’m not able to treat it. My concern would really be that if I don’t treat it, I feel like DKA could happen somewhat easily. I’m doing my best to drink a bunch of water, but haven’t really ate.
I did move my pump to see if my spot was just bad and did a small correction of 2 units instead of 6. Anyone have any advice on how to adequately control blood sugar while being cautious about not being able to keep things down?
They did test for DKA at the ER and gave me fluids just as a good protocol but I still just hung around the 180s.
Hi @Tee25 i just correct. It’s rare that I couldn’t crunch a glucose tab or eat a sweet tart and not be able to keep it down.
Do you do your full amount of correction?
No advice on insulin here, but crackers and ginger ale are gentle on the stomach if you do need to eat something. Feel better soon!
Sorry to hear that you are not feeling well, Taylor @Tee25 .
As far as a number of units correction you should take is impossible for anyone to calculate for you without knowing the amount of insulin you usually use. it is not unusual for illness to require twice the daily amount of insulin when “sick” even when NOT eating - depending on the illness, viral, bacterial, etc.
Your doctor is correct in telling you not to “over correct” and drive yourself too low; white grape juice is heavy in carbs, and sits comfortably in my stomach when I’m not feeling up to snuff.
A safe correction, repeated every “few hours” until you are back on your feet would be calculated as follows:
[ ( BG - Target ) / ISF ] * 0.6
Years ago at Joslin I was given a “Sick Day” rule that I’ve used ever since with good results: “Every four hours take by injection 25% of my TOTAL daily insulin dose.” Yes, it sounds like a lot of insulin, but apparently that is what my body needed when I was ill.
Know too, that a “high BG” like 250 mg/dl will probably NOT drive you into DKA - DKA is much, much more than a high blood sugar. However, I expect that you may see an elevated level of ketone in your urine just because of your illness - don’t be alarmed by “Trace” or “low” readings on your dipstick.
Thanks all! I’m trying to eat some stuff but haven’t tried carbs yet. I like your 25% rule every 4 hours. I’ll give it a shot if I continue with highs. The good news is I took 2 units of insulin (which for me is a low correction) and it brought me down to the high 170s. I’ve been advised to not correct under 200 until we know how I can handle food. I am keeping an egg down now and water so that’s a good sign.
As far as DKA goes, they’re telling me not to even test ketones unless I’m high for a long time and look more at how my body is responding to insulin. Since like you said Dennis, trace and low levels are common with any illness and I assume if I’m not eating much (just 1 egg so far today) I’d like test positive for ketones regardless since I’ve ate very little today.
Planning on trying some carbs later with dinner as long as I hold this egg down.
Yes Taylor @Tee25 , ketones will appear just because you are not eating and your natural body function is to feed itself from your stored fat and mussel.
Any time we inject insulin we need to be aware of the consequences, so especially with corrections, caution is necessary. Taking less than the “calculated amount” is always better than taking too much - that is why the formula I offered above provides only 60% of what appears to be the correct amount. In other words, I’m suggesting reducing a correction by 40%, as a safety.
Hope you are feeling “just wonderful” VERY soon.
Ahh! That makes sense. Thanks for the help!
Do whatever works for you - I always found fresh fruit sat well on my stomach when I was sick (the crackers I mentioned before got boring after a while😊).
Thanks! Do you still bolus for carbs or no? Example I’m eating chicken noodle soup which 1 cup is 13g of carbs. My blood sugar was 117. Should I take 3-5 grams worth of insulin or since I literally haven’t had any carbs at all today just eat and see what I’m at in a couple of hours? Sorry I feel like I should know this but I so rarely get sick that I’m not sure what to do
I just saw this post and hope you are feeling better. I just got over a similar bug myself. My BGs were running much higher than normal (@250mg/dl) and I wasn’t hungry at all. I set a temp rate on my pump for 150%. This brought my BG down to the mid 80’s which is where I am comfortable. Once I started to feel hungry (around dinner that night), I then ate a lite meal of cheese and crackers. Nausea came back though, so I kept the 150% temp going over night. Had a mild low (@70mg/dl) @ 3am, so I may have slightly over corrected. I ate one glucose tablet and was at 86mg/dl the next morning. My endo would probably have told me to cut back to a 125% temp. So, knowing this, I did just that the following night. No lows overnight, but I was back in the 200’s the next morning, which I don’t like. So I adjusted to 140% after that and ran in the @120 - 130.
As you can see, I react to relatively small changes in my dose as well as my diet. So, you have to figure out what works for you. For me, if the 2 units only brought me down to 180, I would take 3 the next time. You might need 4 units, or if you’re comfortable at 180, you could just stay at 2 units.
I don’t live alone, so I don’t have to worry as much as someone who does about going too low. I can usually catch a low at 70, but if I don’t I know someone is always here to help me if I need it. If you live alone, you may want to keep your BG higher. Most endos I’ve seen have told me to keep mine @120 - 150 when I am sick - - they know I normally keep my BGs in the 80 - 100 range. So, 120 is a little higher than normal, but not too high.
Anyway, enough on that! My suggestions for when sick: I have found that Gatorade/Powerade (not the no sugar ones!) or regular Sprite/7Up are good if I am worried about a low. Saltine crackers are also good when I feel sick to my stomach. Drink plenty of water, which I see you are doing (good for you!). And get plenty of rest. It helps your body heal!
Hope you are feeling better!
T1D 56+ years and counting!
Thank you everyone! I survived my stomach bug and am feeling so much better. Gatorade and jello were a lifesaver
Glad you’re feeling better!