Stomach bug / IBS and suddenly don’t need much insulin

pinewood

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Ever since Christmas Eve I have had some stomach troubles (bloating, nausea, acid reflux, loss of appetite, some stomach pain).

It got better yesterday so I tried to start eating “normally” again but I was full very quickly and then yesterday evening it was back again with a vengeance and I was up in the night with bad reflux and pain.

I’m really worried it could be something serious like IBD so I have a doctor appointment arranged for the New Year.

What is really worrying me is that I need basically no insulin, even when I am eating. I had my usual portion of cereal yesterday morning which would usually need 4 units and I only needed 1 unit and even then had to have some orange juice to bring me back up.

In the meantime I’m curious if anyone else has ever expirenced anything like this or has any tips?

Thanks in advance
 

Mep

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Ever since Christmas Eve I have had some stomach troubles (bloating, nausea, acid reflux, loss of appetite, some stomach pain).

It got better yesterday so I tried to start eating “normally” again but I was full very quickly and then yesterday evening it was back again with a vengeance and I was up in the night with bad reflux and pain.

I’m really worried it could be something serious like IBD so I have a doctor appointment arranged for the New Year.

What is really worrying me is that I need basically no insulin, even when I am eating. I had my usual portion of cereal yesterday morning which would usually need 4 units and I only needed 1 unit and even then had to have some orange juice to bring me back up.

In the meantime I’m curious if anyone else has ever expirenced anything like this or has any tips?

Thanks in advance

Sorry to hear you're having a rough time. I'm glad to see you have booked in to see your doc as definitely worthwhile getting a check up.

As you can see in my signature I have quite a few gastric conditions which includes irritable bowel syndrome. I find when it's really playing up my pain level tends to increase my need for more insulin because my sugar levels soar. We're all different though. I have combination IBS so it's either going way too fast or too slow and sometimes both (yep in one BM I mean). My entire GI tract doesn't move properly so I don't think I digest too well either which will affect my sugar levels. I can hypo an hour after eating and then again I can be in the teens on my glucometer 3 or 4 hours after eating too with eating the exact same meal. Also what is interesting is I'm still burping up food I ate 4 hours ago at times.... especially if it's fish or meat of some sort. I don't have gastroparesis though.... although sometimes I think my stomach definitely doesn't empty as fast as other times. Perhaps you have something similar going on? I wish you the best. :)
 

Bluey1

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Sorry to hear you are sick. When I get sick either I need buckets of insulin or almost none. Welcome to Diabetes lottery. I suspect a lot has to do with digestion. I had serious constipation and my need for insulin skyrocketed. I have only had a gastro bug once with the dreaded D and my need for insulin was almost zero.
 
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pinewood

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Thanks for the replies; helpful reading.

Yesterday I didn’t need any bolus AT ALL and I ate a lot (breakfast cereal, soup, chocolate, milk shake, noodle dinner, ice cream). This would usually have needed a daily dose of c. 12-16 units of NovoRapid.

I’m starting to worry myself with horror stories of cancer and other major illlnesses like kidney disease causing things like this. I have a GP appt tomorrow and will ask to see a gastroenterologist but my digestive symptoms really aren’t that bad. I have had Gastro bugs before and they resulted in high blood sugars.... I would understand not needing much insulin if I wasn’t eating much but I’m eating normally now so to not need bolus at all is such a strange situation to be in and is actually really disconcerting
 

kitedoc

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Hi @pinewood, So you are not prescribed metformin?
And I am unsure whether many would class your breakfast as a normal for a T1D. And what were BSLs after that breakfast?
It certainly sounds like a gastroenterologist and an endocrinologist might be useful to consult.
 

pinewood

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Hi @pinewood, So you are not prescribed metformin?
And I am unsure whether many would class your breakfast as a normal for a T1D. And what were BSLs after that breakfast?
It certainly sounds like a gastroenterologist and an endocrinologist might be useful to consult.
I always have cereal - I eat a “normal” diet and my hba1c has always been below 6. Not sure what you mean by “normal” for T1D; there is no such thing. No I do not take metmorfin. Blood sugar after the breakfast was 6, usually it would be in the teens without a bolus
 

kitedoc

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Ok, Thank you @pinewood. How long have you been diagnosed as Type 1 and what age group are you in?
 

kitedoc

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So unlikely to be a honeymoon phase as a reason for less insulin if one reads the Home page description.
And apologies, I misread the food you ate as being all for breakfast !! So I presume you take some basal insulin as well?
You say your BSL is 6 after breakfast but when is that reading taken and have you tested later to see if for some reason your rise in BSL after food is delayed??
Other thoughts, could your bowel still be recovering from whatever gastro bug and not readily absorbing food at the moment?
 

pinewood

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So unlikely to be a honeymoon phase as a reason for less insulin if one reads the Home page description.
And apologies, I misread the food you ate as being all for breakfast !! So I presume you take some basal insulin as well?
You say your BSL is 6 after breakfast but when is that reading taken and have you tested later to see if for some reason your rise in BSL after food is delayed??
Other thoughts, could your bowel still be recovering from whatever gastro bug and not readily absorbing food at the moment?
Thanks @kitedoc - yes, I’ve been on 14 units of Tresiba but 2 days ago I lowered it to 10 units because of all these issues to try and see if that can help me with the lows. I know changes to Tresiba dosing take a few days to take effect so hopefully I will see some benefit from this reduction today or tomorrow.

I am lucky enough to have a Dexcom G6 so I know there isn't a delayed rise, I was between 4 and 7 all day yesterday! I was so worried that I thought my Dex must be wrong but I did 7 or 8 finger sticks and every one matched up with the Dexcom.

Yes, even though I’m eating normally now my stomach is still playing up a little bit so I expect I still have / am recovering from some kind of bug (or maybe it’s IBS, I am not sure). However, last time I had a gastro bug my levels went up - not down - so it’s all a little confusing and strange ....
 

kitedoc

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Hopefully your doctor can sort it out with tests if need be. And if food absorption is the problem my guess is that one would expect that to settle in several days ?
 
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Simha

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Hope you are feeling better, today. IBS is a ******. I had a handful of unsalted assorted nuts yesterday. My gut doesn't like nuts. Hadn't eaten them in years as I don't really like nuts. But wanted to give it a try as everybody tells you to eat nuts as part of your diet. :bored:
 
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Mep

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Thanks @kitedoc - yes, I’ve been on 14 units of Tresiba but 2 days ago I lowered it to 10 units because of all these issues to try and see if that can help me with the lows. I know changes to Tresiba dosing take a few days to take effect so hopefully I will see some benefit from this reduction today or tomorrow.

I am lucky enough to have a Dexcom G6 so I know there isn't a delayed rise, I was between 4 and 7 all day yesterday! I was so worried that I thought my Dex must be wrong but I did 7 or 8 finger sticks and every one matched up with the Dexcom.

Yes, even though I’m eating normally now my stomach is still playing up a little bit so I expect I still have / am recovering from some kind of bug (or maybe it’s IBS, I am not sure). However, last time I had a gastro bug my levels went up - not down - so it’s all a little confusing and strange ....

I hope you don't have another disease to contend with. I have a T1 friend who was having stomach issues too and they found out they now have another illness. At first they were concerned they had celiac as apparently T1 are more prone to that as it is an auto immune disease.... although got diagnosed with another condition but still hard to manage. The trouble with IBS is it can be quite unpredictable so it can make it harder to manage sugar levels. I'd imagine it would be the same with any other bowel condition. I wish you the best. :)
 

pinewood

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I hope you don't have another disease to contend with. I have a T1 friend who was having stomach issues too and they found out they now have another illness. At first they were concerned they had celiac as apparently T1 are more prone to that as it is an auto immune disease.... although got diagnosed with another condition but still hard to manage. The trouble with IBS is it can be quite unpredictable so it can make it harder to manage sugar levels. I'd imagine it would be the same with any other bowel condition. I wish you the best. :)
Thank you and sorry to hear about your friend. May I ask what it was? Was it Chron’s disease or Ulcerative Colitis? I’ve heard these are also more common on T1D.
 
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Mep

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Thank you and sorry to hear about your friend. May I ask what it was? Was it Chron’s disease or Ulcerative Colitis? I’ve heard these are also more common on T1D.

I think it was the colitis she got diagnosed with from memory. She's having to take steroids for it.
 

pinewood

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So today is my third day without needing any bolus insulin whatsoever and with my levels staying firmly within the 4-8 range seemingly regardless of what I eat or drink!!! It feels like I am no longer diabetic!!!

I am seeing my GP this evening and requesting a gastroenterologist referral as my stomach is still playing up a little bit. Fingers crossed I can get some light shed on what is going on; never in a million years thought I'd be complaining about such amazing control and insulin sensitivity but can't help feeling incredibly nervous and apprehensive about what is causing this...
 

kitedoc

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Hi @pinewood, very curious about your state of less insulin requirements. Please keep us informed of what the docs make of it !!
 

pinewood

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Hi @pinewood, very curious about your state of less insulin requirements. Please keep us informed of what the docs make of it !!
Still not taking any bolus insulin, so I haven't needed NovoRapid for 5 days now!

I spoke with my DSN who said it was peculiar, but she was not really worried or concerned. My GP is running some stool samples to check for stomach/digestive issues and then I'll try to get a gastroenterologist referral if things continue. I feel like I am cured from T1D at the moment! It's a truly bizarre feeling.
 

kitedoc

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Hi @pinewood, Strange! Have you grown some beta cells ???
The other thing I have heard is that our kidney clear out insulin once it has done its thing. If kidneys are not being as efficient insulin hangs around longer and so has prolonged effects.
Fingers crosse there will be an easy answer. Meanwhile enjoy the relative freedom!!
 
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