Type 1 diabetes and vomiting - Please help!

[npatel19]

Hi guys I really need some advice, I started vomiting on Tuesday morning and had monitored my sugars which were quite high at about 19.6 which I was effectively able to bring down my Tuesday evening with no blood ketones or urine ketones. However since Wednesday I’ve been feeling very ill, the bizarre thing is my sugars have been stable at 6/7/8 and the highest it has been was today at 10.6. However I was sick again this morning and I’ve developed blood ketones and the highest they’ve been is at 1.3 this morning alongside a ++ reading of my urine ketones. I have finally managed to eat a little and my ketones in my urine have cleared for now. I have just tested my sugar and it is 6.7 but blood ketones have gone up to 0.5 I’m not sure why this is happening. I don’t know if it’s a stomach bug. Any advice would be hugely appreciated as I am really quite scared

 

[Diakat]

Call 111.

 

[npatel19]

Hello. I have done that, however in the current climate they’ve advise me to manage this at home and that I should call back if I continue to vomit or if my ketones increase beyond 1.5 I’m just unsure as to why my blood sugars are stable but I have ketones

 

[Juicyj]

Hello @npatel19

Are you familiar with sick day rules ? Have a look at the DAFNE guidelines, high ketones become an issue if you are running continuously high and are feeling unwell with pear breath and tiredness:

http://www.dafne.uk.com/uploads/224/documents/G01.002,%20version%201%20(May%202018)%20-Sick%20day%20rules%20-%20Standard.pdf?0.8191162855364382

 

[npatel19]

Hello thank you, yes currently implementing these, I haven’t had pear breath the highest my blood ketones have been is 1.3 this morning but then came down to 0.3 however have now gone up to 0.7 with a bs of 6.9. Could this be due to not eating? I’m so confused as to what has caused this.

 

[Juicyj]

Hello @npatel19

Personally I don’t test for ketones and would only do so if running continuously high and feeling unwell - they are only an issue then, as long as your feeling ok now and Bg levels are within range then it shouldn’t be an issue.

If you continue to vomit then another call to 111 but otherwise keep drinking lots of fluids and keep a close eye on your BG levels, hope you feel better soon.

 

[npatel19]

Thank you so much, yes if I vomit again will have to call 111 because even though my bg are low surely vomiting and the production of ketones is unusual?

 

[kev-w]

Thank you so much, yes if I vomit again will have to call 111 because even though my bg are low surely vomiting and the production of ketones is unusual?

How are you feeling today and have the ketones reduced yet?

I'd repeat what was said about sick day rules, staying hydrated and testing your bloods more often, and if the ketones don't go then to ring 111 again.

 

[Jaylee]

Thank you so much, yes if I vomit again will have to call 111 because even though my bg are low surely vomiting and the production of ketones is unusual?

Hello,

Sorry to read you are unwell..

I'm not a doctor.
However my understanding is it can be possible if your BG is now stable (in range.) to have a ketone reading in the urine or blood if the body is using fat for fuel instead of glucose. This can happen with chronic vomiting,
Your body maybe burning body storage of fat for fuel if you haven't been able to eat for a while..?

Please keep in contact with your doctor though..

 

[npatel19]

Hello

Sorry to read you are unwell..

I'm not a doctor.
However my understanding is it can be possible if your BG is now stable (in range.) to have a ketone reading in the urine or blood if the body is using fat for fuel instead of glucose. This can happen with chronic vomiting,
Your body maybe burning body storage of fat for fuel if you haven't been able to eat for a while..?

Please keep in contact with your doctor though..


Hello thank you for asking, I really appreciate it, I’m feeling ok not too great, I tested my bg at 10:00 this morning and it was 4.7 and my blood ketones were 0.4 I still feel nauseous though so going to have to monitor incase I vomit again. My abdominals feel achy and burn slightly but that could be do with what you mentioned above as I’ve not been able to eat much so will need to focus on doing that today.
I’ve also been getting headaches on and off but my temperature has been normal it hasn’t gone above 37.4. But I have had an intermittent cough alongside this vomiting and nausea so I don’t really know what that tells me. I’m just in a constant state of panic because of what’s going on and the news. I’m so scared. I will be calling my doctor tomorrow morning. I wish they offered community testing to all type 1 diabetics so that it would put my mind at ease.

 

[Jaylee]

Hello thank you for asking, I really appreciate it, I’m feeling ok not too great, I tested my bg at 10:00 this morning and it was 4.7 and my blood ketones were 0.4 I still feel nauseous though so going to have to monitor incase I vomit again. My abdominals feel achy and burn slightly but that could be do with what you mentioned above as I’ve not been able to eat much so will need to focus on doing that today.
I’ve also been getting headaches on and off but my temperature has been normal it hasn’t gone above 37.4. But I have had an intermittent cough alongside this vomiting and nausea so I don’t really know what that tells me. I’m just in a constant state of panic because of what’s going on and the news. I’m so scared. I will be calling my doctor tomorrow morning. I wish they offered community testing to all type 1 diabetics so that it would put my mind at ease.

Hi,

I empathise with your concern regarding the current "situation."

I know from my own experience with vomiting, stomach acid can burn or irritate the throat?
There is also a wretching feeling too, which can contribute?

I must admit, I have only ever called a doctor out once. Due to this sort of sickness. Traveling through south India with my wife.
We were both ill & I feared for her.
We were both proscribed a powder which was mixed & drunk with water, (slowly.) which helped replace nutrients lost?
Long time ago now..

Consult your HCP at the first opportunity.

& keep us posted on your progress..!

 

[npatel19]

Hi,

I empathise with your concern regarding the current "situation."

I know from my own experience with vomiting, stomach acid can burn or irritate the throat?
There is also a wretching feeling too, which can contribute?

I must admit, I have only ever called a doctor out once. Due to this sort of sickness. Traveling through south India with my wife.
We were both ill & I feared for her.
We were both proscribed a powder which was mixed & drunk with water, (slowly.) which helped replace nutrients lost?
Long time ago now..

Consult your HCP at the first opportunity.

& keep us posted on your progress..!

Thank you I will do. I may try drinking some of those soluble vitamin tablets that dissolve in water to see if it helps me regain some energy. Will be calling both my GP and diabetic nurse tomorrow for advice. I’m just scared about going into hospital and contracting the virus there or something I’m so glad I joined this forum it’s been so helpful.

 

[Jaylee]

Thank you I will do. I may try drinking some of those soluble vitamin tablets that dissolve in water to see if it helps me regain some energy. Will be calling both my GP and diabetic nurse tomorrow for advice. I’m just scared about going into hospital and contracting the virus there or something I’m so glad I joined this forum it’s been so helpful.

Soluble vitamins wouldn't do you any harm, if you can keep it down. Little & often with the sips.
From my own experience with vomiting..
If you can get a telephone consultation & can comfortably self isolate whilst you recover?
Minimising contact unless absolutly necessary, may well be the best option..

We can't diagnose members on the forum, but a sickness bug would be my guess.. Not pleasant at the best of times.
But do monitor for or if any changing symptoms..

Regarding any anxieties with COVID 19. There have been some encouraging news of diabetics recovering.

Hope this reassures you in that "department."

 

[npatel19]

Soluble vitamins wouldn't do you any harm, if you can keep it down. Little & often with the sips.
From my own experience with vomiting..
If you can get a telephone consultation & can comfortably self isolate whilst you recover?
Minimising contact unless absolutly necessary, may well be the best option..

We can't diagnose members on the forum, but a sickness bug would be my guess.. Not pleasant at the best of times.
But do monitor for or if any changing symptoms..

Regarding any anxieties with COVID 19. There have been some encouraging news of diabetics recovering.

Hope this reassures you in that "department."

Hi Jaylee, thank you so much for the advice I have been able to eat some porridge this morning which I hope is a positive sign so will be sipping on some vitamin water in a little while.
Will make contact with my nurse tomorrow. Currently have a headache which I have taken paracetamol for. Will continually monitor. Thank you for the reassuring news about type 1 diabetics coming out on the other side of this.

 

[Jaylee]

Hi Jaylee, thank you so much for the advice I have been able to eat some porridge this morning which I hope is a positive sign so will be sipping on some vitamin water in a little while.
Will make contact with my nurse tomorrow. Currently have a headache which I have taken paracetamol for. Will continually monitor. Thank you for the reassuring news about type 1 diabetics coming out on the other side of this.

No worries,

If your starting to eat again, you may see a drop in ketone readings?

Here is a link to at least one good news story.. https://www.leicestermercury.co.uk/news/uk-world-news/diary-dad-coronavirus-day-day-3953592

Hope you feel better soon!

 

[npatel19]

No worries,

If your starting to eat again, you may see a drop in ketone readings?

Here is a link to at least one good news story.. https://www.leicestermercury.co.uk/news/uk-world-news/diary-dad-coronavirus-day-day-3953592

Hope you feel better soon!

Hi jaylee
So I have just tested and my bg is 5.5 and blood ketone is reading at 0.4 and urine at -/+ not sure what to make of that as I’ve had porridge and have given insulin to cover it so thought it would have bought the blood ketone down will continue to monitor.

 

[Jaylee]

Hi jaylee
So I have just tested and my bg is 5.5 and blood ketone is reading at 0.4 and urine at -/+ not sure what to make of that as I’ve had porridge and have given insulin to cover it so thought it would have bought the blood ketone down will continue to monitor.

Your BG looks great & the keytone level looks like a reasonable reading too?

Here is some NHS guidelines regarding keytone levels & dangers with potential ketoacitosis..
https://www.nhs.uk/conditions/diabetic-ketoacidosis/

Hope this helps you..!

 

[slikwipman]

Thank you so much, yes if I vomit again will have to call 111 because even though my bg are low surely vomiting and the production of ketones is unusual?

This is not uncommon and happened to me at the end of last month, sadly I didn’t have your knowledge or control, keep doing well with those numbers

 

[npatel19]

This is not uncommon and happened to me at the end of last month, sadly I didn’t have your knowledge or control, keep doing well with those numbers

Hello thank you for your kind words, can I ask what is is that causes it and how you regained control? Did you have to go into hospital?

 

[slikwipman]

Hello thank you for your kind words, can I ask what is is that causes it and how you regained control? Did you have to go into hospital?

As I understand in simple terms is because you are vomiting you have no carbs so the body finds glucose by burning fat, burning fat is what leads to ketones , the body also can also put lots of glucose in your blood to try and give you energy to fight the illness so insulin should be injected accordingly. I wasn’t aware of this and it resulted in a hospital stay but don’t worry you are a long way from that . All this is only as I understand it and may have mistakes