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BG levels and illness....

J

jonesy

Well-Known Member
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my 9year old boy has got a virus (cough, snotty, bad throat, aching body, high temp) and his levels are going mad.

on monday they were up around 12 and 13, but yesterday they were around 18 in the afternoon and at 25.8 before bedtime!


is this normal?

jonesy
 
Yes this can happen, it's happened to Jess in the past. Make sure you check for keytones (blood keytone tests are better than urine tests) and I'd get in touch with your GP or consultant for further advice. The advice we've always been given is to treat with calpol, drink plenty of fluids, keep giving insulin as usual, keep a close eye on BG levels and treat with extra Novorapid to bring down high readings. If he's not eating and his levels are dropping too low then sipping coke is a good way to bring the levels up a bit. Jess has always been prescribed a course of antibiotics when she has a temp and that has done the trick. It's usually an ear or throat infection that she develops from a cold. You want to keep control of those BG readings as best you can and keep his temp down.
 
Yep.

My levels run higher when i'm ill, and with kids bodies they can be very unpredictable.
Nutrtious food when they feel like eating, calpol, and lots of love.
That's about it really. Do what you can, and don't wory too much.
 
In the past I've had to DOUBLE my basal insulin during illness/infection to stay on top of bg levels, and increase bolus insulin for food - such as I was eating anyway - although not by the same factor. And definitely watch for those ketones!
 
update.....

just checked for ketones, and absolutely normal.

his levels are better, but still high, today.
can anyone explain WHY the rise in BG happens?


another question guys....when we were treating billy on an insulin/carb ratio of 1/20, consultant said 1 click of novorapid would bring him down about 5 mmol.
we now use 1/30 for breakfast and lunch, and 1/40 for dinner. how do i work out how much 1 click would bring him down now?

is there an equation, or is it, purely, trial and error?

jonesy
 
Hi Jonsey, Unfortunately there is not an exact way of calculating a correction dose and it is going to be a case of trial an error. My little boy is 5 and his ratio's are not disimilar to your sons. We normally give a half unit for readings over 10mmol and 1 unit for 15 mmol and over. Hope this helps. Leggott
 
Not sure why insulin requirements increase so significantly during illness; although I'm normally very curious about such anomalies this is one that I just accept at face value, backed up by the meter of course! Someone with more brain power than me will be able to explain.

There ARE equations that can help calculate correction and insulin/carb ratios, but I've found them tricky to pin down and am currently stuck on just one set. It's therefore fortunate that my insulin profile matches the criteria for the formulae:

For a pump user with a basal insulin level at 50% of TDD, correction ratio calculates as 100 divided by TDD, insulin/carb ratio as 500 divided by TDD. These are surprisingly accurate for me, but I'm on a pump and my basal averages at almost exactly 50% of TDD, so a near perfect match for the numbers, which do change according to daily insulin profile. For example, someone with a basal at 35% of TDD would use 110 divided by TDD to get the correction ratio. And that's where my current knowledge of the formulae sadly ends.

I use the formulae to double-check the ratios against what I use in practice - they're a starting point only, but quite useful nonetheless. I've been trying for some times to find a reference that will tell me the different numbers to use in the calculations for different basal percentages, in order to further fine-tune my weekly checks, but without much success so far.
 
Hi jonesy

Hope your son is feeling better.
Apologies for not responding to your posting sooner – I spotted a newer post regarding why blood glucose levels rise during infection and then spotted your posting.

My understanding of why blood glucose levels rise during infection is as follows:

Infection causes stress on our bodies.
When this occurs, the body needs more energy to "fight" this stressor i.e. the infection caused by the virus or bacteria, so it releases hormones - called "counter-regulatory hormones".
These hormones tell the liver to release extra glucose to provide the body with this energy.
These hormones also unfortunately inhibit the effect of insulin - which means the body becomes somewhat insulin resistant & the cells that normally uptake the insulin become temporarily less sensitive.
As a result, blood glucose rises & overall levels become more erratic.


Depending on the extent of the infection, blood glucose might be more difficult to control for a while after infection.
It is also very common in diabetes, for a period of up to 2 weeks following an infection for blood glucose levels to continue to be slightly higher and somewhat erratic before settling down again.

Hope that sort of answers the question!

Best wishes

Txx
 
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