High blood glucose following "rash".

[markpj31]

Hi all,

So my bloods have been excellent up until last week. Up until then, my HbA1c has been 48 and then 49 6 months later. Readings on average between 4-8mmol/l.

That is. until Saturday last week. Felt i'll. high temp (41c), slept and couldn't eat a thing- assumed it was flu. Anyway, cleared 3 days later (well the fever) and then discovered some kind of rash up the back and front of my left leg. Left it for abit, then it got angry and turned into painful purple "blotches". Was referred to AMU, prescribed antibiotics which I have been on for about 3 1/2 days now.

Problem is. I just can't get BSG down, its sitting mostly between 12-15mmol/l. no matter how little I eat or how much insulin I chuck at it. I can't move around a whole lot at the moment because of the pain (I normally walk at least 5 miles a day), surely it cant be the not walking along that is raising it to >15 from what normally sits at 5s?

Thank you

 

[Antje77]

AMU, prescribed antibiotics

This suggests you have some kind of infection. Those things tend to raise our BG, it will likely get better once you get better.

 

[markpj31]

This suggests you have some kind of infection. Those things tend to raise our BG, it will likely get better once you get better.

By such large margin? I've got to admit, I don't get ill often. Last time was December 21 with Covid.
Do you find that with yourself when you test and are ill?

 

[Hopeful34]

Illness makes my blood sugar rise, and requires more insulin to get back to normal blood sugar levels.
Having said that, have you started a new pack of insulin pens (Basal and bolus), to check your insulin hasn't degraded?
Not being able to do your normal exercise will probably have contributed to your raised bloods as well.

 

[Antje77]

By such large margin? I've got to admit, I don't get ill often. Last time was December 21 with Covid.
Do you find that with yourself when you test and are ill?

I've had covid twice since having diabetes, which didn't raise me.
Otherwise, I seem to have avoided most common illnesses since my diagnosis. Except for a nasty cold with fever (flu?) in the early days, so not much experience.
With that cold I remember being very amused with the effect of paracetamol: after taking it, my BG dropped together with the fever to go back up when the effect of the paracetamol ran out. I guess it takes a fever to be greatly amused by this though, fever messes with my mind in that way!

Problem is. I just can't get BSG down, its sitting mostly between 12-15mmol/l. no matter how little I eat or how much insulin I chuck at it.

Are you only chucking extra bolus insulin at it or have you increased your basal as well?
Sick day rules for T1s usually mention upping basal as well, although you need to be very careful because of lows once you're getting better.

From other diabetics I read they'll easily go into the high teens or twenties when ill, even with extra insulin, so yes, I think your numbers aren't unusual.

Hope you'll get better soon, and by all means contact your doctor or diabetes nurse if you're worried!

 

[markpj31]

Illness makes my blood sugar rise, and requires more insulin to get back to normal blood sugar levels.
Having said that, have you started a new pack of insulin pens (Basal and bolus), to check your insulin hasn't degraded?
Not being able to do your normal exercise will probably have contributed to your raised bloods as well.

Hi, these ones I have been using for a little while and have been kept in the fridge - very cold.

 

[markpj31]

I've had covid twice since having diabetes, which didn't raise me.
Otherwise, I seem to have avoided most common illnesses since my diagnosis. Except for a nasty cold with fever (flu?) in the early days, so not much experience.
With that cold I remember being very amused with the effect of paracetamol: after taking it, my BG dropped together with the fever to go back up when the effect of the paracetamol ran out. I guess it takes a fever to be greatly amused by this though, fever messes with my mind in that way!


Are you only chucking extra bolus insulin at it or have you increased your basal as well?
Sick day rules for T1s usually mention upping basal as well, although you need to be very careful because of lows once you're getting better.

From other diabetics I read they'll easily go into the high teens or twenties when ill, even with extra insulin, so yes, I think your numbers aren't unusual.

Hope you'll get better soon, and by all means contact your doctor or diabetes nurse if you're worried!

Interesting because I take paracetamol at night at the moment to help with the pain and I noticed the blood glucose in the morning is generally 9mmol/l when I wake (and thats when it all goes downhill from then on).

I am yes, increased the basal by 2 units.

Thank you

 

[Hopeful34]

You're not using Fiasp by any chance are you, as some people find that when it's nearing the end it can be less effective (although that's usually the vials that I've heard of).

If it were me, I'd start new pens of both insulins, just to rule that out.

 

[Hopeful34]

Interesting about Paracetamol @Antje77 That's maybe why my bloods go down initially after a vaccination when I take paracetamol, rather than it being the vaccine. Will have to test that when I've not had a vaccination!!

 

[EllieM]

@markpj31 as you are on insulin your clinic should have given you "sick day rules" to handle insulin dosing when ill. Yes, some people find their insulin needs go up massively and they need help to judge how much extra insulin they need. But it's unfprtunately one of those things that varies dramatically between people and between illnesses, so there's no way to tell how much to take without doing blood tests (whether cgm or fingerprick),

 

[plantae]

I don't have sick day rules yet. Unfortunately I was diagnosed right at the beginning of the holiday season and, well, everyone's on holidays. If I get sick I guess I'll just have to wing it or go to hospital (gosh I hope not hospital it's so boring and they give me 4 million grams of carbs for every meal on the "diabetic menu". Ok, maybe not 4 million but 3 or 4 times what I'd normally eat in a whole day: breakfast porridge, 2 x toast, weetabix, 1 x bread roll, banana, orange juice, apple juice... I guess they're scared of hypos?)

 

[markpj31]

@markpj31 as you are on insulin your clinic should have given you "sick day rules" to handle insulin dosing when ill. Yes, some people find their insulin needs go up massively and they need help to judge how much extra insulin they need. But it's unfprtunately one of those things that varies dramatically between people and between illnesses, so there's no way to tell how much to take without doing blood tests (whether cgm or fingerprick),

Not in clinic, just under GP who just gave me fixed doses morning, lunch, dinner. I do a lot of testing though, I just haven't had an appetite of later so I'm missing mid-day meal and dose.

 

[markpj31]

I don't have sick day rules yet. Unfortunately I was diagnosed right at the beginning of the holiday season and, well, everyone's on holidays. If I get sick I guess I'll just have to wing it or go to hospital (gosh I hope not hospital it's so boring and they give me 4 million grams of carbs for every meal on the "diabetic menu". Ok, maybe not 4 million but 3 or 4 times what I'd normally eat in a whole day: breakfast porridge, 2 x toast, weetabix, 1 x bread roll, banana, orange juice, apple juice... I guess they're scared of hypos?)

Yeh, there is no different menu for diabetics in hospital, the stuff I was given even back on oral meds was complete trash.

 

[markpj31]

I don't have sick day rules yet. Unfortunately I was diagnosed right at the beginning of the holiday season and, well, everyone's on holidays. If I get sick I guess I'll just have to wing it or go to hospital (gosh I hope not hospital it's so boring and they give me 4 million grams of carbs for every meal on the "diabetic menu". Ok, maybe not 4 million but 3 or 4 times what I'd normally eat in a whole day: breakfast porridge, 2 x toast, weetabix, 1 x bread roll, banana, orange juice, apple juice... I guess they're scared of hypos?)

Yeh, there is no different menu for diabetics in hospital, the stuff I was given even back on oral meds was complete trash.