Insulin resistance after sickness

Good morning all, I was hoping someone may be able to offer some advice here from previous experiences. Some background info to start: Type 1 since July 2012. Have been on Novorapid (ratio 10:1) and Levemir (once per day before bed) ever since. Have always taken pride in my control and pretty much keep it consistently perfect. Admittedly my lifestyle isn't completely normal, I weight train 5 days a week without fail plus post workout cardio and have always tracked my macros and weighed my food. I even did this before my diagnosis so its just how I've always been. I eat pretty much the same meals everyday (boring I know but I have always done this for ease when weighing out food) so it becomes very obvious when something isn't quite right.

On Sunday 3rd of March I woke up to what I originally thought was food poisoning from eating out on the Saturday night. I only had a fillet steak and broccoli so did question how that had happened. I was vomiting constantly all day and struggled to even keep water down. I ate nothing on this day bar a few sweets when my levels would drop slightly to keep me at around 5 to 6. Had the following Monday off work also as I still felt rough but managed to start eating again around lunchtime, no more vomiting. Tested for ketones and came back negative just to be sure. 2 more days pass and I'm back in the gym. Didn't feel 100% admittedly but well enough to train. Felt slightly nauseous at points in the following days and then I think around Thursday 7th I woke up with a BG of 12. Very abnormal for me as I tend to wake up around 4 most days. Since that day I've struggled to control my BG until today, but it has taken me pretty much double the amount of Novorapid to do so. I have also put up my Levemir to 30 units, from the the usual 22 units daily. Also for peace of mind, I started two brand new pens of both Novorapid and Levemir.

For example, a typical breakfast for me is 40g peanut butter and 70g whey protein. For this I would (and have always) injected 3 units of Novorapid and this works as it should. I think my insulin sensitivity tends to be pretty good due to all of the consistent resistance training I do. This morning I had to administer 6 units to get the normal result 2 hours post consumption. If not, I would end up at around 13 two hours later, as I have done for the past few days whilst I've been trying to work the issue out.

From my knowledge, I am thinking that it wasn't in fact food poisoning but a sickness bug, and my body is still recovering from this 11 days on. My body is producing cortisol in response to fighting the bug, which in turn is causing my liver to produce glucose, raising my BG level. Can someone confirm/agree to this? If so, and if you have experienced similar, how long should I expect this to go on until things resume to normal? Should I think about going to the doctors to get checked out? I imagine over the next week or so I will slowly begin to start hypoing consistently and that will indicate that I need to bring everything back down? Thats what I'm hoping anyway. Its really thrown me off as I tend to find my diabetes very easy to manage considering my somewhat repetitive lifestyle.

I apologise for the long read, I wanted to try here first as I don't actually even have a contact for a diabetic nurse as I've literally never had any issues that needed addressing since about a year after diagnoses. Hoping someone can share a similar experience or give me any advice? I would really appreciate any information.

evilclive said:

I think the short answer is "yes, that's what's happening" and "it'll finish when it finishes". As you suggest, keep monitoring, and your insulin requirements should drop. Don't push yourself too hard while you're ill, or at the early stages of recovery - that can lead to relapses.
Adjusting your doses to cope with what your body is doing is the right thing to do IMO. If you're confident enough to do it, it'll get the fastest feedback. But keep measuring, so you don't get caught out.
If you stay ill for a while, talk to your GP.

(and what's "tracking macros"? Visual basic does that for me in Excel, but I suspect that's not what you're talking about )

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Thanks Clive, I guess you are right. I think im more just frustrated with it not being as easy as normal and want it to just go back to how things were asap! I have been testing about twice as much as normal since this all started so I shall continue to do so until things (hopefully) return to normal.

Ha! Tracking macros as in macronutrients i.e. carbohydrates, fats and proteins. I have a figure I need to hit each day that together make up a daily calorie limit. I use the MyFitnessPal app to track everything I eat so I can log it all!

Thanks for the advice!

Just a quick update for anyone that had taken the time to read this! BG is now completely back to normal since yesterday, have adjusted evening Levemir dose back to what it was and my ratio for carbs has returned to 10:1. Resting BG is back at ~5 rather than ~9 so I'm happy. I guess I will take this as a learning curve that a virus can take around 2 weeks to properly be flushed from the body. Thanks all.