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Sick Bug

mountaintom

Well-Known Member
Messages
574
Location
Lauragh, Kerry
Type of diabetes
Type 1
Treatment type
Insulin
Okay so I spent yesterday night and today looking after my 5 year old daughter who picked up a sick bug and hey presto at around 10pm tonight I vomit violently. Really nasty bug this one. Don’t know if it’s relevant but I had a massive, almost unbeatable hypo shortly before. I drank 2 cans of coke 8 glucose tablets and some fruit pastilles as it wouldn’t get up past 3.1, 3.2.
I’ve vomited again and checked my bg which are at 10.2 and probably rising. I think I’ll be sick again (daughter was about 8 times over 12 hour period. Should I be checking my ketones and also, should I have some correction insulin say if I go up past 13/14?
Thanks. Bleurgh.
P.S. that hypo was a record breaker. Utterly smashed me and wouldn’t give in.
 

I'm not T1, so can't be definitive, but I'd err on the side of caution and check your ketones if your numbers are high. Are you familiar with Sick Day Rules?

These could maybe be useful: http://www.leicestershirediabetes.org.uk/uploads//documents/Type1_Sickdays_LDC_JAN2015.pdf

As always, if in doubt, 111 or A&E if you're very unwell. Better safe than sorry.
 
Sorry you're unwell. It's not easy to look after your diabetes when you feel like this but it IS more important than ever. So check ketones. Have water to hand and try to drink some regularly, even if you don't feel like it. Test your blood glucose and ketones every two hours if your ketone reading from a blood test was more than 1.5mmol/l. Calculate your Total Daily Dose of insulin from yesterday's diary. If ketones are 1.5 - 3mmol/l on blood test meter, give 10% of TDD as rapid-acting insulin every 2 hours, if ketones are over 3mmol/l on blood test meter, give yourself 20% of TDD as rapid-acting insulin every 2 hours. You probably aren't eating, but if you are, you will need also to give your usual ratio of rapid acting insulin to match the food. Continue to take your basal insulin as normal.
I hope you feel better soon. When I last had this sort of illness, I couldn't have done any of the above because I felt too ill! I'm just quoting Sick Day Rules for you - but they are easier said ( or written) than done.
 
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Thanks. I’m not sure I’ll be keeping any fluids down for a while. I’ll go check my ketones now. Bg is steady at 10.2 which doesn’t bother me too much.
 
lizdeluz said:
I'm just quoting Sick Day Rules for you - but they are easier said ( or written) than done.
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Wow, that's interesting about the ketones. I've been T1 for 48 years and never had DKA or bothered to test for ketones. If I get sick I just keep track of sugars and if I'm vomiting or have diarrhoa (OK have no idea how to spell that) I make sure that my sugars aren't so low as to cause a hypo....
I'm in New Zealand - not sure if there are any ketone testing strips available to the public....certainly wasn't offered any by my diabetic nurse....?
 
Still poorly. Was sick 5 times last night. Ketones are 0.2 which is fine. Bg’s are 12/13. Should I do a correction? I can barely keep water down.
 
Yes, I've been T1 for, um, 33 years, and have never had DKA nor known anything about ketone testing...... until a month ago, when I was offered and attended a Dafne course at my local hospital, in part to help me with overnight low blood sugars. As part of the course we were taught the Sick Day Rules, and were given ketone test strips to use with a blood sugar monitor. I haven't been ill for quite a while, but whenever I do get a sickness bug I know I'm in no fit state to do any testing at all, I can't focus on the blood sugar monitor (because of a blinding headache) even if I do manage to do a blood test, I can't eat so that's not relevant either. However, in the brief respites between throwing up (sorry!) and perhaps other unmentionables, I can see that testing for ketones and attempting to prevent rises in blood sugar due to the infection is something I would want to try to do, if only to keep myself out of A&E. I find when I have these sickness bugs occasionally, that low blood sugars are not likely to happen: high blood sugars, though, are very likely when I'm ill, despite my not eating anything.
 
mountaintom said:
Still poorly. Was sick 5 times last night. Ketones are 0.2 which is fine. Bg’s are 12/13. Should I do a correction? I can barely keep water down.
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Yes, one unit would be safe enough and perhaps help to avoid a further rise. In two hours, if you can, test again, and give another small correction dose? Question mark, because I'm not qualified to advise, but if I were you, this would be my plan of action.
 
Thanks guys. I’m keeping water down now so I think on the mend. Bg’s have levelled at 11 with no correction.
 
Hi @mountaintom . Whenever I'm sick as you are at the moment I tend to let my sugars run in the low teens. In fighting any infections the body reacts differently to normal times and even with minimum food intake you may find that you have raised levels, it's how the body's defence system works.
If you do a correction dose be careful that you don't end up on a rollercoaster. Sugars go to low, you eat, you vomit, you battle a hypo and then your sugars go high and you start all over again.
I think a lot of us T1's who have been doing it for some time are happy to run that little bit higher whilst sick. As long as the ketones are good, being high for a few days shouldn't cause any problems.
Hope you feel better soon.
 

Fantastic. That’s kind of what my body told me. I’m letting the bg’s take a back seat for a day or so. I’m thinking about eating some plain porridge in a few hours so will bolus accordingly for that.
Thank you so much
 
I only test for keytones if bloods go over 13mmol and i tend not to give correction doses unless over15 but thats just me and what i do when im ill as i end up on the high/low rollercoaster otherwise hppe this helps
 
When I have a stomach bug I can only eat dry toast/banana/stewed apple/boiled rice and carrots = all things that usually spike my blood sugars! But somehow my body knows what it needs as my numbers stay more or less ok (I guess I'm eating way less than normal so it kind of balances out?)
 
mountaintom said:
Fantastic. That’s kind of what my body told me. I’m letting the bg’s take a back seat for a day or so. I’m thinking about eating some plain porridge in a few hours so will bolus accordingly for that.
Thank you so much
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mountaintom, I'm tagging @Juicyj , and I'm neither T2 nor an insulin user . I'm hoping if JuicyJ or one of the other T1s comes around I'll be educated a bit here, but my question would be, would it be wise to take a "proper"dose of insulin with the first food after a vomiting bug, or would it be safe to either take a little less, then correct later or split the dose, just in case mountaintom sees the porridge again?

Mountaintom - Please don't be influenced by my question or think I'm suggesting you're wrong
 
If your starting to feel better then take your bolus dose as per normal with food, I wouldn't be so worried if your feeling better. Sorry to hear you've been unwell, it's pretty stressy being sick with type 1 as there's so much more to think about, but ultimately sickness is temporary and getting your bg back into range again now is important.
 
Thanks JuicyJ
 

I had the same thought as I was loading up my needle and decided to eat 15g of porridge which is about 10g of carbs and NOT bolus, just in case. I thought it’d be better to see how I got on. It’s stayed down so I might leave the bolusing until breakfast as I don’t think I should eat anything else. I just had to put something in my stomach as it was painful!
Thanks for your well wishes. Having T1 and a stomach bug is quite a mission. Having a massive hypo just before vomiting is as well! Won’t forget this one.
Really appreciate everyone’s input. Thanks.
 
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