Gastroenteritis or Ketoacidosis Abroad

[YorkshireDave]

My wife was diagnosed as having diabetes a few years back and has coped with all the problems that arise from this condition and I couldn?t be more proud of her. As a vegetarian she has always ate well and neither does she consume too much alcohol. She drinks litres of mineral water every day. She also exercises on a regular basis down at our local gym.

So what is the problem you ask?...

Every year we go abroad to the Greek islands and the last couple of times she has ended up with Gastroenteritis or ketoacidosis and has been omitted to hospital on her return.

This time we had to return a week early because of these problems. Do not get me wrong this is not the issue. I would just like to know why this only appears to happen when we go abroad and never at home (UK).

I know when going abroad you have to more vigilant with testing your levels to which she does and she also drinks her mineral water by the litre/s and washes her hands religiously.

Against my wishes she still smokes and in her defence she only smokes 2-3 a day and on this holiday she found it hard to eat in a morning as it was too hot.

So

Can anyone out there let me know if they have experienced the same problems abroad with Gastroenteritis or ketoacidosis and if so:

What signs should we look out for?

How did you resolve it?

What precautions can be taken?

Are there any medicines or things we can do before going on our holidays.

Any advice or support would be much appreciated and valued.

I don?t want to see my lovely wife poorly and she deserves her holiday as she works extremely hard throughout the year and coping with me!!

Thanks again,

YorkshireDave

 

[Steff]

Hi Dave and a warm welcome to the forum ,sorry I cant directly help with your queries but i wanted to say good on you for joining here you sound like you love your wife dearly,and you are indeed correct she does deserve some time out and to be able to enjoy her holidays without illness getting in the way.Anyway never fear you will get some great help from here.

Steph 🙂

 

[Northerner]

Hi Dave from a fellow Yorkshireman! 🙂 As you mention ketoacidosis I presume your wife is Type 1? It sounds as though she is particularly vulnerable to picking up bugs when abroad, and illness can have a profound effect on blood sugar control. Has she been taught 'sick day rules'? This is an approach that should be taken when ill, to take extra insulin injections in order to bring down high blood sugar levels. The gastroenteritis is a bad enough experience for anyone, but when coupled with insulin-controlled diabetes its effects can be much more serious. If levels climb too high and there is insufficient insulin then this is when ketoacidosis occurs as the body can't utilise the glucose in the blood.

I don't have any tips on avoiding gastroenteritits, other than those you are clearly already aware of. One thing to bear in mind is that it's possible for insulin to lose its potency if it gets too warm so needs to be kept cool - might this have happened?

 

[shiv]

Hi Dave, have you spoken to her diabetes team about this? They may be able to help you identify why she is going into ketoacidosis and help you work out strategies to stop it happening.

 

[margie]

As Northerner said Insulin can lose its potency in the heat.

When I went to Turkey I was advised not to drink tap water and to avoid ice-cubes which could be made from tap-water, plus avoid salads - washed in tap water. I don't know if the same advice is given for Greece but maybe your wife should try and stick with cooked meals - I know that is hard in the heat.

 

[Robster65]

Hi Dave.Welcome 🙂

Ditto what's already been said.

As your wife is a vegetarian, I'm guessing there is a greater risk of contaminated food, possibly from salad or uncooked veg ?

No idea what the answer to that is, but wondered if you have any thoughts on how she could have contracted the gastro-enteritis ?

Rob

 

[Ellie Jones]

When you are away do you eat out a lot in local resturants!

As it may be that she's getting the gastroenteritis because if she's eating raw vegetables or salads, it's being washed with tap water, which the locals will be used to, but your wife stomach may not be...

So perhaps, keeping to cooked when out, and if preparing meals at home ensure well washed in bottle water..

Other mistakes often made by holiday makers aboard which leads to the deli bellies, is ice-cubes in their drinks being made from tap water, and one that caught my brother out... Using tap water when brushing teeth!

As to the ketoacidosis, well your wife needs to speak to her clinic so that can go through sick days rules.. If she's on insulin then they can give guidence to how to increase this to prevent it going into DKA..

If she tablet controlled, then perhaps they can issue insulin for emergency use, showing her how to inject etc so if her BG's start going upwards etc then she might avoid going DKA

Do you take keto sticks as the early you can pick up ketones and start sick day rules the more likely you can avoid DKA

 

[Caroline]

Hi just wanted to say welcome to the forum. I can't add to advice already given, but I think your wife is very lucky to have such a good husband.

 

[YorkshireDave]

Just wanted to thank everyone for their messages of advice and support,
I really do appreciate it. Please keep the advice and tips coming.
A few of the posts mentioned about the insulin losing it's potency if it's too warm. Would you advise me to put the insulin in the fridge when going on holiday to a hot country?

I am trying to ensure this doesn't happen to my wife again when going abroad so any ideas would be welcome.

Thanks again and have a good weekend.

YorkshireDave

 

[Caroline]

To keep insulin cool many people use things called Frio Packs and report they are very efficient, someone will be along soon to tell you more.

I seem to remember when I was a kid, my mum would go to the chemist and get some tablets that tasted like cardboard that were supposed to stop stomach upsets. I don't know if you can do the same now. It may be worth talking to the doctor or the pharmacist about it. I don't know if you can still get them. Last time we went abroad we stuck to cooked food and bottled drinks.