Gastroparesis and diabetes

[Isma1123]

Which might point to thrush. Very common in diabetes.

Hmmmm yeah it is true, I was thinking it might be due to my gastroparesis, I’ve mentioned all this to the clinician, but she didn’t say that it could be thrush, some of these health professionals don’t have a bloody clue. I’ve been given laxido, sugar free oral sachets to take, to help with my stools, but am not having much luck. Thank you

 

[Leadinglights]

Hmmmm yeah it is true, I was thinking it might be due to my gastroparesis, I’ve mentioned all this to the clinician, but she didn’t say that it could be thrush, some of these health professionals don’t have a bloody clue. I’ve been given laxido, sugar free oral sachets to take, to help with my stools, but am not having much luck. Thank you

If you could take a picture of your tongue or get someone else to do it and send to your GP they could likely be able to tell if it could be thrush and do a swab test to check and then you could have the correct treatment. Thrush is a yeast infection and loves a sugary acidic environment to grow.

 

[AJLang]

Hey there, in terms of the food emptying, it does take the most, two days for me, why do you say? My gastroparesis doesn’t tolerate fibre at all, hence why I’ve cut it out completely. The clinician said to me yesterday that when I go for my diabetes review, they may be able to further refer me to any other specialists. I hope so too. My weight hasn’t changed since the last month, even though I’ve lost 10 pounds, over the year, presuming I had changed my diet and was eating more healthily, like a lot of vegetables and salads, cutting out anything bad etc. I wouldn’t say I’m gone gaunt or anything, more than anything, I look pretty much the same.

I ask because I wonder how you know it takes two days to empty. What shows you that it takes two days As that does seem a long time Even with gastroparesis.
Youve also said that your blood sugar went up after eating 10 carbs. The nature of gastroparesis is if you’ve had the bolus insulin for carbs with gastroparesis your blood sugar would have usually stayed the same or gone down one hour after eating. I’m just concerned that you haven’t had a correct diagnosis.

 

[Isma1123]

If you could take a picture of your tongue or get someone else to do it and send to your GP they could likely be able to tell if it could be thrush and do a swab test to check and then you could have the correct treatment. Thrush is a yeast infection and loves a sugary acidic environment to grow.

Yeah I will do that, I’m presuming that the thrush must have got triggered from the gastro, I’m trying keep hydrated by drinking plenty of fluids, which I do. My hbc1 was 7.1 back in August, which is pretty decent. Even though you don’t have gastro, would you know where abdomen discomfort precisely occurs, mine is under the rib cages, on both sides of stomach and below, by my pelvic. At least like this, I can get a clear picture, that’s it very possible I do have it. I haven’t actually had a diagnosis done yet & one nurse asked me, if I’m self diagnosing myself. I don’t pass stools after two days and not much, I’m pretty certain I do have it. It’s pretty daunting all this is. For everyone on here also, who has battled with it for a long time. I want to thank everyone, including yourself for being an ear to fall on and a guidance for support. It sometimes makes me doubt my future and it’s pretty scary. Just being really honest here, feeling very overwhelmed right now. Thank you again

 

[Leadinglights]

Yeah I will do that, I’m presuming that the thrush must have got triggered from the gastro, I’m trying keep hydrated by drinking plenty of fluids, which I do. My hbc1 was 7.1 back in August, which is pretty decent. Even though you don’t have gastro, would you know where abdomen discomfort precisely occurs, mine is under the rib cages, on both sides of stomach and below, by my pelvic. At least like this, I can get a clear picture, that’s it very possible I do have it. I haven’t actually had a diagnosis done yet & one nurse asked me, if I’m self diagnosing myself. I don’t pass stools after two days and not much, I’m pretty certain I do have it. It’s pretty daunting all this is. For everyone on here also, who has battled with it for a long time. I want to thank everyone, including yourself for being an ear to fall on and a guidance for support. It sometimes makes me doubt my future and it’s pretty scary. Just being really honest here, feeling very overwhelmed right now. Thank you again

I think it is really important you get a proper diagnosis rather than second guessing as you may be missing out on treatment that would help you.
Maybe one of the others would be in a better position to comment on your symptoms.

 

[Isma1123]

I ask because I wonder how you know it takes two days to empty. What shows you that it takes two days As that does seem a long time Even with gastroparesis.
Youve also said that your blood sugar went up after eating 10 carbs. The nature of gastroparesis is if you’ve had the bolus insulin for carbs with gastroparesis your blood sugar would have usually stayed the same or gone down one hour after eating. I’m just concerned that you haven’t had a correct diagnosis.

I ask because I wonder how you know it takes two days to empty. What shows you that it takes two days As that does seem a long time Even with gastroparesis.
Youve also said that your blood sugar went up after eating 10 carbs. The nature of gastroparesis is if you’ve had the bolus insulin for carbs with gastroparesis your blood sugar would have usually stayed the same or gone down one hour after eating. I’m just concerned that you haven’t had a correct diagnosis.

Huh, you think? I might be wrong about having it? Well I haven’t had a diagnosis yet, I’ve told the staff that it’s very possible I may have it because I’m having the symptoms. But the nurse said to have my Diabetes reviewed before anything, before I go down that road that’s all, my main symptom is delayed stools & a little slight discomfort of the abdomen, nothing severe. I just don’t understand then if that’s the case, why am I having trouble digesting my food, that’s a very big concern. Otherwise my appetite is absolutely fine, not throwing up and I’m full of beans. But thank you for pointing that out, yeah you do make sense. Could be a case of having to get my insulin adjusted which the nurse had assumed, but I’m not 100% going by it. Maybe it could be insulin resistance, sensitivity, we are different, but I really don’t know. Isn’t insulin sensitivity caused by uncontrolled diabetes, or am I wrong? I’m also getting a few unusual slight spikes like 10 and 11 readings. I do majority of the time get the readings within the target range, but the spikes don’t make sense, hence why I’m putting it down to having gastro.

 

[Leadinglights]

This link has lots of information about the tests which you could have to confirm your diagnosis and also suggests that the NICE guidelines would indicate you should qualify for an insulin pump as well as some other suggestions for helping manage the condition if indeed you do have it.

Gastroparesis | Causes, Symptoms, Treatment & Diet | Guts UK Charity

Gastroparesis is a condition that affects the stomach. The name means stomach (gastro) paralysis (paresis). Gastroparesis is a chronic (long-term) disorder. In gastroparesis, the stomach does not empty its contents in the usual way.

gutscharity.org.uk

 

[Isma1123]

I think it is really important you get a proper diagnosis rather than second guessing as you may be missing out on treatment that would help you.
Maybe one of the others would be in a better position to comment on your symptoms.

Yeah sure thing

 

[Isma1123]

This link has lots of information about the tests which you could have to confirm your diagnosis and also suggests that the NICE guidelines would indicate you should qualify for an insulin pump as well as some other suggestions for helping manage the condition if indeed you do have it.

Gastroparesis | Causes, Symptoms, Treatment & Diet | Guts UK Charity

Gastroparesis is a condition that affects the stomach. The name means stomach (gastro) paralysis (paresis). Gastroparesis is a chronic (long-term) disorder. In gastroparesis, the stomach does not empty its contents in the usual way.

gutscharity.org.uk

I’m glad you sent me this link, cos I don’t actually have 90% of them symptoms………. Thank you for this, it’s quite reassuring and a godsend, thank you for your support.

 

[Isma1123]

This link has lots of information about the tests which you could have to confirm your diagnosis and also suggests that the NICE guidelines would indicate you should qualify for an insulin pump as well as some other suggestions for helping manage the condition if indeed you do have it.

Gastroparesis | Causes, Symptoms, Treatment & Diet | Guts UK Charity

Gastroparesis is a condition that affects the stomach. The name means stomach (gastro) paralysis (paresis). Gastroparesis is a chronic (long-term) disorder. In gastroparesis, the stomach does not empty its contents in the usual way.

gutscharity.org.uk

I’m glad you sent me this link, cos I don’t actually have 90% of them symptoms………. Thank you for this, it’s quite reassuring and a godsend, thank you for your support

 

[Leadinglights]

The trouble is it is very easy to assume you have something when in fact you haven't but have something else which needs attention and for which there would be some straightforward treatment.
Please do see your doctor and try to get some reassurance.

 

[Isma1123]

I’m glad you sent me this link, cos I don’t actually have 90% of them symptoms………. Thank you for this, it’s quite reassuring and a godsend, thank you for your support

I’m glad you sent me this, I don’t have 90% of them symptoms but I do have delay of stomach emptying and I do feel dehydrated. And what’s with the unusual spikes I will talk to my doctor about this on Monday and get some examinations booked. Thank you so much, but one more thing, dosent it vary from person to person, some may have all symptoms, some may have few. Don’t the hospital do these tests rather than the G.P, I would have been informed about this, when I first shared my concerns. But thank you overall

 

[Isma1123]

The trouble is it is very easy to assume you have something when in fact you haven't but have something else which needs attention and for which there would be some straightforward treatment.
Please do see your doctor and try to get some reassurance.

I will do, thank again

 

[rebrascora]

I suspect that your diet is responsible for your infrequent stool passing. Not enough fibre and mostly protein will slow things down in your gut and can very easily make you constipated.

As regards sugar spikes, going up to 10 or 11 would be pretty normal for Type 1 but I am guessing this is 2 hours after a meal if you are only finger pricking and don't have gastroparesis and your levels may even be going higher in that 2 hour period, but you can reduce the spikes by taking your insulin a little earlier before you eat. So for instance I usually need to inject my insulin 15-20mins before eating, but at breakfast time I need to inject it much earlier to prevent spiking. This timing is much easier to work out when you have Libre to see how your levels are reacting and when your insulin is kicking in. I didn't suggest this earlier because with Gastroparesis, the food sits in your stomach and releases it's glucose much more slowly, so taking insulin earlier would lead to hypos. It doesn't sound like you have gastroparesis from the things you have said, but your diet may not be helping your gut. Having plenty of fibre is really important for your gut health and bowel movements.

 

[AJLang]

I suspect that your diet is responsible for your infrequent stool passing. Not enough fibre and mostly protein will slow things down in your gut and can very easily make you constipated.

As regards sugar spikes, going up to 10 or 11 would be pretty normal for Type 1 but I am guessing this is 2 hours after a meal if you are only finger pricking and don't have gastroparesis and your levels may even be going higher in that 2 hour period, but you can reduce the spikes by taking your insulin a little earlier before you eat. So for instance I usually need to inject my insulin 15-20mins before eating, but at breakfast time I need to inject it much earlier to prevent spiking. This timing is much easier to work out when you have Libre to see how your levels are reacting and when your insulin is kicking in. I didn't suggest this earlier because with Gastroparesis, the food sits in your stomach and releases it's glucose much more slowly, so taking insulin earlier would lead to hypos. It doesn't sound like you have gastroparesis from the things you have said, but your diet may not be helping your gut. Having plenty of fibre is really important for your gut health and bowel movements.

I completely agree with what @rebrascora has said. After reading all the posts this is exactly what I was thinking last night. I think you also need to get your basal insulin sorted out as it doesn’t sound like you are having enough. Hopefully someone can post you to the link on basal testing.

 

[rebrascora]

Link to basal testing...

Basal Testing Made Easy

Here's a link for basal testing, which will hopefully clear up the myths for anyone starting on their pump journey http://diatribe.org/issues/13/learning-curve Plus this might help as well. http://diatribe.org/issues/26/thinking-like-a-pancreas

forum.diabetes.org.uk

 

[Isma1123]

I suspect that your diet is responsible for your infrequent stool passing. Not enough fibre and mostly protein will slow things down in your gut and can very easily make you constipated.

As regards sugar spikes, going up to 10 or 11 would be pretty normal for Type 1 but I am guessing this is 2 hours after a meal if you are only finger pricking and don't have gastroparesis and your levels may even be going higher in that 2 hour period, but you can reduce the spikes by taking your insulin a little earlier before you eat. So for instance I usually need to inject my insulin 15-20mins before eating, but at breakfast time I need to inject it much earlier to prevent spiking. This timing is much easier to work out when you have Libre to see how your levels are reacting and when your insulin is kicking in. I didn't suggest this earlier because with Gastroparesis, the food sits in your stomach and releases it's glucose much more slowly, so taking insulin earlier would lead to hypos. It doesn't sound like you have gastroparesis from the things you have said, but your diet may not be helping your gut. Having plenty of fibre is really important for your gut health and bowel movements.

So why the sugar spikes, unless my diabetes is getting abit hard to manage, I pray it’s not that but don’t seem sure anymore, I just feel helpless. I had a reading of 11 just before writing this, or maybe it could be that I injected just before having my meal, I usually do inject 20 mins earlier. My readings today were 9.8 before breakfast, then it was around the same 1 hour after. Before lunch it was 10 and I’ve just checked and it was 11, that is quite high isn’t it? My bowels are not emptying very well it’s taking me about 2 to three days to empty and not much is coming out. And if I eat fibre, it will make it worse cos it breaks down slower than carbs & spike my blood sugars. I don’t really get any other symptoms apart from that. I will next meal increase my insulin abit and take it more earlier, that should hopefully bring it down again. It does help when I do that, so maybe with that tad mistake was the result of that reading. I’m feeling too overwhelmed and my mind is abit all over the place. I was on the phone to the out of hours service the other day and the clinician also said that it’s normal for levels to go up that much. But it’s not ideal is it, if you know what I mean, incase it can go up.

 

[rebrascora]

@Isma1123 These levels are not sugar spikes they are your base levels when you are high above range before meals and my guess is, they are too high because your basal (long acting) insulin dose is probably not enough, which is why basal testing has been suggested. What level did you go to bed on the night before and when do you inject your basal (long acting) insulin? I think you said you use Levemir don't you? Do you take it as a single dose or split into 2 doses, morning and night?
What did you have for breakfast and how much NovoRapid did you inject for it?

Fibre does not cause sugar spikes because it is not digestible. It provides soft bulk to help move the protein waste through your gut. Fibre is really important for good gut health. I take a fibre supplement as well as eating plenty of vegetables. It has made a huge difference to my bowel movements being regular (once daily), easy to pass and healthy.

Do be careful with taking your insulin too far ahead of a meal if your BG levels are low (4 or 5) before the meal as you could easily hypo, but if they are high (7 or above) before the meal like yesterday morning before breakfast when you were 9.8, then it will usually help to give the insulin a bit of time to start working before you eat.

Being consistently about 10 is not desperately bad short term for a few days or even a week or two and happens to many of us when we have an illness or when our basal insulin dose needs adjusting, as it does occasionally, but obviously you don't want it to be in double figures for months on end, so working out what you need to do to change that and carefully adjusting things to bring it down slowly into range is important. This was one of the main things I learned from the DAFNE course. How and when to adjust my long acting insulin to balance my levels.

 

[Isma1123]

@Isma1123 These levels are not sugar spikes they are your base levels when you are high above range before meals and my guess is, they are too high because your basal (long acting) insulin dose is probably not enough, which is why basal testing has been suggested. What level did you go to bed on the night before and when do you inject your basal (long acting) insulin? I think you said you use Levemir don't you? Do you take it as a single dose or split into 2 doses, morning and night?
What did you have for breakfast and how much NovoRapid did you inject for it?

Fibre does not cause sugar spikes because it is not digestible. It provides soft bulk to help move the protein waste through your gut. Fibre is really important for good gut health. I take a fibre supplement as well as eating plenty of vegetables. It has made a huge difference to my bowel movements being regular (once daily), easy to pass and healthy.

Do be careful with taking your insulin too far ahead of a meal if your BG levels are low (4 or 5) before the meal as you could easily hypo, but if they are high (7 or above) before the meal like yesterday morning before breakfast when you were 9.8, then it will usually help to give the insulin a bit of time to start working before you eat.

Being consistently about 10 is not desperately bad short term for a few days or even a week or two and happens to many of us when we have an illness or when our basal insulin dose needs adjusting, as it does occasionally, but obviously you don't want it to be in double figures for months on end, so working out what you need to do to change that and carefully adjusting things to bring it down slowly into range is important. This was one of the main things I learned from the DAFNE course. How and when to adjust my long acting insulin to balance my levels.

My basal is 22 units per night, at ten at a fixed time. Maybe they might be able to adjust that with me at my Diabetic review clinic, incase that works. Even though my readings are abit high, doing the same dosage more earlier does not make a difference to my sugar levels, hence why I need to increase them abit. Yesterday I had for breakfast two boiled eggs, the reading after one hour was the same, 9.3 even though I increased my dosage abit. I know that fibre doesn’t cause sugar spikes, but because my digestion is delayed, which im assuming maybe gastroparesis related, I could be wrong, but it’s a long term complication caused by uncontrolled diabetes, my diabetes wasn’t controlled over the years, hence why I think I may have it and with digestive issues, fibre is the last thing to eat as it takes longer to break down which causes the spike. What if it’s not for a few weeks and it takes longer struggling to get sugar levels under range? My doctor rang me today, asking about everything and she said that my Diabetes might not be the problem as my bg levels are near range and that she may have to take some bloods from me to find out whether it’s due to hormones or hormonal change. She also wants me to do a urine sample. Yesterday I ran on a couple of 11 and one 10. Then last night I managed to get it down to 6, then it was 4 post meal and 5 after one hour, but something happened last night, which may have caused it, I had a hype around 5am and my reading was under 3, I had a few biscuits and 2 spoonfuls of Nutella spread, i checked my reading again after 10 mins only went up slightly, so I had a few more biscuit and a few mouthfuls of Nutella spread. I then checked my levels, it went up to 7.9 abit high, maybe the mistake could have been I overate the sweet things, so will remember next time to have way more less or even better have a few sips of sugar in water as it reaches the bloodstream much much quicker. And my morning reading was over 11. I think the DAFNE course may be a godsend. I’m also eager to get the omnipod as I’ve heard and read on fb that it’s helped so many people with their health and changed their life. My anxiety is still pretty much the same, I try to stay calm and think good thoughts, overthinking could be the culprit, I don’t know. I’m sick of eating smaller meals and just want to eat a big normal meal, my appetite is absolutely fine and I don’t really ever get any abdominal discomfort, just a little pain on both sides of stomach and under the ribs and near pelvis, I’m never sick and I can pretty much eat as normal. My mental health has gone downhill significantly, just feel abit helpless.

 

[Leadinglights]

My basal is 22 units per night, at ten at a fixed time. Maybe they might be able to adjust that with me at my Diabetic review clinic, incase that works. Even though my readings are abit high, doing the same dosage more earlier does not make a difference to my sugar levels, hence why I need to increase them abit. Yesterday I had for breakfast two boiled eggs, the reading after one hour was the same, 9.3 even though I increased my dosage abit. I know that fibre doesn’t cause sugar spikes, but because my digestion is delayed, which im assuming maybe gastroparesis related, I could be wrong, but it’s a long term complication caused by uncontrolled diabetes, my diabetes wasn’t controlled over the years, hence why I think I may have it and with digestive issues, fibre is the last thing to eat as it takes longer to break down which causes the spike. What if it’s not for a few weeks and it takes longer struggling to get sugar levels under range? My doctor rang me today, asking about everything and she said that my Diabetes might not be the problem as my bg levels are near range and that she may have to take some bloods from me to find out whether it’s due to hormones or hormonal change. She also wants me to do a urine sample. Yesterday I ran on a couple of 11 and one 10. Then last night I managed to get it down to 6, then it was 4 post meal and 5 after one hour, but something happened last night, which may have caused it, I had a hype around 5am and my reading was under 3, I had a few biscuits and 2 spoonfuls of Nutella spread, i checked my reading again after 10 mins only went up slightly, so I had a few more biscuit and a few mouthfuls of Nutella spread. I then checked my levels, it went up to 7.9 abit high, maybe the mistake could have been I overate the sweet things, so will remember next time to have way more less or even better have a few sips of sugar in water as it reaches the bloodstream much much quicker. And my morning reading was over 11. I think the DAFNE course may be a godsend. I’m also eager to get the omnipod as I’ve heard and read on fb that it’s helped so many people with their health and changed their life. My anxiety is still pretty much the same, I try to stay calm and think good thoughts, overthinking could be the culprit, I don’t know. I’m sick of eating smaller meals and just want to eat a big normal meal, my appetite is absolutely fine and I don’t really ever get any abdominal discomfort, just a little pain on both sides of stomach and under the ribs and near pelvis, I’m never sick and I can pretty much eat as normal. My mental health has gone downhill significantly, just feel abit helpless.

Perhaps if you are having some dialogue with your GP you could ask for the diagnostic tests mentioned on the GUTS.uk site to confirm your self diagnosis as that might then support getting a pump or other technology.