Imodium and Insulin

Status
Not open for further replies.
C

CMH

Active Member
Relationship to Diabetes
Carer/Partner
Hi all,
I’m on typing duty for my OH again. He’s been on insulin for nearly a month now and his blood sugars are much better controlled if slightly higher than they should be because he been suffering from hypo anxiety. His DN recommend he aim to keep his blood sugar between 7 and 12 in the short term and then work on lowering that target slowly to help reduce anxiety.

Today he’s had his first hypo. His blood sugar was at the high end of normal (around 8) before lunch. He injected 6 units of novorapid as normal and ate a typical meal. Normally his blood sugar rises a little after eating and then is back to a pre-meal level within two hours. However today he was at 3.6 less than an hour later (Libre said 2.8 but finger prick was 3.6). He actually had hypo symptoms before his low alarm went off, so I guess his blood sugar must have been dropping quickly. One difference from normal was that he’s taken Imodium today because of his ongoing diarrhoea troubles. Could the slowing down of his digestion that Imodium causes be related to the hypo? If so, is it worth avoiding Imodium in the future or is there a way to stop the drop from happening?
 
@CMH If he has diarrhoea, he’s probably not absorbing his food properly - hence the drop. I suggest he reduces his mealtime insulin and monitors closely. The last time I had a nasty stomach virus, even when I was back to eating, I only needed 1/3 of the insulin for a meal than I’d normally have for that meal. This gradually returned to normal.
 
Just to add, I’ve never heard of Imodium affecting blood sugar. It’s more likely to be his digestion working erratically and unpredictably.
 
I remember your husband now. Has he been able to see a consultant about his GI issues? It sounds horrible for him.
 
Inka said:
@CMH If he has diarrhoea, he’s probably not absorbing his food properly - hence the drop. I suggest he reduces his mealtime insulin and monitors closely. The last time I had a nasty stomach virus, even when I was back to eating, I only needed 1/3 of the insulin for a meal than I’d normally have for that meal. This gradually returned to normal.
Click to expand...
Hi Inka, thanks for your quick reply. Unfortunately for him, the frequent diarrhoea is a daily occurrence but it was worse than usual today, hence the Imodium.
He hasn’t seen a consultant but the GP has finally worked out how to order a fecal elastase test to see if it’s pancreatic enzyme insufficiency so he’s waiting on results for that. He’s also got an appointment about a colonoscopy on the 20th. Even on insulin he’s still losing a lot of weight and feeling pretty terrible.
 
I hope he gets the results back quickly @CMH It must be sapping all his energy and making him miserable. It’s bad enough for a few days. I hope he gets answers - and help - very soon.
 
I'm having a similar issue at the moment - Food does eventually hit my BG but its being very delayed and I'm not certain it is all being absorbed. Thread HERE

He could play with his libre alarms a little bit, making it a pretty tight window based on the number he is when eating so he will know quickly which direction it is heading in.
ie if he was 8 at the time, setting a 6.5 low, and if he took a reduced dose of insulin setting 10 high (or whatever he feels is appropriate)
He can then take action based on what alarm went off
give more/the rest of the fast acting for high alarm if it is a normal (for him) meal trend
get going on bringing it back up earlier with glucose tabs if the low alarm went off
Maybe moving alarms about through the course of the fast acting effective window too depending what is happening

I am doing no fast acting and using the high alarm to tell me if/when I need to add some but I am t2/have some effective insulin supply of my own which is safe for me to do so for me as I have more of a safety net. I do not know your hubby's circumstances.

The important bit is to remember to reset alarms after each meal to what he normally has them at.

I hope he get some answers soon. I really do understand how miserable it is. Let us know how he's getting on.
(p.s. I have been strongly advised to get some barrier cream for prep day 😉 )
 
CMH said:
He hasn’t seen a consultant but the GP has finally worked out how to order a fecal elastase test to see if it’s pancreatic enzyme insufficiency so he’s waiting on results for that. He’s also got an appointment about a colonoscopy on the 20th. Even on insulin he’s still losing a lot of weight and feeling pretty terrible.
Click to expand...

Hope the test results come through speedily, and help provide some understanding. The weight loss must be quite worrying for you both :(

Do let us know what they find out, and hopefully it will point the way to a better treatment plan. Those on the forum who take Creon for PEI comment how important it is for them, and how effective. Hope it’s something as simple as that.
 
Hear hear to the barrier cream for his poor forcibly overworked bum. First time I had a colonoscopy one could still get zinc & castor oil cream from pharmacies but since then - because husband had prostate cancer which was removed, and followed by radiography which didn't help put brakes on the defecating frequency front (TMI) we've always got an open tub of Sudocrem - so I was willing and able to use that too, when I needed a camera up my rear end the other week. The absolutely worst thing about the whole procedure for me both times, was drinking the prep.
 
gll said:
I hope he get some answers soon. I really do understand how miserable it is. Let us know how he's getting on.
(p.s. I have been strongly advised to get some barrier cream for prep day 😉 )
Click to expand...
Thanks so much for your response @gll. I hope you also get some answers soon. It’s been so hard for him and I really feel for both him and you.
 
trophywench said:
Hear hear to the barrier cream for his poor forcibly overworked bum. First time I had a colonoscopy one could still get zinc & castor oil cream from pharmacies but since then - because husband had prostate cancer which was removed, and followed by radiography which didn't help put brakes on the defecating frequency front (TMI) we've always got an open tub of Sudocrem - so I was willing and able to use that too, when I needed a camera up my rear end the other week. The absolutely worst thing about the whole procedure for me both times, was drinking the prep.
Click to expand...
Thanks for your response! We’ll definitely invest in some sudocrem. He says he’s not too worried about the prep - it sounds like it will be fairly similar to what he experiences on a daily basis!
 
gll said:
I'm having a similar issue at the moment - Food does eventually hit my BG but its being very delayed and I'm not certain it is all being absorbed. Thread HERE

He could play with his libre alarms a little bit, making it a pretty tight window based on the number he is when eating so he will know quickly which direction it is heading in.
ie if he was 8 at the time, setting a 6.5 low, and if he took a reduced dose of insulin setting 10 high (or whatever he feels is appropriate)
He can then take action based on what alarm went off
give more/the rest of the fast acting for high alarm if it is a normal (for him) meal trend
get going on bringing it back up earlier with glucose tabs if the low alarm went off
Maybe moving alarms about through the course of the fast acting effective window too depending what is happening

I am doing no fast acting and using the high alarm to tell me if/when I need to add some but I am t2/have some effective insulin supply of my own which is safe for me to do so for me as I have more of a safety net. I do not know your hubby's circumstances.

The important bit is to remember to reset alarms after each meal to what he normally has them at.

I hope he get some answers soon. I really do understand how miserable it is. Let us know how he's getting on.
(p.s. I have been strongly advised to get some barrier cream for prep day 😉 )
Click to expand...
The advice about appropriate alarm setting is soooooo valid. Alas no-one told Abbott. The maximum (highest) setting for Libre 2 is 5.6mmol/L. My D is deemed brittle and on a poor day I can drop 3.5mmol/L in 5 minutes (I use the Diabox app which quantifies the rate of change numerically and has an alarm for rapid rate of change). When I'm crashing I no longer do the precautionary bit of finger pricking and checking; I get hypo before I can get my meter out (or so it seems). I just rush for JBs or equivalent and hope to arrest the crash.
 
I should have added that during my face to face consult 10 days ago my Endo told me to set myself the target of no lower than 7.0 - not only to help mitigate this brittleness but to reduce rhe constant anxiety about my tendency to crash and needing to be on guard against that. She also reminded me that even short low periods are damaging cumulatively and the concern is about longer term declining mental capacity.

She even encouraged me to not correct just because I was high at 10 unless I'd been at that level for several hours and was confident that I was no longer carrying insulin on board; but to have a personal high threshold of 12 or even higher - principally to generally keep me above 7 after corrections.
 
Status
Not open for further replies.
Back
Top