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Sick Days And High BGLs

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This thread is now closed. Please contact Anna DUK, Ieva DUK or everydayupsanddowns if you would like it re-opened.
TheClockworkDodo

TheClockworkDodo

Well-Known Member
Relationship to Diabetes
Type 1
I'm not well at the moment, a stressful situation has made my ME very bad and I'm struggling to sleep and to eat. Yesterday I slept a lot during the day, but last night I hardly slept at all. Occasionally I think I could manage a piece of toast ... but my blood sugar is stuck on 11! I don't want to inject and wait before I eat because there's a good chance I might fall asleep before I get round to eating, through sheer exhaustion. I don't really want to eat when my blood sugar's over 8. But given that I can't eat much at all, I really want to be able to eat something when I can. I've already lost about a kg over the last couple of days.

Should I eat toast while 11? I can't just eat things which aren't carbs as I can't face anything much other than toast during the day (I did manage a small helping of normal-ish dinner last night, but it spiked me up to 13, and I feel worse today, can't really face anything other than toast).
 
Thank you both, I'd not thought of injecting after eating - normally if 11 I'd inject and wait before eating!
I can't face cheese, Benny, can't face anything except dry toast.
Thanks for the chart, Mike. I have been given rules but not in chart form like that, that's useful.
 
Hope you feel better soon x

I've got that sick day rules chart pinned to my fridge, it's really helpful, plus my OH referred to it the last time I had a vomiting bug and rang 111 for advice when my bgs went up to 14 and ketones started to rise.
 
I have a few questions about sick day rules, if anyone can help?

I hadn't thought to test for ketones! - so the chart has been a useful reminder - I normally only test for them if my bgl's over 14 twice in a row or over 17 once. It's now hovering around 11, and spiking up a bit more than that in the evening. I have trace ketones. The chart says I should inject 2 units as a correction dose - this is a bit scary as my normal correction dose for 11 would be 1 unit - 2 units at 11 would bring my bgl down to 1! Anyone else ultra-sensitive to insulin out there? Do you do the full 2 units as a correction dose if you have trace ketones and your levels are at the lower end of the chart?

Then, if you follow the chart it says test blood sugar every 4-6 hours and repeat process, but it also says to inject correction dose with food. The trouble is, I'm not eating anything at all in the morning, I'm then maybe eating a piece of toast at 2-3ish and another piece of toast at 5ish and then I'm managing something a bit more substantial in at 7ish in the evening. This would be easier to manage on a pump, but I'm on MDI, and I'm injecting for what I'm eating. I presume I should just inject the correction dose every 4-6 hours rather than every time I inject for food, as half the time I'm injecting for food I already have insulin in my system? - this is what I'm doing, but my bgl isn't going down at all (so maybe that answers my first question and I should have the full 2 units! Eek!).

And any advice about what I should do at night? A normal correction dose (eg 1 unit if my bgl's 11) or the 2 units? I'd be really worried about over-correcting at night, as I usually have so many hypos, so would be inclined to err on the side of caution, but I like being 9-14 even less than I like being under 4!
 
TheClockworkDodo said:
And any advice about what I should do at night? A normal correction dose (eg 1 unit if my bgl's 11) or the 2 units? I'd be really worried about over-correcting at night, as I usually have so many hypos, so would be inclined to err on the side of caution, but I like being 9-14 even less than I like being under 4!
Click to expand...

Any chance you can ask your DSN/clinic? Do you have email contact details?

My guess would be that you should trust your instincts and your knowledge of your insulin sensitivity. But do keep an eye on things and see if the correction you would normally give has the normal effect. I wonder if part of the sickday rules involves the fact that when ill insulin may not be as effective as normal?

Having said that it is almost certainly based around average insulin sensitivity - and I think you are right to be cautious, especially if you are finding it difficult to eat.
 
Thanks for your thoughts, Mike.

I haven't seen a DSN since I moved here over 4 years ago, I do have an email address for one, but she doesn't know me or very much about me so her advice could only be general rather than specific. I've been seeing the surgery diabetes nurse, but she tends to take a week or two to reply to emails so not ideal, and obviously she doesn't have the experience of type 1 a DSN will have.

Insulin is certainly not being as effective as normal, I've increased all my doses and am adding extra on top, and am still hovering around 10 or 11. Ketones have gone though, so hoping my bgl will go down soon, though also hoping not too far or fast! I have been dizzy all day today and keep testing thinking it's my bgl going down at last, but no, it seems to be my ME 🙄
 
TheClockworkDodo said:
Thanks for your thoughts, Mike.

I haven't seen a DSN since I moved here over 4 years ago, I do have an email address for one, but she doesn't know me or very much about me so her advice could only be general rather than specific. I've been seeing the surgery diabetes nurse, but she tends to take a week or two to reply to emails so not ideal, and obviously she doesn't have the experience of type 1 a DSN will have.

Insulin is certainly not being as effective as normal, I've increased all my doses and am adding extra on top, and am still hovering around 10 or 11. Ketones have gone though, so hoping my bgl will go down soon, though also hoping not too far or fast! I have been dizzy all day today and keep testing thinking it's my bgl going down at last, but no, it seems to be my ME 🙄
Click to expand...
Are you seen in Oxfordshire? I went to a DUK meeting about a year ago, a 'meet the team from the Oxfordshire Trust', and one thing came out about people being seen by non-specialist surgery nurses. The DSN from the Oxfordshire team said that surgery nurses can ring a specialist DSN at the hopsital at any time, and ask for advice, and that the specialist DSN could see or speak to the patient direct, if necessary. It wasn't something I was aware of.( and I'm afraid I've never had cause to test it out)
 
That sounds really good, Robin, but no, my surgery nurse is in Gloucestershire and my consultant and the DSN I've been in touch with about the CGM are in Wiltshire. My surgery nurse does have a phone number for DSNs, I think, but as she takes so long to answer emails and I can't use the phone it's not ideal for me.

However, I have now had 3 readings in succession under 8, so I think I'm on the mend 🙂
 
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This thread is now closed. Please contact Anna DUK, Ieva DUK or everydayupsanddowns if you would like it re-opened.
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