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High Blood Sugar When Sick

Planning Ahead For Sick Days

Planning Ahead For Sick Days

Having a bad cold or the flu can make anyone want to crawl into bed and stay there until it’s over. But when you have diabetes, hiding under the covers and sleeping until you feel better isn’t the best option (although getting plenty of rest is still a good idea). That’s because any illness or infection can make your blood glucose more difficult to control, which increases the risk of serious acute complications. So just when you’re feeling your worst is when it’s most important to stay vigilant about your diabetes care and to take good care of yourself to help your body heal. What happens when you’re sick Your body may know it’s sick even before you feel any symptoms, and a good clue can be an unexplained steady rise in blood glucose. Everybody has a high release of stress hormones when they’re battling or about to battle an illness. Typically, stress hormones cause a rise in blood glucose level because they cause the liver to release more glucose than normal into the bloodstream. People who don’t have diabetes can compensate by releasing more insulin, but people who have diabetes may produce no insulin, or their bodies may not use insulin efficiently, so blood glucose levels stay high unless something is done (such as taking insulin) to lower them. The release of stress hormones and consequent rise in blood glucose level is why people with diabetes are advised to continue taking their diabetes medicines (insulin or oral medicines) when they are sick, even if they’re vomiting. Monitoring blood glucose levels every 2–4 hours and sipping liquids every 15 minutes to stay hydrated are also important. Not taking diabetes medicines during an illness raises the risk of developing diabetic ketoacidosis (DKA), a medical emergency characterized by high bloo Continue reading >>

Ask D'mine: To Throw Up Or Not To Throw Up - That Is The Question

Ask D'mine: To Throw Up Or Not To Throw Up - That Is The Question

Got questions about life with diabetes? So do we! That's why we offer our weekly diabetes advice column, Ask D'Mine, hosted by veteran type 1, diabetes author and community educator Wil Dubois . This week, Wil's talking sick days and what to do when your stomach is not happy. An ugly subject, but someone's got to do it... {Got your own questions? Email us at [email protected]} Lauralee, type 3 from Washington, writes: I'm mom to a 16-year-old who has had Type 1 for 3 years. Thankfully he has not yet had any sort of stomach bug with vomiting, though at some point I know that might happen. I understand about how the body keeps producing glucose even when one is not eating, and so one still needs to take insulin, and that makes sense. But I have also read that one is supposed to keep on drinking and /or take antiemetics, and don't quite understand why that would be advisable. Is it not better to allow the body to throw up until one has eliminated the offending bug, and the illness has run its course? And drinking anything before things have settled down is just asking for more vomiting. Could you explain the physiology of how the non-diabetic vs. diabetic body handles such illnesses and the resultant ketones? And the best way to manage a short-term, like a day or two, vomiting illness? I know something major like salmonella or E coli would be a whole different issue. I learn a great deal from your columns, have printed out the one about drinking to give to my son as mandatory reading, and really enjoy your wit. Thank you for helping all of us who are affected by diabetes. [email protected] D'Mine answers: You're welcome, and thank you for your kind words! This is a great question, and I hope everyone can stomach talking about vomiting first thing in the morning! Now, you don Continue reading >>

Sick Days

Sick Days

When you’re unwell, you need to take extra care. As a person with diabetes, when you are sick your body’s increased production of stress hormones will cause your blood glucose levels to rise. Make sure you keep a list of contact numbers for your doctor, Credentialled Diabetes Educator, hospital and ambulance by the phone. If possible, have a friend or relative come and regularly check on you. You can also see our information sheets on sick days with type 1 type 2 diabetes in our Publications and Resources section. When you’re sick, you should continue to take your usual dose of insulin. Never stop taking or reduce your insulin dose. Sometimes when you are sick you may need more insulin or extra doses of insulin. Contact your doctor or Credentialled Diabetes Educator if your illness lasts for more than one day, or if you vomit more than three times in a day, to discuss whether your insulin needs to be changed. Eat according to how you feel and what food you can tolerate. If you can’t eat your usual meals, make sure you have small low-fat snacks at regular intervals throughout the day (for example, toast, crackers, boiled rice, soup, low-fat custard or ice-cream). If you can’t eat food, have sips of fluid every few minutes. Include carbohydrate drinks (such as fruit juice or lemonade) if your blood glucose level is below 15 mmol/L or unsweetened fluids (such as soda water or diet lemonade) if your blood glucose level is above 15 mmol/L. High blood glucose levels, vomiting and diarrhoea can all lead to dehydration. You will need to drink more, but it is important what you should drink, based on your blood glucose levels. If your blood sugar level is more than 15 mmol/L then you should drink unsweetened fluids like water, clear soups, weak tea, or diet lemonade. I Continue reading >>

Diabetes: What To Eat When You're Sick

Diabetes: What To Eat When You're Sick

When a diabetic comes down with the flu or a bad cold, diabetes care often takes a backseat. Who can be bothered to check blood sugar when just getting out of bed seems like a chore? And who wants to follow a meal plan when it's hard to keep food down? As difficult as it may seem, you actually need to pay more attention to your diabetes when you aren't feeling well. Common illnesses such as a cold or flu can boost your blood sugar, so it's very important that you check your sugar levels several times during the day. You also need to get enough fluids and fuel to get through the day. A healthy diet will help speed your recovery and keep your blood sugar from getting too high or too low. Sick day diet Before you feel that first sniffle coming on, talk to your doctor or a registered dietitian about your "sick day" diet. In general, you should stick as closely as possible to your regular meal plan. If your stomach is a little queasy, you can still reach your daily nutritional goals with mild foods such as gelatin, crackers, soup, or applesauce. If even these foods cause trouble and you need to keep your blood sugar levels steady, try broth, fruit juice, pudding, sherbet, or yogurt. The American Diabetes Association recommends aiming for 50 grams of carbohydrates every three to four hours. Read the labels and do the math. (Or check with your doctor or nutritionist now -- before you get sick -- if you aren't sure how to do this.) You should also be sure to get plenty of fluids throughout the day. Four ounces of water or diet soda every hour should do the trick. As long as you're reading labels, be sure you take into account the sugar content of medications you're taking. Some cold and flu medicines contain sugar. If your blood sugar gets too high, you may need to rethink your Continue reading >>

Diabetes And Colds

Diabetes And Colds

Colds aren't fun for anyone, but if you have diabetes, all that sniffling and sneezing comes with an extra risk. When you're sick, there's a chance your blood sugar levels could go up. Some smart strategies can get you back on track. Why Is My Blood Sugar Going Up? When you have a cold, your body sends out hormones to fight the infection. The downside: That makes it hard for you to use insulin properly, and your blood sugar levels may rise. If you have type 1 diabetes and your blood sugar levels get hard to manage, it can lead to problems like ketoacidosis. That's a buildup of too much acid in your blood and it's potentially life-threatening. If you have type 2 diabetes, especially if you're older, very high blood sugar can bring on a serious condition called diabetic coma. How Often Should I Check My Blood Sugar? Check it at least every 3 or 4 hours when you're sick with a cold. If your levels aren't near your target, you can tweak your diabetes management plan -- your doctor may tell you to use more insulin if your blood sugar levels are too high. What Should I Eat and Drink? You may not feel hungry when you first get sick, but it's important to try to eat something anyway. You can have foods from your regular meal plan. The American Diabetes Association recommends you try to eat something with about 15 grams of carbohydrates every hour or so. Some foods to try: 3-ounce fruit juice bar 1/2 cup frozen yogurt 1/2 cup cooked cereal If you don't eat, your blood sugar might fall too low. *CGM-based treatment requires fingersticks for calibration, if patient is taking acetaminophen, or if symptoms/expectations do not match CGM readings, and if not performed, may result in hypoglycemia. Please see important risk and safety information. If you have a fever, vomiting, or diarr Continue reading >>

Dealing With Illness

Dealing With Illness

It is important to know how to cope with illness if you have diabetes, or if you know or care for somebody with the condition. You'll also need to know how to manage insulin or other diabetes medications, blood or urine tests, and diet during illness. Illness and infections, as well as other forms of stress, will raise your blood glucose levels. As part of the body’s defence mechanism for fighting illness and infection, more glucose is released into the bloodstream and prevents insulin from working properly. This happens even if you are off your food or eating less than usual. Diabetes and illness People who do not have diabetes simply produce more insulin to cope, but when you have diabetes; your body cannot do this. As a result, your blood glucose levels rise, causing you to pass more urine and feel thirsty. This in turn can make you dehydrated. The symptoms of high blood glucose can add to those of the original illness or infection and make it much worse. Dehydration and diabetes Dehydration is made worse when you have a temperature or are being sick. In some cases, blood glucose levels can become so uncontrolled that treatment in hospital is necessary. Severe dehydration and very high blood glucose levels may be serious for both those with Type 1 and Type 2 diabetes. That’s why being prepared, and following the necessary steps when ill, is vital to manage your diabetes well and avoid the worst effects of illness. Steroids Some conditions (eg Addison's disease, severe asthma, rheumatoid arthritis, and lupus) are treated with steroids. If you have diabetes, you may well find that your blood glucose levels rise while taking high doses of steroids for periods of time. This should not stop you taking steroids if your doctor has prescribed them, even if your blood glu Continue reading >>

Hyperglycaemia (high Blood Sugar)

Hyperglycaemia (high Blood Sugar)

Hyperglycaemia is the medical term for a high blood sugar (glucose) level. It's a common problem for people with diabetes. It can affect people with type 1 diabetes and type 2 diabetes, as well as pregnant women with gestational diabetes. It can occasionally affect people who don't have diabetes, but usually only people who are seriously ill, such as those who have recently had a stroke or heart attack, or have a severe infection. Hyperglycaemia shouldn't be confused with hypoglycaemia, which is when a person's blood sugar level drops too low. This information focuses on hyperglycaemia in people with diabetes. Is hyperglycaemia serious? The aim of diabetes treatment is to keep blood sugar levels as near to normal as possible. But if you have diabetes, no matter how careful you are, you're likely to experience hyperglycaemia at some point. It's important to be able to recognise and treat hyperglycaemia, as it can lead to serious health problems if left untreated. Occasional mild episodes aren't usually a cause for concern and can be treated quite easily or may return to normal on their own. However, hyperglycaemia can be potentially dangerous if blood sugar levels become very high or stay high for long periods. Very high blood sugar levels can cause life-threatening complications, such as: diabetic ketoacidosis (DKA) – a condition caused by the body needing to break down fat as a source of energy, which can lead to a diabetic coma; this tends to affect people with type 1 diabetes hyperosmolar hyperglycaemic state (HHS) – severe dehydration caused by the body trying to get rid of excess sugar; this tends to affect people with type 2 diabetes Regularly having high blood sugar levels for long periods of time (over months or years) can result in permanent damage to parts Continue reading >>

8 Sneaky Things That Raise Your Blood Sugar Levels

8 Sneaky Things That Raise Your Blood Sugar Levels

Skipping breakfast iStock/Thinkstock Overweight women who didn’t eat breakfast had higher insulin and blood sugar levels after they ate lunch a few hours later than they did on another day when they ate breakfast, a 2013 study found. Another study in the American Journal of Clinical Nutrition found that men who regularly skipped breakfast had a 21 percent higher chance of developing diabetes than those who didn’t. A morning meal—especially one that is rich in protein and healthy fat—seems to stabilize blood sugar levels throughout the day. Your breakfast is not one of the many foods that raise blood sugar. Here are some other things that happen to your body when you skip breakfast. Artificial sweeteners iStock/Thinkstock They have to be better for your blood sugar than, well, sugar, right? An interesting new Israeli study suggests that artificial sweeteners can still take a negative toll and are one of the foods that raise blood sugar. When researchers gave mice artificial sweeteners, they had higher blood sugar levels than mice who drank plain water—or even water with sugar! The researchers were able to bring the animals’ blood sugar levels down by treating them with antibiotics, which indicates that these fake sweeteners may alter gut bacteria, which in turn seems to affect how the body processes glucose. In a follow-up study of 400 people, the research team found that long-term users of artificial sweeteners were more likely to have higher fasting blood sugar levels, reported HealthDay. While study authors are by no means saying that sugary beverages are healthier, these findings do suggest that people who drink artificially sweetened beverages should do so in moderation as part of a healthy diet. Here's what else happens when you cut artificial sweetener Continue reading >>

Sick Days

Sick Days

Every day illnesses such as the flu and infections can cause your blood glucose levels to rise. If you get sick while you are pregnant, you will need to be particularly careful and check your blood glucose levels more frequently. You may also need to increase your insulin doses or have small frequent doses to prevent ketoacidosis. Make sure you have in-date ketone monitoring strips and that you know what to do if you find ketones present. Talk to your diabetes health professionals about developing a sick day management plan, as this takes the guess work out of managing blood glucose levels when you are unwell. Call your doctor or diabetes educator if you are vomiting or unable to eat or drink or if you are worried about high blood glucose levels. Managing sick days Follow your sick day management plan. Check your blood glucose levels more frequently when you are unwell. Take your insulin even if you are vomiting or not eating - talk to your diabetes health professionals about adjusting your insulin dose. Check your urine or blood for ketones. Call your doctor or diabetes educator if: your urine ketone reading is more than 1+ your blood ketone reading is more than 0.6 mmol/L you are vomiting or unable to eat or drink you are worried about high blood glucose levels See your doctor to find out the cause of the illness. Discuss hypo management with your diabetes health professionals. If you are vomiting so much that you cannot keep food or fluids down, call your doctor or diabetes educator immediately or go to the Emergency Department of your nearest maternity hospital. Download a copy of the ADEA consumer resource Sick Day Management of Adults with Type 1 Diabetes and the Sick Day Action Plan to discuss with your diabetes in pregnancy team. For more information about sick Continue reading >>

Can Infection Raise Blood Sugar Levels In Nondiabetics?

Can Infection Raise Blood Sugar Levels In Nondiabetics?

Even if you do not have diabetes, you can experience drops and spikes in blood sugar levels for many reasons. If your blood sugar level gets too high or too low, you might develop many symptoms and/or health problems. Stress, poor diet, illness and infections can all cause your blood sugar level to change, and if you notice the warning signs, it is important to talk to your physician about the best treatment approach. Video of the Day After a meal, your body breaks food down into glucose either for immediate use, or else it's stored for later use. The hormone insulin, as well as other chemicals, regulate how much glucose is in your system. If the level of glucose in your bloodstream gets too high, many complications can result. A general goal for everyone is to keep your blood sugar levels no higher than 100 mg/dL, says MedlinePlus. A blood sugar level higher than this can indicate not just diabetes, but also some forms of cancer, Cushing syndrome, an imbalance of various hormones, thyroid disorders or it might be the body's reaction to stress, trauma or an infection. Infections and Blood Glucose Levels When your body is under mental or physical stress, such as when fighting off an infection, hormones such as cortisol are released to help your body cope. The hormones that are released to fight off the infection might have the side effect of raising your blood sugar levels, so your body has the energy it needs to get better. This effect can happen to both diabetics and nondiabetics. If you have an infection and are concerned about your blood sugar levels, it is important to know the warning signs of nondiabetic hyperglycemia, which are the same symptoms that occur in diabetics: hunger, sweating, shakiness, dizziness, lightheadedness, thirst, sleepiness, confusion, diffic Continue reading >>

Managing Diabetes With A Cold Or Flu

Managing Diabetes With A Cold Or Flu

The cold and flu season is on its way. And while sick days bring everyone down, people with type 2 diabetes have some special considerations when they're under the weather. In addition to choosing the right cold medications and checking in with your doctor about possible dosage changes, good diabetes care means being prepared for the days when you would rather not drag yourself out of bed for a glucose check or a snack. Pick the Right Cold Medicine “A lot of [cold and flu] medications, particularly cough syrup, are high in glucose,” says internist Danny Sam, MD, the program director of the residency program at Kaiser Permanente in Santa Clara, Calif. His practice specializes in adult diabetes. If you have diabetes, your best bet is a medicine that is clearly labeled sugar-free. Almost every major pharmacy has a store brand of sugar-free cold or cough medicine, says Dr. Sam. If you have questions, ask your pharmacist for help. Check Blood Sugar Often “Diabetes is not as well controlled when you are sick,” observes Sam. This is because when your body fights infection, it releases a chemical cascade that can alter your body’s glucose and insulin response. As a result, you may need to check your blood sugar more often than you usually do. People with type 2 diabetes may need to check their blood sugar four times a day, and should check their urine for ketones anytime their blood sugar level is higher than 300 mg/dL. Other medications you may need to take when you are sick can affect your blood sugar levels: Aspirin may lower blood sugar levels Certain antibiotics may decrease blood sugar levels in those taking some oral diabetes medications Decongestants may raise blood sugar levels Adjust Your Plan “You have to monitor your blood sugar more frequently and you m Continue reading >>

Diabetes - When You Are Sick

Diabetes - When You Are Sick

Check your blood sugar more often than usual (every 2 to 4 hours). Try to keep your blood sugar at less than 200 mg/dL (11.1 mmol/L). There may be times when you need to check your blood sugar every hour. Write down all your blood sugar levels, the time of each test, and the medicines you have taken. If you have type 1 diabetes, check your urine ketones every time you urinate. Eat small meals often. Even if you are not eating as much, your blood sugar can still get very high. If you use insulin, you may even need extra insulin injections. DO NOT do vigorous exercise when you are sick. If you take insulin, you should also have a glucagon emergency treatment kit prescribed by your doctor. Always have this kit available. Drink plenty of sugar-free fluids to keep your body from getting dried out (dehydrated). Drink at least twelve 8-ounce (oz) cups (3 liters) of fluid a day. Fluids you can drink if you are dehydrated include: Water Club soda Diet soda (caffeine-free) Tomato juice Chicken broth If your blood sugar is less than 100 mg/dL (5.5 mmol/L) or falling quickly, it is OK to drink fluids that have sugar in them. Try to check their effect on your blood sugar in the same way you check how other foods affect your blood sugar. Fluids you can drink if your blood sugar is low include: Apple juice Orange juice Grapefruit juice Gatorade or other sports drink Tea with honey Lemon-lime drinks Ginger ale If you throw up, DO NOT drink or eat anything for 1 hour. Rest, but DO NOT lie flat. After 1 hour, take sips of soda, such as ginger ale, every 10 minutes. If vomiting persists call or see your provider. When you have an upset stomach, try to eat small meals. Try carbohydrates, such as: Bagels or bread Cooked cereal Mashed potatoes Noodle or rice soup Saltines Gelatin (such as Je Continue reading >>

Treating High Sugar: What Do I Do About Food, Fluids & Insulin When I Feel Sick?

Treating High Sugar: What Do I Do About Food, Fluids & Insulin When I Feel Sick?

Share: When you are sick (blood glucose levels are running high): Always take some insulin! Never omit it! When ill, your body may release its own stored sugar, causing a rise in blood glucose even though you may not eat as much. You always need to take insulin and you may need extra insulin. Check your blood glucose and keytones (blood or urine). Test blood glucose & ketones before meals and/or every 4 hours around the clock. Drink plenty of extra fluids. Your body needs about 9 cups (2200 ml) of fluid daily to prevent dehydration. If you cannot eat as usual, replace solid food with sugar containing fluid. If you vomit twice or more within 8 hours, call your doctor or go to an Emergency Room. Remember to call your diabetes doctor or nurse if you need help. Dietary Guidelines: If you cannot eat as usual, replace solid food with sugar containing fluids. Try to take 10 grams of carbohydrate every hour. Suggested 10 grams servings: mls. cups 75 apple or pineapple juice 1/3 125 orange juice 1/2 50 regular Jello 1/4 75 regular pop 1/3 100 ice cream 1/3 50 sherbet 1/4 200 milk 3/4 75 sugar-sweetened Kool-Aid 1/3 125 apple sauce 1/2 1/2 Popsicle **Avoid milk products if you are vomiting or have diarrhea Managing your insulin doses when you are ill Use the ‘sick day’ Diabetes Management Guidelines below for dealing with high blood s sugars when you have a fever, flu or infection, and when your blood glucose levels are running high. Test blood sugar (glucose) and ketones every 4 hours, all day & night. If blood ketones >3.0 mmol/L at any time, go to an Emergency Room immediately - you will need Intravenous (IV) insulin and fluids. The Total Daily Dose (TDD) formula helps you decide how much extra rapid or fast-acting insulin you need to take. Add up the number of units of in Continue reading >>

How Can You Manage Your Diabetes?

How Can You Manage Your Diabetes?

The goals of diabetes management are to: Keep your blood sugar levels as near normal as safely possible by balancing food intake with physical activity and medication. Help slow or possibly prevent the development of diabetes-related health problems. Here are five tips to remember when managing your diabetes: Test your blood glucose as recommended by your health care professional. Take your medicine as prescribed by the doctor-- be it tablets (pills) or injectable medicines like insulin. Make healthy food choices. Be physically active. Learn all you can do to manage your diabetes and live a healthier life. Continue reading >>

Take Care Of Yourself When Sick Or Under Stress

Take Care Of Yourself When Sick Or Under Stress

When we're stressed, our bodies need extra energy to help us cope and recover. This is true whether bodies are under stress from illness or injury or are dealing with the effects of emotional stress, both good and bad. To meet the demand for more energy, the body responds by releasing into the bloodstream sugar that's been stored in the liver, causing blood sugar levels to rise. In someone without diabetes, the pancreas responds to the rise in blood sugar by releasing enough insulin into the bloodstream to help convert the sugar into energy. This brings blood sugar levels back down to normal. In someone with diabetes, the extra demand usually means needing to take more diabetes medicine (insulin or pills.) To make sure your body is getting enough medicine to help keep your blood sugar levels close to normal, you'll need to test more often when you are: Sick Recovering from surgery Fighting an infection Feeling upset Under more stress than usual Traveling Type 1 Diabetes In people with type 1 diabetes, blood sugar levels rise in response to stress, but the body doesn't have enough insulin to turn the sugar into energy. Instead, the body burns stored fat to meet energy needs. When fat is burned for energy, it creates waste products called ketones. As fat is broken down, ketones start to build up in the bloodstream. High levels of ketones in the blood can lead to a serious condition known as diabetic ketoacidosis (DKA), which can cause a person to lose consciousness and go into a diabetic coma. Type 2 Diabetes In people with type 2 diabetes, the body usually has enough insulin available to turn sugar into energy, so it doesn't need to burn fat. However, stress hormones can cause blood sugar levels to rise to very high and even dangerous levels. People with type 2 diabetes Continue reading >>

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