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High Blood Sugar When Sick

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 >>

What Does It Feel Like To Have High Blood Sugar Levels?

What Does It Feel Like To Have High Blood Sugar Levels?

The human body naturally has sugar, or glucose, in the blood. The right amount of blood sugar gives the body's cells and organs energy. The liver and muscles produce some blood sugar, but most of it comes from food and drinks that contain carbohydrates. In order to keep blood sugar levels within a normal range, the body needs insulin. Insulin is a hormone that takes blood sugar and delivers it to the body's cells. Contents of this article: What does it feel like to have high blood sugar levels? Blood sugar is fuel for the body's organs and functions. But having high blood sugar doesn't provide a boost in energy. In fact, it's often the opposite. Because the body's cells can't access the blood sugar for energy, a person may feel tiredness, hunger, or exhaustion frequently. In addition, high sugar in the blood goes into the kidneys and urine, which attracts more water, causing frequent urination. This can also lead to increased thirst, despite drinking enough liquids. High blood sugar can cause sudden or unexplained weight loss. This occurs because the body's cells aren't getting the glucose they need, so the body burns muscle and fat for energy instead. High blood sugar can also cause numbness, burning, or tingling in the hands, legs, and feet. This is caused by diabetic neuropathy, a complication of diabetes that often occurs after many years of high blood sugar levels. What does high blood sugar mean for the rest of the body? Over time, the body's organs and systems can be harmed by high blood sugar. Blood vessels become damaged, and this can lead to complications, including: Damage to the eye and loss of vision Kidney disease or failure Nerve problems in the skin, especially the feet, leading to sores, infections, and wound healing problems Causes of high blood sugar Continue reading >>

5 Best Tips To Manage Diabetes When You’re Sick

5 Best Tips To Manage Diabetes When You’re Sick

Whether you are sick or are just getting older, there are times in life when you don’t feel much like eating. If you’re eating fewer calories because you’ve lost your appetite, you’ll probably need to pay closer attention to your blood sugars and adjust your diabetes medications. Here are some tips from the experts to help you manage your diabetes: 1. Stay hydrated You can easily get dehydrated if you have fever, vomiting or diarrhea. Your main risk from dehydration is hyperglycemia (high blood sugar). Taking certain cold medications, skipping diabetes medications and eating food erratically can also sometimes lead to high blood sugar. “When you’re ill, it’s very important to check your blood sugar regularly, continue to take medications on a schedule and drink fluids regularly,” says diabetes specialist Bartolome Burguera, MD. If your blood sugar goes over 250, check your urine for keytones, which are produced when your body has difficulty processing blood sugar, and call your doctor, Dr. Burguera says. 2. Change up your diet When you’re not able to eat as much as normal or don’t have an appetite, meal replacement drinks are often helpful. “Nutritional shakes formulated for people with diabetes have a moderate amount of carbohydrate, which is appropriate,” Dr. Burguera says. You can also make homemade meal-replacement shakes using: Frozen fruit A protein source (e.g., protein powder, Greek yogurt, peanut butter, tofu) Milk, soy milk or almond milk “Noodle soups are also typically well tolerated and the noodles offer carbohydrates, which may help prevent low blood sugars,” he says. 3. Create a sick-day tool kit Dr. Burguera suggests putting together a “sick-day diabetes tool kit” that includes things you can eat or drink when you aren’t Continue reading >>

Why Does My Blood Sugar Go Up When I'm Sick?

Why Does My Blood Sugar Go Up When I'm Sick?

Your blood sugar rises when you are sick because the body secretes of variety of hormone and other substances in the process of fighting infection that either raise blood sugar directly or make the body resistant to the actions of insulin. Cortisol is the body’s main “stress” hormone, and cortisol makes the body more resistant to insulin action. In other words, insulin will not lower blood sugar as well in the presence of high levels of cortisol as it does when cortisol levels are lower. This is the same reason that man-made anti-inflammatory steroids, like prednisone, which are all patterned after cortisol, will raise blood sugar. Many people who have autoimmune or inflammatory disorders will see a dramatic rise in their blood sugars when they are given prednisone. Other hormones, like adrenaline (also called epinephrine) will cause the liver to release glucose directly into the bloodstream. This is why certain asthma medications which mimic adrenaline action (a common example being albuterol) will also raise blood sugar levels. Think of the person who has diabetes and asthma who gets pneumonia which is severe enough to require hospitalization. Between the body’s rise in cortisol and adrenaline, and the administration of large doses of prednisone and albuterol to combat airway constriction, you can see how complex the interactions become in treating diabetes in combination with other medical problems! When you're sick, your body makes hormones to fight the illness. Those same hormones raise blood sugar, which is why when you're sick you need to test your blood sugar more frequently. Even though you may not be eating normally, you still need to take some or all of your medication. Contact your physician for instructions. Videos Questions Important: This content Continue reading >>

What A High Blood Sugar Feels Like.

What A High Blood Sugar Feels Like.

The American Diabetes Association cites the following symptoms as indicative of high blood sugar: High blood glucose [Editor’s note: Duh] High levels of sugar in the urine Frequent urination Increased thirst And if high blood sugar goes untreated? “Hyperglycemia can be a serious problem if you don’t treat it, so it’s important to treat as soon as you detect it. If you fail to treat hyperglycemia, a condition called ketoacidosis (diabetic coma) could occur. Ketoacidosis develops when your body doesn’t have enough insulin. Without insulin, your body can’t use glucose for fuel, so your body breaks down fats to use for energy. When your body breaks down fats, waste products called ketones are produced. Your body cannot tolerate large amounts of ketones and will try to get rid of them through the urine. Unfortunately, the body cannot release all the ketones and they build up in your blood, which can lead to ketoacidosis.” – ADA website But what does a high blood sugar feel like? Because when you see someone who is working through an elevated blood sugar, they may not look terribly out of sorts. But what is happening inside of them is real, and plays out in a myriad of ways for every person with diabetes. I’ve tried to write about it several times, but each high is different, and affects me in different ways: “It’s a thick feeling in the base of your brain, like someone’s cracked open your head and replaced your gray matter with sticky jam. I find myself zoning out and staring at things, and my eyeballs feel dry and like they’re tethered to my head by frayed ropes instead of optic nerves. Everything is slow and heavy and whipped with heavy cream.” – Oh, High! “There’s something about a high blood sugar that makes my body feel weighted down, l Continue reading >>

Battling Winter Colds And Illness When Type 1 Diabetic

Battling Winter Colds And Illness When Type 1 Diabetic

My carefully laid training plans were recently axed by a “stinking cold” that seemed to go round amongst colleagues and friends. What started off with body aches on a Friday, feeling cold and having headaches on a Saturday, had turned into a proper cold by Sunday with all the common symptoms: Runny nose, cough, congestion, headaches, sneezing and feeling generally quite lousy. And with that started a new challenge altogether: Managing my diabetes! From incubation to outbreak – Blood sugar observations As the weekend progressed, my sugar levels became gradually harder to manage until, eventually, with the outbreak of the cold, they were staying up at around 200-220mg/dl (11-12mmol/l). Any slow-release carbohydrates I would eat and cover with short-acting insulin (bolus) would send levels even higher within 30-60 minutes of injecting. My body had become highly insulin resistant and my diabetes an uncontrollable beast! Real life example: Day 2 of the cold and blood sugar levels My target range is shown in gray; levels between 85-140mg/dl (4.7-7.5mmol/l). I generally have good control with HbA1c results of ca 6.2%. When illness strikes however, chaos rules: Below graph shows how elevated glucose levels were despite: A temporary basal rate at 140-150% from waking up throughout the day until early evening an additional circa 15 -20 units of correction with short-acting insulin over the course of the day Little carbohydrate intake Notice the spike from 160mg/dl (8.9mmol/l) to 271mg/dl (15mmol/l) around 19:00 (7 pm)? This came after eating 12 grams of COH in form of Pumpernickel bread – and carbohydrates were measured correctly. This required significant correction with short-acting insulin (no ketones present). Illness, food and Type 1 don’t go well together. The bod 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 >>

What A High Blood Sugar Feels Like? Signs & Symptoms Of Hyperglycemia

What A High Blood Sugar Feels Like? Signs & Symptoms Of Hyperglycemia

I get my first cup of coffee and sit on the sun deck with the birds singing. I feel as if I have not slept a wink, and my head aches. I could go back to bed and sleep all day, but work awaits. It’s a beautiful, sunny day, but my body feels heavy, and stuck to the chair. It hurts to lift my arms. My blood sugar was 381 this morning. Again. I think about having to face the day at the office. Driving down the interstate, the lines are blurry. I know that if the DMV got wind of it, I might not be driving as high as my A1C had been. When I get to the office, I walk in with a dark fog feeling surrounding me, and take some deep breaths at my desk. As I begin to review the end of the month reports, the numbers get fuzzy, and I can’t concentrate on them. My 36 ounce water bottle with only a few sips left beads sweat on the desk, and it’s across the building to get to the bathroom. Sometimes it’s a race to get there in time. My body is taught and swollen, like the Blueberry Girl from Willy Wonka’s Chocolate Factory. My blood sugar is a blue river of sticky blueberry filling as I roll down the hall toward the bathroom. I feel that if I had a needle, I could pop myself. That would surely be a mess. My skin is so dry and flaky that no amount of lotion will hydrate it. No amount of water can quench my thirst, and my mouth feels like the Sahara Desert. With one hand on the water cooler, and the other hand on the bathroom door, I guzzled down what I could until the feeling hit that I wasn’t going to be able to wait any longer. I was out of regular insulin, and I had taken my long acting insulin. I was not so patiently waiting for it to kick in. This morning was not starting out so well. I’d have to tackle the reports in my current brain fog. I did have a doctor’s appoin 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 >>

Diabetic Emergencies, Diagnosis And Clinical Management: Sick-day Rules In Diabetes, Part 2

Diabetic Emergencies, Diagnosis And Clinical Management: Sick-day Rules In Diabetes, Part 2

Konstantinos Makrilakis, Nikolaos Katsilambros In patients taking insulin — either basal only ( ± pills) or a more intensified regimen (insulin mixtures two or three times daily or a basal-bolus regimen) — the “sick-day rules” should be taught and the patient should be provided with urine strips to test for ketones (e.g., Ketostix) and rapid-acting soluble insulin (human or insulin analog) along with their usual insulin and blood glucose testing kit.12 Glucagon injection should also be available at home for family members to use in case of severe hypoglycemia. They should also have clear “contact criteria” and contact telephone numbers for their health care provider team (see “Patient advice” below). For patients following an intensified insulin regimen (usually Type 1 diabetic patients) the insulin regimen is followed, basically, as it is, provided the patient is feeding normally. If needed, the doses of “prandial” and basal insulin are increased, based on frequent blood glucose measurements. Sometimes it may be necessary to administer rapid-acting insulin (or even better a rapid-acting insulin analog) in between meals. In this case, small doses are preferred. If the patient is unable to take food (due for example to nausea/vomiting), the dose of basal insulin is administered normally and, if needed, rapid-acting insulin is administered every 4-6 hours, or a rapid-acting analog every 3-4 hours.14 At the same time, intake of carbohydrates in the form of liquid or semi-solid food (i.e., juice, refreshments, soups, purée, etc.) is recommended. Insulin dose is empirically determined each time as 1/10th of the usual total daily dose when blood glucose is > 150 mg/dl (8.3 mmol/L), or as 1/5th of the total daily dose when blood glucose is > 200 mg/dl (11 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 >>

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

What Are They? “My Doctor Says I Should Learn Sick Day Rules...†BD Getting Started™ 1 What’s different about being sick because I have diabetes? When most people are sick with a cold or the flu, they usually rest, drink tea or eat chicken soup. If they do not start to feel better in a couple of days, they will usually call their doctor. When you have diabetes, not feeling well affects your eating patterns and how your blood sugar reacts to your usual dose of insulin or diabetes pills. When you are sick, your body will release hormones that work to help your body fight against your illness, but they will also make your blood sugar levels rise. This means that your diabetes will be more difficult to control when you are sick. That is why it is so important to plan ahead and be prepared in case of illness. Sickness can include: a cold, flu-like symptoms such as vomiting, diarrhea, sore throat, and infections such as ear, teeth or bladder, or more serious illnesses like pneumonia or a foot infection. 2 What happens when I am sick? Illness puts your body in a state of stress. When you don’t feel well, your body produces stress hormones. These hormones work to help your body fight the infection or injury that is making you sick. They send a signal to your liver to release sugar to help in the fight. This makes your blood sugar rise. In people without diabetes, when the liver releases sugar to help the body fight against the illness, the pancreas also makes extra insulin. This allows the body to use the sugar for energy and the blood sugar remains within a normal range. However, if you have diabetes, your body cannot make the extra insulin needed and your blood sugar will go up. The stress hormones also work against insulin. Together, the sugar p Continue reading >>

High Blood Sugar (hyperglycemia) In Diabetes

High Blood Sugar (hyperglycemia) In Diabetes

What is high blood sugar? High blood sugar means that the level of sugar in your blood is higher than recommended for you. If you don’t keep your blood sugar at a normal, healthy level most of the time, you will increase your risk of heart and blood vessel disease, stroke, kidney problems, and loss of vision. The medical term for high blood sugar is hyperglycemia. Blood sugar is also called blood glucose. What is the cause? Blood sugar that stays high is the main problem of diabetes. Your body breaks down some of the foods you eat into sugar. Normally the hormone insulin moves this sugar into your cells, where your body uses it for energy. In diabetes the insulin is not moving the sugar into the cells, so it builds up in the bloodstream and starts to cause problems. Sometimes you may have high blood sugar even though you are taking diabetes medicine. This can happen for many reasons but it always means that your diabetes is not in good control. Some reasons why your sugar might go too high are: Skipping your diabetes medicine Not taking the right amount of diabetes medicine Taking certain medicines that increase your blood sugar or make your blood sugar medicines work less well Taking in too many calories by eating large portions of food, choosing too many high-calorie foods, or drinking too many high-sugar beverages Eating too many carbohydrates, such as foods made mainly with sugar, white flour (in bread, biscuits, pancakes, for example), white potatoes, or white rice Not getting enough physical activity (exercise lowers your blood sugar) Having increased emotional or physical stress Being sick, including colds, flu, an infected tooth, or a urinary tract infection, especially if you have a fever If you are using insulin, having a problem with your insulin (for examp Continue reading >>

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 >>

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