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Type 1 Diabetes Fever

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Diabetic ketoacidosis (DKA) happens when your blood sugar is high and your insulin level is low. This imbalance in the body causes a build-up of ketones. Ketones are toxic. If DKA isn’t treated, it can lead to diabetic coma and even death. DKA mainly affects people who have type 1 diabetes. But it can also happen with other types of diabetes, including type 2 diabetes and gestational diabetes (during pregnancy). DKA is a very serious condition. If you have diabetes and think you may have DKA, contact your doctor or get to a hospital right away. The first symptoms to appear are usually: frequent urination. The next stage of DKA symptoms include: vomiting (usually more than once) confusion or trouble concentrating a fruity odor on the breath. The main cause of DKA is not enough insulin. A lack of insulin means sugar can’t get into your cells. Your cells need sugar for energy. This causes your body’s glucose levels to rise. To get energy, the body starts to burn fat. This process causes ketones to build up. Ketones can poison the body. High blood glucose levels can also cause you to urinate often. This leads to a lack of fluids in the body (dehydration). DKA can be caused by missing an insulin dose, eating poorly, or feeling stressed. An infection or other illness (such as pneumonia or a urinary tract infection) can also lead to DKA. If you have signs of infection (fever, cough, or sore throat), contact your doctor. You will want to make sure you are getting the right treatment. For some people, DKA may be the first sign that they have diabetes. When you are sick, you need to watch your blood sugar level very closely so that it doesn’t get too high or too low. Ask your doctor what your critical blood sugar level is. Most patients should watch their glucose levels c Continue reading >>

Diabetes Case Study: A New Perspective On Type 1 And Type 2

Diabetes Case Study: A New Perspective On Type 1 And Type 2

I have noticed when I was younger, when my blood glucose control was poor, that when I got a cold or infection, I usually got a fever. As I got older and my blood glucose control improved I have noticed that I would get sick but not get a fever. I do not remember having had a fever for at least ten years. In the past year my blood glucose control has been near normal most of the time (this will be explained later). When I am sick I just feel tired and out of it, major symptoms are less pronounced and fevers are not there. Type 1 diabetics have blood glucose controlled by exogenous insulin and may therefore not experience spikes in blood glucose levels. I speculate that perhaps hyperglycemia is an important natural phenomenon that triggers an immune response and fevers, that non-diabetics would have while they have an infection, without even being aware of it (because they don’t check their blood glucose.) Could ketoacidosis have been the likely cause of many deaths attributed to fevers? Continue reading >>

Sick Day Management Tips When Your Child Has Type 1 Diabetes

Sick Day Management Tips When Your Child Has Type 1 Diabetes

Having a sick child can be challenging—getting time off work and securing a last-minute doctor's appointment isn't always easy. But when your sick child also happens to have type 1 diabetes, it presents a separate set of complications relating to insulin and blood glucose (blood sugar) management. This article covers some important considerations to keep in mind the next time your child with type 1 diabetes feels under the weather. Checking Blood Glucose and Ketones Even the most common ailments, such as a cold or flu, can cause your child's blood glucose levels to rise. Plus, some over-the-counter medications can cause blood glucose levels to increase even more. Complicating matters, your child's blood glucose levels may actually drop too low if he or she is vomiting or has stopped eating. You just can't be certain how an illness will affect your child's blood glucose—that's why it's important to check their levels more often than you normally would. A general guideline to shoot for is to check their blood glucose every 2 to 3 hours, but remember—that's a guideline. Your child may require more or fewer checks, depending on your health care professional's recommendations. In addition to checking blood glucose levels, you also need to check for the presence of ketones in the urine. In people with type 1 diabetes, common illnesses can lead to diabetic ketoacidosis, a condition characterized by acidic blood caused by the release of too many ketones. Ketones are released when your body doesn't have enough insulin, so it's important to check your child's urine regularly (usually every 4 hours) until there are no ketones detected. If ketones are still present, that's a sign that your child needs more insulin. There are 2 ways to check ketones: using urine ketone strips Continue reading >>

Cold, Flu And Other Infections

Cold, Flu And Other Infections

It is a good idea to develop an action plan in anticipation of sick days, with your healthcare team. An acute disease almost always raises blood glucose (sugar) levels because of: the secretion of stress hormones (also known as counterregulatory hormones: primarily cortisol, adrenaline and glucagon), which have an insulin-antagonistic effect; less regular exercise, which makes the injected insulin less effective, even if the amount of food consumed is reduced. Sick days on insulin The daily insulin needs of people with diabetes often rise when they get sick. Consequently, even though diabetics may eat less when ill, they still need to take their regular insulin doses as prescribed, or adjusted, by their doctors. Advice and adjustments Take your blood glucose (sugar) readings more often: every 2-4 hours, or more often if necessary. Take your insulin or diabetes medication as usual, unless advised otherwise by your doctor. Take your temperature: if needed, take acetaminophen to lower your temperature and prevent dehydration through sweating caused by fever. If you have type 1 diabetes: if your blood glucose (sugar) is above 14.0 mmol/L, measure the ketones in your blood or urine every 2 to 4 hours, or more often if necessary. Diet: If you lose your appetite, drink liquid or semi-liquid sources of carbohydrates (fruit sauces, yogurt, etc.) at the rate of 15 g of carbohydrates per hour if you have taken the proper insulin doses. Hydration: If your blood glucose (sugar) level is high: Drink lots of unsweetened liquids (sparkling water, diet soft drinks, bouillon, etc.) to avoid becoming dehydrated, at the rate of 250 ml every hour. If your blood glucose (sugar) levels tend to fall: Have small amounts at a time of sweetened foods (fruit juice, regular Jell-OTM, milk, etc.). S Continue reading >>

In The Spotlight: Handling Sick Days With Type 1 Diabetes

In The Spotlight: Handling Sick Days With Type 1 Diabetes

Just when you thought you had this whole blood sugar management thing down, along comes a cold, flu, or some other common bug. Not quite sure what to do when your child is sick? From blood sugar-friendly foods that will stay down with an upset tummy to managing unpredictable highs and lows, here are some T1D sick-day tips. Dos & Don’ts When a child becomes ill, stress hormones released by the body can interfere with insulin. In a child without diabetes, the body can simply produce more insulin to compensate, but when a child has type 1, being sick often results in high blood sugar readings that require correction. How out-of-range can you expect your child’s numbers to go? There’s really no way to predict, according to Kathy O’Malley, R.N., B.S.N., C.D.E., a certified diabetes educator at Children’s Hospital & Medical Center in Omaha, Neb., who explains, “Blood sugars may vary depending on the type of illness and the severity.” Numbers may also fluctuate suddenly, which is why O’Malley’s first piece of advice for parents with a sick child is to check blood sugars more frequently and treat highs (and lows) as needed. Also on her sick-day to-do list: test urine more frequently for ketones. When these chemical compounds start building up in the blood, it’s a sign that the body is using fat and muscle for energy. Ketones are often present when blood sugar readings are high; elevated ketones typically mean that a child with type 1 is not getting enough insulin. Very high levels of ketones can be a sign of diabetic ketoacidosis (DKA), a health complication that requires immediate medical attention. “When a child is sick, ketones should be checked with each [urine] void,” says O’Malley’s colleague, Kevin Corley, M.D., staff endocrinologist at Childr Continue reading >>

I Have Diabetes And I Am Sick With A Temperature Of 102. What Precautions Should I Take?

I Have Diabetes And I Am Sick With A Temperature Of 102. What Precautions Should I Take?

Dear CDE- Help! I began feeling sick and when I checked my temperature, I realized that I have a fever of 102. I also have diabetes. What precautions should I take? Answer Needed Urgently, Tiffany Answer: Tiffany- Here are a few things you should keep in mind when faced with illness and diabetes: 1) Always take your diabetes medications. Illness may cause an increase in blood sugar levels. 2) Test blood sugar more frequently. For those with type 1 diabetes, check every 4 hours and those with type 2 check 2-4 times per day 3) Drink extra water or caffeine free sugar free fluids (8oz.every hour when awake) 4) Try to eat the usual amount of carbohydrate. Soft foods or liquids may be easier to consume. 5) If having difficulty eating, try drinking 15 grams of carbohydrate every hour. 6) Test for urine ketones every 4 hours (if you have type 1) 7) OTC meds and prescription meds may contribute to hyperglycemia Foods for Sick Day Management if you can’t or do not feel like eating that contain approximately 15 grams of carbohydrate 4 oz. juice (1/2 cup) 1 cup Gatorade ½ cup regular soda ½ cup regular gelatin ½ cup unsweetened applesauce 1 slice toast 6 saltine crackers 1 cup soup ½ cup sugar free pudding When do you contact your Physician? 1) Fever >100 degrees for 24 hours 2) Persistent hyperglycemia (>300 mg/dl) 3) Persistent diarrhea (for more than 8 hours) 4) Vomiting and unable to take fluids for over 4 hours 5) Sick longer than 24 hours 6) Severe abdominal pain 7) Difficulty breathing 8) Moderate to large ketones ( type 1) 9) Other unexplained symptoms We all get sick at one time or another so it is a good idea to be prepared as best you can. Get your flu shot every year. Wash your hand a lot particularly if you work in situations with a lot of people who may be brin Continue reading >>

Diabetes And Infection: How To Spot The Signs

Diabetes And Infection: How To Spot The Signs

Diabetes can slow down your body's ability to fight infection. The high sugar levels in your blood and tissues allow bacteria to grow and help infections develop more quickly. Common sites for these problems are your bladder, kidneys, vagina, gums, feet, and skin. Early treatment can prevent more serious issues later on. What to Look For Most infections in people with diabetes can be treated. But you have to be able to spot the symptoms. Tell your doctor immediately if you have any of the following: Fever over 101 F Pain, tenderness, redness, or swelling Wound or cut that won't heal Red, warm, or draining sore Sore throat, scratchy throat, or pain when you swallow Sinus drainage, nasal congestion, headaches, or tenderness along upper cheekbones White patches in your mouth or on your tongue Flu-like symptoms (chills, aches, headache, or fatigue) or generally feeling "lousy" Painful or frequent peeing or a constant urge to go Bloody, cloudy, or foul-smelling pee *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. Continue reading >>

Can A Simple Fever Be That Bad For A Diabetes Patient?

Can A Simple Fever Be That Bad For A Diabetes Patient?

No doubt you’ve heard the advice, “Drink plenty of fluids,” for a fever. This is because fever causes considerable fluid loss through the skin as perspiration. Your loss of fluid can be difficult to estimate, so your physician may want to assume that you’d require 1–2 more quarts of fluid daily than you’d normally need. Ordinarily, a mild fever helps to destroy the infectious agent (virus or bacteria) that caused the fever. The tendency to sleep out fever may also be beneficial. For a diabetic, however, the somnolence that you experience with fever may discourage you from checking your blood sugar, covering with insulin, drinking adequate fluid, and calling your physician every few hours. If you don’t have someone awaken you every 20 minutes, you should use aspirin, acetaminophen (Tylenol), or ibuprofen (Advil or Motrin), in accordance with your doctor’s instructions, to help fight the fever. Beware, however, that aspirin can cause false positive readings on tests for urinary ketones, so don’t even test for ketones if you are using aspirin. Never use aspirin or ibuprofen (or any of the nonsteroidal anti-inflammatory drugs, NSAIDs) for fever in children because of the risk of Reye’s syndrome. Excessive doses of aspirin or NSAIDs (naproxen, ibuprofen, and many others) can cause severe hypoglycemia. If at all possible, try not to use NSAIDs, as the combination of these drugs with dehydration can cause kidney failure. Acetaminophen can be highly toxic if used in doses greater than those indicated on the package label. If you have fever, the guidelines for blood sugar control and replacement of fluid are almost the same as indicated previously for vomiting. There is one difference, however. Since there is very little electrolyte loss in perspiration, it Continue reading >>

Cold And Flu And What To Do

Cold And Flu And What To Do

Getting sick can be scary and especially when you or a loved one is Type 1. As the body tries to fight off the virus, blood glucose levels elevate, causing rapid and dangerous highs. And when youre not feeling well, you may find it difficult to keep down fluids or even eat, causing you to go too low. Then theres the issue of medicine which to take and how to dose for it if needed. Theres a lot to consider, but rest assured! Weve talked to doctors about what is recommended in terms of planning ahead and the protocol if you or your loved one are faced with a bug. While this season brings with it challenges to staying healthy, here are some helpful guidelines when facing off with the cold or flu. Whatsthedifference between a cold and flu? A cold is a milder respiratory infection than a flu. While both can cause a soar throat, cough, runny nose and congestion, a flu is usually accompanied by body aches, fever and lasts much longer than a common cold. As a Type 1 or as a caretaker of a Type 1, you should plan ahead so youre readynot only for the cold, a common and frequent ailment, but also, the more unruly cousin the flu, who outstays his welcome and can cause serious havoc if left unchecked. lists of recommended medications you can taketo alleviatecertain symptoms the contact of your doctor and when / where they can be reached during regular hours as well as holiday time a plan of action (if / then scenarios), how often you should check your BGLs and whenyou should contact a doctor. low-calorie sports drinks (for fast-acting sugars and electrolytes) These are usually offered in the fall and are highly recommended for anyone who is at higher risk for complications if they contract influenza. Youve heard it a million times, but it really is one of the best ways to prevent c Continue reading >>

Flu And Diabetes

Flu And Diabetes

Tweet People with diabetes are generally at a greater risk if they catch flu (influenza) as it can pose significant difficulties with diabetes management. Flu is a viral infection which is easily caught through inhaling small droplets released when someone with the flu virus nearby coughs or sneezes. A dangerous complication of the flu is pneumonia and people with diabetes are more at risk of developing this complication than people without diabetes. Flu, and other viral infections, can lead to higher blood sugar levels and increase the risk of serious short term complications risk, particularly short term complications such as ketoacidosis and Hyperosmolar Hyperglycaemic State (HHS). Read more on getting vacinated against the flu. What are the symptoms of flu? Symptoms of flu may occur rapidly and include: Severe aching and pain in joints Aching muscles Aching around the eyes Fever Warm, flushed skin Headache Dry cough Sore throat and discharge from the nose Complications of the flu Influenza can lead to chest infections which may develop into pneumonia. Rarer complications include tonsilitis, meningitis and encephalitis. The flu can be a killer and is responsible for around 600 deaths a year. During an epidemic, flu can kill thousands of people in a year. Diabetes and flu medication Some over-the-counter flu medication is suitable for people with diabetes. Some over-the-counter flu medication will be more suitable for people with diabetes than others. For instance, some flu medications contain non-steroidal anti-inflammatory drugs, such as ibuprofen, which are not usually recommended for people with diabetes because they may slightly increase the risk of heart problems and stroke. A number of flu medications may contain a relatively high level of sugar which could pre 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 >>

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 >>

Diabetes (mellitus, Type 1 And Type 2)

Diabetes (mellitus, Type 1 And Type 2)

A A A Are There Home Remedies (Diet, Exercise, and Glucose Monitoring) for Diabetes? Diabetes is a condition characterized by the body's inability to regulate glucose (sugar) levels in blood. In type 1 diabetes, the body does not produce enough insulin. People with type 2 diabetes can produce insulin, but the body is not able to use the insulin effectively. The cause of type 1 diabetes is an autoimmune reaction. Combinations of genetic risk factors and unhealthy lifestyle choices cause type 2 diabetes. The main diagnostic test for diabetes is measurement of the blood glucose level. Changes in lifestyle and diet may be adequate to control some cases of type 2 diabetes. Others with type 2 diabetes require medications. Insulin is essential treatment for type 1 diabetes. No effective approach yet exists to prevent type 1 diabetes. Prevention of type 2 diabetes can be accomplished in some cases by maintaining a healthy weight, exercising, sustaining a healthy lifestyle. Prediabetes is a condition that can occur before development of type 2 diabetes. Complications of any type of diabetes include damage to blood vessels, leading to heart disease or kidney disease. Damage to blood vessels in the eye can result in vision problems including blindness. Nerve damage can occur, leading to diabetic neuropathy. Diabetes mellitus (DM) is a set of related diseases in which the body cannot regulate the amount of sugar (specifically, glucose) in the blood. The blood delivers glucose to provide the body with energy to perform all daily activities. The liver converts the food a person eats into glucose. The glucose is then released into the bloodstream from the liver between meals. In a healthy person, several hormones tightly regulate the blood glucose level, primarily insulin. Insulin is Continue reading >>

Early Symptoms Of Diabetes

Early Symptoms Of Diabetes

What are the symptoms of diabetes? Although the signs of diabetes can begin to show early, sometimes it takes a person a while to recognize the symptoms. This often makes it seem like signs and symptoms of diabetes appear suddenly. That’s why it’s important to pay attention to your body, rather than simply brushing them off. To that end, here are some type 1 and type 2 diabetes symptoms that you may want to watch out for: If you’re experiencing frequent urination your body might be telling you that your kidneys are trying to expel excess sugar in your blood. The resulting dehydration may then cause extreme thirst. Along the same lines, the lack of available fluids may also give you dry mouth and itchy skin. If you experience increased hunger or unexpected weight loss it could be because your body isn’t able to get adequate energy from the food you eat. High blood sugar levels can affect blood flow and cause nerve damage, which makes healing difficult. So having slow-healing cuts/sores is also a potential sign of diabetes. Yeast infections may occur in men and women who have diabetes as a result of yeast feeding on glucose. Other signs of diabetes Pay attention if you find yourself feeling drowsy or lethargic; pain or numbness in your extremities; vision changes; fruity or sweet-smelling breath which is one of the symptoms of high ketones; and experiencing nausea or vomiting—as these are additional signs that something is not right. If there’s any question, see your doctor immediately to ensure that your blood sugar levels are safe and rule out diabetes. So what are the low blood sugar symptoms you should look out for? It’s important to realize that the signs of… Polyuria occurs when your body urinates more frequently—and often in larger amounts—than Continue reading >>

Diabetes: When To Call The Doctor

Diabetes: When To Call The Doctor

Part of caring for a child with diabetes is knowing when to get medical help. As you gain experience in helping your child manage diabetes, you'll become more confident about how to handle all kinds of health issues. Whether your child has type 1 or type 2 diabetes, the diabetes management plan provides instructions about what to do when your child is sick, hurt, or having a diabetes problem. Who you'll call for help willdepend on a variety of things, like the symptoms and their severity. For most medical problems, you should first call your child's primary care doctor, such as a pediatrician or family doctor. Whether you need to ask a question or make an appointment, the doctor can advise you. In some cases, however, the diabetes management plan might direct you to other members of the diabetes health care team, such as a pediatric endocrinologist , nurse, or certified diabetes educator . If you think the situation is an emergency, call 911 or take your child to the emergency department. But first give emergency treatments as you've been instructed such asgiving a glucagon injection for a severe low blood sugar reaction before calling the doctoror rushing to the emergency department. Have this information handy when calling the doctor or seeking emergency medical care, as you might be asked about your child's: medications, as well as yourpharmacist's phone number diabetes health care team's contact information If your child is ill (especially with afever, nausea, vomiting, or diarrhea) or has a problemeating or drinking, call your doctor. Also notify the doctor and other members of the diabetes health care team if your child: has had a significant injury (more than a minor cut, scrape, or bump) needs surgery (especially if it interferes with eating or involves anesthe Continue reading >>

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