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When You Are Sick Does Your Blood Sugar Go Up?

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 >>

How Many Factors Actually Affect Blood Glucose?

How Many Factors Actually Affect Blood Glucose?

A printable, colorful PDF version of this article can be found here. twitter summary: Adam identifies at least 22 things that affect blood glucose, including food, medication, activity, biological, & environmental factors. short summary: As patients, we tend to blame ourselves for out of range blood sugars – after all, the equation to “good diabetes management” is supposedly simple (eating, exercise, medication). But have you ever done everything right and still had a glucose that was too high or too low? In this article, I look into the wide variety of things that can actually affect blood glucose - at least 22! – including food, medication, activity, and both biological and environmental factors. The bottom line is that diabetes is very complicated, and for even the most educated and diligent patients, it’s nearly impossible to keep track of everything that affects blood glucose. So when you see an out-of-range glucose value, don’t judge yourself – use it as information to make better decisions. As a patient, I always fall into the trap of thinking I’m at fault for out of range blood sugars. By taking my medication, monitoring my blood glucose, watching what I eat, and exercising, I would like to have perfect in-range values all the time. But after 13 years of type 1 diabetes, I’ve learned it’s just not that simple. There are all kinds of factors that affect blood glucose, many of which are impossible to control, remember, or even account for. Based on personal experience, conversations with experts, and scientific research, here’s a non-exhaustive list of 22 factors that can affect blood glucose. They are separated into five areas – Food, Medication, Activity, Biological factors, and Environmental factors. I’ve provided arrows to show the ge Continue reading >>

Diabetes And Illness

Diabetes And Illness

It is very important to know how to cope with illness if you have diabetes or know or care for somebody with diabetes. If in doubt, always seek advice from your doctor or nurse straightaway. Any illness or other type of stress will raise your blood sugar (glucose) levels, even if you are off your food or eating less than usual. People with diabetes are unable to produce more insulin to control the glucose level. The increased glucose level can make you become very lacking in fluid in the body (dehydrated). Acting quickly and following advice helps to keep your glucose levels in the normal range or only slightly high. Because it can sometimes be very difficult to control your blood glucose levels, treatment in hospital may be needed. Hospital treatment may also be needed if you become very dehydrated. What happens to my diabetes when I am unwell? When a person with diabetes is unwell the sugar level in the blood tends to increase. This can happen even with a very mild illness such as the common cold. The blood sugar (glucose) may go up even if you are not eating properly or are being sick (vomiting) or have loose or watery poo (diarrhoea). The increase in blood sugar may make you very lacking in fluid in the body (dehydrated). What should you do when you are unwell? Contact your GP or practice nurse for advice if you are not sure. You may also need treatment for the illness that is making you feel unwell. If you check your blood sugar (glucose) levels then these checks should be more regular. A practice nurse or district nurse can help with checking blood glucose levels, especially if you don't usually check them regularly. Continue eating as normally as possible. If you don't feel like eating, replace your solid food with soup, milk, ice cream, fruit juice, sugar or hon 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 >>

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 >>

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 >>

Diabetes And Dehydration: A Dangerous Combination

Diabetes And Dehydration: A Dangerous Combination

When you experience vomiting, nausea, fever, diarrhea, or any form of infection, you should immediately contact your physician. I can’t really emphasize enough the importance of getting treatment and getting it fast. To drive home this point, I’ll share the following experience. Some years ago, I got a call from a woman at about four o’clock on a Sunday afternoon. She wasn’t my patient, but her diabetologist was out of town for the weekend with no backup for emergencies. He had never taught her what I teach my patients — the contents of this chapter. She found my Diabetes Center in the white pages of the phone book. She was alone with her toddler son and had been vomiting continuously since 9:00 a.m. She asked me what she could do. I told her that she must be so dehydrated that her only choice was to get to a hospital emergency room as fast as possible for intravenous fluid replacement. While she dropped off her son with her mother, I called the hospital and told them to expect her. I got a call 5 hours later from an attending physician. He had admitted her to the hospital because the emergency room couldn’t help her. Why not? Her kidneys had failed from dehydration. Fortunately, the hospital had a dialysis center, so they put her on dialysis and gave her intravenous fluids. Had dialysis not been available, she would likely have died. As it turned out, she spent five days in the hospital. Clearly, a dehydrating illness is not something to take lightly, not a reason to assume your doctor is going to think you’re a hypochondriac if you call every time you have one of the problems discussed in this chapter. This is something that could kill you, and you need prompt treatment. Why is it, then, that diabetics have a more serious time with dehydrating illness th 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 you’re not feeling well, you may find it difficult to keep down fluids or even eat, causing you to go too low. Then there’s the issue of medicine — which to take and how to dose for it if needed. There’s a lot to consider, but rest assured! We’ve 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. What’s the difference 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 you’re ready not 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. Be Prepared Sick Day Plan lists of recommended medications you can take to alleviate certain symptoms doctor contacts 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 when you should contact a doctor. Food + drink stock up diet, clear sodas, without caffeine clear broths sugar-free popsicles saltines glucose gel (fast-acting to treat lows) low-calorie sports drinks (for fast-acting sugars and electrolytes) regular ginger ale cereals (like oatmea Continue reading >>

Take Care Of Your Diabetes During Sick Days & Special Times

Take Care Of Your Diabetes During Sick Days & Special Times

Diabetes is part of your life. You can learn how to take care of yourself and your diabetes when you’re sick, when you’re at school or work, when you’re away from home, when an emergency or a natural disaster happens, or when you’re thinking about having a baby or are pregnant. When You’re Sick Having a cold, the flu, or an infection can raise your blood glucose levels. Being sick puts stress on your body. Your body releases hormones to deal with the stress and to fight the sickness. Higher hormone levels can also cause high blood glucose levels. You should have a plan for managing your diabetes when you’re sick. The first step is to talk with your health care team and write down how often to check your blood glucose levels whether you should check for ketones in your blood or urine whether you should change your usual dose of your diabetes medicines what to eat and drink when to call your doctor Action Steps If You Take Insulin Take your insulin, even if you are sick and have been throwing up. Ask your health care team about how to adjust your insulin dose based on your blood glucose test results. Action Steps If You Don't Take Insulin Take your diabetes medicines, even if you are sick and have been throwing up. People who are sick sometimes feel as though they can’t eat as much or can’t keep food down, which can cause low blood glucose levels. Consuming carbohydrate-rich drinks or snacks can help prevent low blood glucose. If you are sick, your health care team may recommend the following: Check your blood glucose levels at least four times a day and write down the results in your record book. Keep your results handy so you can report the results to your health care team. Keep taking your diabetes medicines, even if you can’t eat. Drink at least 1 cu 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 >>

15 Ways High Blood Sugar Affects Your Body

15 Ways High Blood Sugar Affects Your Body

High blood sugar symptoms Glucose, or sugar, is the fuel that powers cells throughout the body. Blood levels of this energy source ebb and flow naturally, depending what you eat (and how much), as well as when you eat it. But when something goes wrong—and cells aren't absorbing the glucose—the resulting high blood sugar damages nerves, blood vessels, and organs, setting the stage for dangerous complications. Normal blood-sugar readings typically fall between 60 mg/dl and 140 mg/dl. A blood test called a hemoglobin A1c measures average blood sugar levels over the previous three months. A normal reading is below 5.7% for people without diabetes. An excess of glucose in the bloodstream, or hyperglycemia, is a sign of diabetes. People with type 1 diabetes don’t make insulin, the hormone needed to ferry sugar from the bloodstream into cells. Type 2 diabetes means your body doesn’t use insulin properly and you can end up with too much or too little insulin. Either way, without proper treatment, toxic amounts of sugar can build up in the bloodstream, wreaking havoc head to toe. That’s why it’s so important to get your blood sugar levels in check. “If you keep glucose levels near normal, you reduce the risk of diabetes complications,” says Robert Ratner, MD, chief scientific and medical officer of the American Diabetes Association. Here’s a rundown of the major complications and symptoms of high blood sugar. No symptoms at all Often, high blood sugar causes no (obvious) symptoms at all, at least at first. About 29 million people in the U.S. have diabetes, but one in four has no idea. Another 86 million have higher-than-normal blood sugar levels, but not high enough to be diagnosed with type 2 diabetes. That's why it’s a good idea to get your blood sugar test Continue reading >>

Taking Care Of Your Diabetes When You Are Sick

Taking Care Of Your Diabetes When You Are Sick

Whether you have a head cold or the flu, being sick can put all of your activities on hold. You are forced to stop and take care of yourself. But, if you have type 1 or type 2 diabetes, this demands extra attention. When you are sick, you are more likely to have a high blood sugar (glucose) level also known as hyperglycemia. This happens because your body creates more hormones to fight infection, and these hormones can counteract the effects of insulin. If insulin cannot do its job, then glucose builds up in the blood. Test Your Blood Sugar Often Since being sick puts you at risk for hyperglycemia, you should consider checking your blood glucose more often. You may need to test more often than usual. What is considered high? This depends on your target range. According to the American Diabetes Association, you should aim for tight control, keeping glucose levels as close to normal as possible (80-130 milligrams per deciliter [mg/dL] before a meal, less than 180 mg/dL 1-2 hours after starting a meal). But not everyone is able to achieve this. Ask your doctor what levels are right for you and when you should call for additional medical advice. You also need to know how to adjust your medication to treat high glucose levels. Ask about the amount of insulin you should give yourself to bring the levels down. If you take oral diabetes medication, find out how to adjust the dose. If you do not already have this information, work with your doctor to create a sick day plan so that you will be prepared. In addition to testing your blood glucose levels, be alert for the symptoms of hyperglycemia such as having to urinate frequently, being very thirsty, and having blurry vision. Test for Ketoacidosis If you have diabetes and high glucose levels, you are at risk for a dangerous cond 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 >>

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 >>

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