Diabetes Details 13: The Sick
I’ve spent the past day and a half with a stomach bug, which made me once again contemplate the possibility of installing Mira Grant-style sanitizing showers and blood screening tests in my house.
I’ve talked before about how I need to regularly test my blood sugar in order to keep my diabetes more-or-less controlled. Well, when I get sick, I have to test even more often. Here’s why:
The vertical axis is my blood sugar readings, and the horizontal shows each blood sugar test throughout the course of two days or so.
It would be one thing if getting sick messed up my blood sugar in a consistent and predictable way. If I knew I’d always run high when I got sick, I could adjust the insulin pump to give me a little more insulin during that time.
But as you can see, I was all over the map for the past 24 hours, with a low of 23 and a high of 468.
Not cool, diabetes fairy. Not cool at all.
The low was the most dangerous. Normal blood sugar should be around 100 or so. I was still up and walking around at 23, but had it dropped any lower, I would have been in trouble.
Here’s a fun scenario. You have a low blood sugar, which is normally treated with juice or other high-carb food and drink. But your stomach is too messed-up to keep anything down. What do you do?
Well, there are pills to help suppress nausea, which I completely forgot about because my blood sugar was 23 and my head was a bit fuzzy. So I ate high-carb, quick-acting snacks, disconnected my insulin pump for about six hours, and hoped I’d absorb some of the glucose before…um…sending a form rejection to my food.
I’m not thrilled about hitting 468, either. This happened after I finally got to sleep, but because I was sleeping, I couldn’t check my blood sugar as frequently. Oops. As much as I needed the rest, in hindsight, it might have been good to set an alarm for one or two in the morning, just to roll over and check my blood.
Short version: Diabetes + Another Illness = Visit from the Blood Sugar Gremlin.
(Also, I’m using this as my excuse for not answering email over the past few days. Sorry about that!)
Paul (@princejvstin)
March 28, 2013 @ 10:23 am
Awww nuts, Jim. Take care of yourself as best you are able. We all understand.
Kaal
March 28, 2013 @ 10:28 am
You don’t need an excuse, Jim… I think that actually constitutes a reason…
Annalee
March 28, 2013 @ 10:29 am
:(. Sorry to hear. I hope you’re feeling better.
Martin
March 28, 2013 @ 10:47 am
@Jim: Hope you get better soon.
I think continual, non-invasive measurement of blood sugar would be the greatest achievement for the quantified self movement.
Due to the fact that i misadjusted my built-in controller for blood sugar regulation with years of wrong food, it would do me a lot of good if i had a proper management tool. The current tools for blood sugar measurement are not cool. They require manual interaction and a minimum level concentration. So i don’t do it.
I want a mechanism to measure the blood sugar level every 5 minutes without any attention on my side and an output to rrdtool combined with scripted alerts.
Jim C. Hines
March 28, 2013 @ 10:49 am
They’ve got some CGMs (continual glucose monitors) on the market, but the technology is still fairly young. At the rate things are going, I’d expect them to be more widely available within the next 5-10 years, though.
Martin
March 28, 2013 @ 10:55 am
The current generation are for patients that (medically) really need them but far from useable for everyone. I hope that such devices one day will be as easy a pulse meter for joggers today.
It’s funny that we monitor the average server more closely than out health. We have no log files no nagios plugin ;-).
Jeff Linder
March 28, 2013 @ 12:33 pm
As far as the nausea/blood sugar issue, my diabetic aunt swore by coke syrup in small doses to settle the stomach and provide sugar (glucose candy also in a pinch).
Ben T
March 28, 2013 @ 12:45 pm
Getting an insulin pump and cgm in a few weeks. How being sick affects blood sugar is good to know. I didnt realize how much it does.
Hanneke
March 28, 2013 @ 2:05 pm
The Continual Glucose Monitor might be good to talk about with your doctor, if this happens somewhat frequently.
My friend has insulin, which was very very hard to get under control, even while sticking faithfully to her diet. Still, she wasn’t in the category that got the CGM from her medical insurance. After talking with her doctor, she’s paid for one herself (it cost a few hundred dollars, I don’t know exactly), and she says it’s one of the best expenditures she ever made, investing in her own health. Her boodsugar is now balanced, she doesn’t get dangerous highs or lows anymore, and is a lot more relaxed, not having that constant worry anymore.
My friend has a little insulin pump thingy on one upper arm, and a CGM measuring little thing on the other arm, and she has to carry two little electronic boxes about in her handbag that are linked to those thingys. At home, the wireless range is enough so she can leave them in a fixed spot, but when she gets out of range of the measuring box it starts to beep, so she carries it with her. It is set to beep when her insulin levels get too low or too high, and on the screen it shows the current level. With the other box, she can wirelessly program the insulin pump to add a bit, or (if a low seems structural) give her a bit less of the frequently-administered basic dose.
It’s made such a big difference in het life, she’s very happy she bought it (after two years of trying to stabilise her bloodsugar the usual ways), and didn’t let the doctor put her off.
If this episode was unusual, you may not need it, but I just wanted to let you know that if you have the same dangerous irregularities fairly often there may be other ways of trying to get control.
Steve Tait
March 28, 2013 @ 2:39 pm
23!!! Holy F(ornication) shit.
“I was still up and walking around at 23, but had it dropped any lower, I would have been in trouble.”
I am fortunate that I get very symptomatic at 60 to 70 and can take action then.
Jim C. Hines
March 28, 2013 @ 3:01 pm
The wacky blood sugar readings when I’m sick isn’t too unusual, but I think this may be the most extreme example.
I’ve talked about the CGM with the endocrinologist and my diabetes nurse before. There are some issues right now, but eventually I’d love to have one.
Jim C. Hines
March 28, 2013 @ 3:02 pm
Most of the time, I start to feel it by the time I drop down to 60. But when I’m sick, some of those symptoms get masked, and I didn’t catch it as quickly as usual. Very annoying.
Jim C. Hines
March 28, 2013 @ 3:04 pm
Most of the time when I get sick, things do get rather messed up, but not usually this bad. Definitely test more often when you’re sick, though.
Sometimes I can tell I’m getting sick because my blood sugar starts to run high a day or so before any other symptoms show up.
And good luck! I hope the pump and CGM work for you!
Sally
March 28, 2013 @ 8:30 pm
I laughed at this, not in a mean way, but in an understanding way. My husband is diabetic and got low blood sugar when we were out yesterday. Luckily we were in a grocery store. I made him eat before we got back on the road b/c as I said to him, “You cannot brain today. You haz teh dumb.” Probably wasn’t at 23, though. It takes a real pro to still be conscious at 23.
(At least this prepares you for the dreaded day before the colonoscopy when you turn 50.)
Jim C. Hines
March 28, 2013 @ 8:34 pm
The sad thing is I had a very similar thought at one point on Tuesday re: the colonoscopy preparation.
My father (also diabetic) apparently played racketball at one point with a blood sugar reading even lower than mine was. Not that this is a *good* thing, but it’s impressive in a scary kind of way.
HelenS
March 28, 2013 @ 9:13 pm
If you don’t have a first-degree relative with colon cancer, a standard often used these days is to let you off with a stool sample (to check for blood). If that’s negative, they don’t bug you about a colonoscopy.
PsychoCat
March 29, 2013 @ 2:21 am
My sympathies – you haz them! I’ve been in that same sort of situation more times than I even want to think about. Glad you’re on the mend, though! One thing that I found helped a lot with the low blood sugar/nausea combo is chewable ginger candy. (Available at any Asian market.) Just a piece or two, and you can even dissolve it in hot water for a tea. Just something about that rhizome that mellows out the stomach.
America Y.
March 30, 2013 @ 5:42 pm
Do me a favor, Jim.
Don’t die. =]
23, Jim? 23? :: shudders at the thought ::
I’ve worked with a diabetic child, and I have a diabetic mother. I’ve seen both of them at that place, and it wasn’t pretty. I’m glad you even had the presence of mind to CHEW!
Jim C. Hines
March 30, 2013 @ 5:44 pm
Not planning on dying any time soon. For some reason, I seem to be fairly functional even at low blood sugars. I commented above that my father, who’s also type 1, once played racketball with an even lower blood sugar than mine.
I’m not saying he played *well*, mind you, but still.
But all the same, I’d prefer not to drop back down that low any time soon. Or ever.
Sally
March 31, 2013 @ 1:50 am
My dad used to get down in the 20’s on the regular too. But he never did anything sporty at that point.
The ancestors of the Hines men were obviously mighty hunters who could throw spears and chase mammoths even when they hadn’t eaten lately. Rawr.
Jim C. Hines
March 31, 2013 @ 9:08 am
I like this theory 🙂