They say that you’re really tested on your TD1 Diabetes management when your little Warrior gets sick. And with the recent change in seasons, combined with the fact that there really is no way to escape these little ones getting something or other from their fellow classmates – we found ourselves this past week in this precise predicament with Eva. After a visit to her Paed and an X-ray later, she was diagnosed with a bad chest infection and what’s the first thing that came to my mind? The ‘up’ arrow on her CGM (continuous glucose monitor). Because as most Gatekeepers know too well, its the undeniable fact that illnesses and infections raise sugar levels! As the body’s natural defense mechanism, it releases large amounts of stress hormones like cortisol and adrenaline into the system causing the liver to release more glucose into the bloodstream leading to the higher levels.
When Warriors are sick and especially when they have a fever, their bodies will increase its insulin requirements sometimes often by 25% for each degree celsius of fever. (usually over 38 deg). This is because high blood sugar levels leads to increased insulin resistance. And before we got the tissue box out, there were Eva’s levels making their steady ascent. Every Warrior is different, but from past experience, we’ve found ourselves increasing her bolus doses by half a unit if her levels are above 10mmol/L. Indeed, it does become a little tricky when she loses her appetite and we find ourselves in a juggling act trying to balance these increased doses with potential hypos. So yes, I feel you fellow Gatekeepers!
Then there’s those Ketones. Mmmmmm. When I think of Ketones, I think of those Oompa-loompas from Charlie and the Chocolate Factory. These orange, fat little things coming out of no where making trouble. The fear of the Oompa-loompa keeps me on my toes, making sure we’re compensating for the natural increase in sugar levels. For those new to TD1 – if blood glucose levels rise, there’s a higher risk of producing ketones. Ketones are acids and if ketones rise, TD1’s can feel very unwell and could end up vomiting and we want to avoid vomiting at all necessary costs.
When Eva has a cough like this, we opt for Prospan. Its sugar free and alcohol free and we’ve found it to be very effective. Yes, there are medications out there of course that contain sugar, however, the sugar content is often quite low enough so not to raise their levels. Then there’s those, that don’t contain any sugar but still affect levels. Ones that contain cortisol or other steroids (eg: prednisolone or dexamethasone) do affect sugar levels quite considerably. Its advisable to speak to your GP or Endocrinologist about increasing the insulin dose to counter act this. Its important to note that personally we’ve been advised by Eva’s Endo that Salicylates (aspirin) tend to affect insulin’s efficacy dramatically.
Accept levels will be higher and do the best you can
I know, its certainly not fun when these little Warrior’s get sick. It puts a huge amount of strain on us and every hour of a snotty nose, cough or uncomfortable moan is a challenge when its combined with sugar monitoring. But remember that you are their Gatekeeper and you will get through this. Here are some personal tips I arm myself with when Eva gets a bug:
- Test often: If your Warrior isn’t on a CGM, its crucial to test as often as possible. When they’re sick, their levels can become quite erratic. Don’t forget to test for Ketones as well.
- Increase the basal rate: Chat to your GP or Endo about compensating for the insulin resistance here.
- Water and more water: Dehydration can happen quickly for these little ones and is amplified by high blood sugar levels.
- Be extra patient on them and yourself: Its not nice for any child to be sick, let alone one that needs injections as well. Try to remind yourself that this will come to an end and if anything its building your experience and knowledge on how to better manage their condition. Once they’ve eventually gone to sleep, take this time to reward yourself – a glass of wine or a hot bubble bath – you deserve it.
- Be prepared for hypo’s: With all the extra insulin you’re giving, there’s bound to be a hypo Im afraid. No its not your fault, its just the way it is, so don’t blame yourself.
Thanks for reading. Remember we’re all in this together. Without community, we’re alone. And managing this condition alone is very challenging and lonely! Please feel free to browse my blog for other articles and if there’s any topic you’d like to know more about-do let me know and I’ll try to feature it in my next post! You can also find me on Facebook and Instagram. Or simply subscribe below and keep up to date with my latest discoveries on this condition 🙂