I remember instances growing up before I had type 1 diabetes, I would start getting a little cough or sneeze a few times. Then I would start to feel lethargic and maybe I would need to blow my nose before going to bed and in the morning. Sometimes, I wouldn’t want to get up at all and would binge watch tv, gorging on chicken soup and feeling very sorry for myself.
Man flu - it’s real.
Now that we’re aware of the dangers of a common cold for a non-diabetic, it’s very important to run through what a diabetic faces once stricken down with the horrific and life altering man flu (if you’re male), or a little snifffle (If you’re female).
A general cold or virus can be a bit of an annoyance and might knock you about a bit. You might lose a couple of days off work or school.
But what’s the impact on a diabetic and how do we combat it’s effect - particularly on our blood sugars and ketone levels?
What‘s actually happening?
According to webmd.com
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.
We all know the feeling. Our blood sugars are just being stubborn and no matter what we do to bring them down, it’s having little affect. It’s scary as we inject more and more insulin but still.. nothing.
So our blood sugars remain high for several hours, combine that with insulin resistance due to the increase of hormones fighting the infection, and the result is ketones.
These aren‘t the same as dietary ketones that are produced to burn fat in the absence of glucose.
These are ketones that are being produced due to the resistance or lack of insulin, and the combined rise in blood sugars. If both continue to rise, it can lead to ketoacidosis, or diabetic coma.
What happened to chicken soup and 56 episodes of Game of Thrones!?
Yes, unfortunately, things have changed. We must now take a few more steps to ensure our ongoing health. But as long as we’re being diligent and following the correct sick day plan, there’s always going to be Game of Thrones and chicken soup (Low carb obviously).
Start taking vitamins plus cold & flu drugs.
Ideally, you should be either eating or supplementing the following: vitamin c - garlic - horseradish are great. Some supplements combine all three.
Check your blood sugars and ketones every 2 hours, including overnight.
Add up your total daily dose (TDD) - basal + bolus + corrections - Work out 10% and 20% of TDD for supplemental doses of rapid-acting insulin.
Increase water intake (minimum - half cup of water every hour)
The next step is to track your ketones and take appropriate action depending on their level.
1) Blood Ketones 0.6 - 1.4 mmol/L
a - take usual basal and bolus when eating.
b - take rapid-acting supplemental dose of 10% of TDD every 2 hours.
c - if ketones aren't decreasing after 2 hours call your doctor or diabetes educator, or go to hospital.
2) Blood Ketones 1.5 +
a - take usual basal and bolus when eating.
b - take rapid-acting supplemental dose of 20% of TDD every 2 hours.
c - if ketones are still 1.5 mmol/L or more call your doctor, diabetes educator.
d - if ketones are 3.0 mmol/L or more go to hospital after taking the supplemental dose (b)
When do you need to check your ketones?
- Your blood sugars are 15 mmol/L or more
- You feel unwell or have nausea, vomiting or abdominal pain
- Your breath smells fruity or like nail polish
- You feel weak or drowsy
There are many scenarios that can play out, so be vigilant with your health and keep checking your blood sugars and ketones.
The main points to remember are:
- BGL = 15 mmol/L +
- Ketones = 1.5 mmol/L +
= action required as above.
For our friends in the United States - 15 mmol/L = 270 mg/dl
Your medical team needs to provide you with a sick-day plan when you’re diagnosed. It should look similar to the above, and if not, ask why.
Things can can get pretty serious very quickly if we’re not prepared for when we’re sick, and we know what to do. Don’t be shy about calling your doctor, diabetes educator or hospital for advise if you need.
Once you have everything covered, you won’t even sweat the small stuff. You’ll get used to doing certain small things that will negate the big things. Even a small thing like drinking lots of water when you know you’re getting sick has a huge impact on the bringing the level of ketones in your blood down.
I didn’t know this the first time I got sick 3 months after I was diagnosed. Can you imagine how stressed I was sitting in a Dubai airport with ketones of 1.6 mmol/L, reading on google that I should be in hospital, but instead I was getting ready to board a 14 hour flight to Sydney.
Don’t be like me.
Educate yourself early on so the big things never happen.
Thanks for reading.
Believe the hypo