It was the best of times . . . the worst of times . . . or maybe just bad timing. Who knows? I suppose it depends on who you ask. For us, 2018 hasn’t started out on the best of notes. My wife, Kelsy, got sick right after New Year’s Day, and despite sleeping in another room and doing everything in my power to avoid catching this nasty bug, I still got it. I’ve spent the better part of a week buried under the covers, going back and forth from clammy and freezing to so hot and sweaty that I can’t breathe. Of course, it’s also hard to breathe (and sleep) when you’re coughing 23 of every 24 hours each day. Hold on . . . I think I just tore an abdominal muscle during one of my coughing fits. Oh how it hurts.
Really, I’m pretty lucky. I don’t get sick all that often, but when I do, it’s usually a doozy. But the thing I hate more than being under the weather is what sickness does to my normally well-controlled blood sugar levels. Once that bug or virus gets itself firmly entrenched into each of my cells, I quickly go from in-control to in-confusion.
During sickness, my insulin needs may go up 30% or more, but adjusting for illness requires a lot more than just simply increasing insulin dosages. The confusing part is how much insulin to take. If we increased our insulin 30% when well, we would likely put ourselves into convulsions or a coma. So naturally, it’s a little scary making such big adjustments when we’re not feeling well or necessarily thinking all that clearly.
If I can tolerate it, I usually like to stick to my “safe foods” when I’m sick. Safe foods are foods that I can calculate insulin dosages for with absolute precision. I know exactly how these foods impact my diabetes, and I always keep some of them around. If I ever get off-track, my safe foods are great for helping me quickly get back under control. Most of these are low-glycemic index and low-fat foods (nothing super fatty that would require the infamous pizza bolus).
Since there’s so much chaos going on biologically within us when we’re sick, I like being able to factor in one constant into the dosage equation. I bolus for my safe foods as I normally would but add in a sliding scale correction to bring down the inevitable highs. Sometimes it works perfectly, and other times I still end up 225 before every meal. I’m one of those type A perfectionists, so this literally drives me mad.
But why, you may be asking, does illness drive our blood sugar levels so high? Well, the answer is pretty simple – stress. When we’re sick, our body thinks it’s under attack and secretes a number of hormones to aid in the fight against our unwelcome intruder. One of the primary stress hormones released is cortisol, which you might be familiar with from the Dawn Phenomenon that raises our morning blood sugars.
Cortisol raises our blood sugar levels in two ways: One, it increases insulin resistance so our insulin doesn’t work as efficiently for us; and Two, it signals the liver to release glucose in the bloodstream. So, you put those two together, and it spells trouble with a capital “T”. Cortisol does this to make sure that we have enough glucose in our blood to function and fight the stressor. As far as the Dawn Phenomenon goes, it works to make sure that we have adequate glucose to start the day. For the non-diabetic, this all works out fine and the body produces enough insulin to keep everything in balance. For us, it isn’t so simple.
To make matters even worse, if the illness is bacterial and not viral, high blood sugar levels reduce the efficiency of our white blood cells’ action to eliminate the offending bacteria. This, of course, can slow down our ability to recover from a bacterial infection.
So, in addition to having to deal with the misery of coughs, colds, and the flu, we diabetics must also wage a secondary battle when we’re sick with abnormally high blood sugars – the double whammy! In the end, I usually just resolve myself to the fact that I’m going to run a little high until I’m well. The last thing I need is to stress myself out even more and get an additional surge of cortisol that complicates the matter even more.
So far, none of the kids have this garbage. I’m crossing my fingers. If they do, I’m getting a hotel room and moving out for the remainder of the winter.
Ouch! I need to go lay down. That torn ab muscle is killing me.
–Tad