Important Note: I am not a healthcare professional – merely just a girl with a crap pancreas who apparently can’t ride a bike or go outside without catching a virus. Please always consult a healthcare professional immediately if you are unwell and need advice on managing Type One Diabetes.
We all have ups and downs, good months and bad months – and I think it’s fair to say this past one hasn’t been my finest. One month and one day ago, I finally picked up my new bike I’ve been waiting on for SO long now, and was super excited (look how pretty she is!). Ironically, the very next day I fell off this beauty and ended up in an ambulance having my ankle realigned and fractured in 3 places. Which was great. (!)
To top it off, I also spent last week enjoying the symptoms of the norovirus. Now I’ll spare you the details, but essentially, it’s a viral stomach bug, it isn’t very nice, and it’s persistent (my symptoms lasted over a week, and knocked me for 6). Pretty impressive for someone who’s been practically housebound for the past month, right?!
Sympathy calls and tiny violins aside, I thought I’d write some tips on how I’ve managed the type one side of all this – because as we all know, even if we’re sick or on holiday or just frankly fed up of it, type one always needs some attention – if not more in these circumstances.
• KEEP TAKING YOUR INSULIN
I’ve put this one first because it’s so SO important. So important that I’m going to write it again.
KEEP TAKING THAT DAMN INSULIN.
Now I know what it’s like – I completely lost my appetite over the past week, and the last thing I wanted to think about when waking up feeling sick and fevery was ‘hmm how’s my blood sugar? What food and carb count will I be able to stomach today?’ – but you have to keep taking your insulin – otherwise you could end up a lot more unwell than you already are (more on this below).
With the virus, I found that I wasn’t really able to eat much until dinner time – so I just made sure to take my morning basal insulin as usual, and when I did manage to eat later in the evening, looked at adding in rapid insulin then. Using my Libre and Miao Miao, I’ve been able to monitor my sugars pretty closely and easily, and if my blood sugars were to run high at any point, I took a correction shot like usual.
• Buy hypo treatments which are easy to take on board
Annoyingly, as crap as you already may feel, you can still get hypos when you’re unwell (isn’t type one fun?!), even if your sugars are generally on the higher side – so make sure you have some quick acting sugar you can face even when you don’t feel your best. I’ve stocked up on OJ cartons, and plain biscuits for when I need long-acting carbs to back up the quick-acting.
• Adjust your insulin ratios accordingly
In terms of the broken ankle, seeing as I can hardly make it up and down the stairs these days (I’m really still not very elegant with these crutches – they looked way more fun when I was a kid than they really are), I’m pretty stuck in terms of exercise and essentially doing absolutely nothing on the physical activity scale. Before all this, I was cycling and running around 3-4 times a week, so I found that I personally had to increase my basal by 5 units to compensate for this (although everyone will be different).
In terms of the virus, this one’s a bit more complicated. It might feel like you’ll need less insulin if you lose your appetite and don’t eat much – however, in contrast to this, often as part of the body’s natural defence mechanism when you’re unwell, your body will trigger and release stress hormones, which can stimulate a release of glucose from the liver, leading to higher than normal blood sugar levels. This can be the case with lots of different things – viruses, bacterial infections and other illness too, and of course different people react differently to different things – so just make sure to monitor your sugars regularly (I’d say at least every 2-4 hrs) and adjust your insulin accordingly.
(Remember to ask your diabetes team/ a HCP if you need help with adjusting your insulin ratios)
• Check for ketones and stay hydrated
This is really important, as being unwell can increase both the risk of dehydration and high blood sugar levels for someone with type one, both of which could increase the risk of diabetic ketoacidosis (DKA) if ignored. Now don’t panic – I’ve never had DKA and you don’t automatically fall into DKA just because you fall unwell – it’s just a risk to be aware of. DKA is a serious condition where the body essentially starts to release acidic ketones into the bloodstream due to a lack of insulin, and if left untreated could lead to hospitalisation.
Try and sip on water throughout the day, keep on taking your insulin (again!) and make sure to test your ketone levels regularly. The ketone strips I use at home are linked here – they’re the purple wrapped strips which work with my Freestyle Libre Reader (v. handy), and I get mine on prescription. Anyone with T1 in the UK should be able to get ketone blood test strips on prescription, so ask you GP or diabetes team if you need some too.
Here are some good links for:
– What DKA is & guidelines over ‘good/bad’ ketone levels:
– A bit more of the science/nitty gritty behind DKA for those interested:
• Be kind to yourself
Finally – make sure to rest up and give yourself the rest you need! Binge watch that series of KUWTK, read that book one more time, have that super long relaxing bath you never usually have time for. Don’t try and push yourself too hard in terms of work or exercise or general ‘life chores’ you keep thinking about – because ultimately you’ll just take longer to get back to your normal self and feel even worse in the process.
Oh and FINALLY like I said at the beginning – I am not a healthcare professional – these are just some tips I’ve found help me (these may or may not work for you – everyone’s diabetes is different). If you’re unsure about ANYTHING – reach out to a healthcare professional, your diabetes team (that’s what they’re there for) or your GP – they’re the experts and will be able to help 😊
Here are some other useful links I’ve found on sick day rules for T1: