Liam was sick the day before yesterday (most likely a stomach bug because it only lasted the evening, but there was a lot of throwing up). He stayed out the next day (yesterday) as the mandatory 24 hour period to wait after vomiting. Today, he said he felt better so we decided to send him to school. He started dropping and no amount of carbs is bringing him back up. He’s been between 38 and 55 for the past hour even though, as you can see, he has over 70g of carbs on board (enough for 3.6 units of Insulin). He has only .58 iob. The last carbs I gave him, it recommended a 3.1u bolus.
What a crazy day…I hate when his body doesn’t “do” what you expect it to do, or what it usually does.
I picked him up. He wasn’t doing much good at school - just laying down in the nurses office sleeping. He’s since come up, but he was low over 2 hours with over 80g carbs in his system at one point with very little insulin.
I’ve noticed a few times when I’ve had food poisoning that for a period of time it’s like carbs are just not being absorbed at all by my body…like it’s rejecting everything…which is scary from a bg perspective. Hope he bounces back quickly!
After a couple of these incidents where I was sick and had to send my wife for glucagon, I decided it was easier just to keep some on hand for those moments.
The alternative solution to this problem is a dextrose IV drip, which any good hospital ER should be able to do.
When I was a kid, I got food poisoning at a diabetes camp (back in the 1-shot a day times). The camp doctor put in a dextrose IV by the light of a gas lantern. It worked wonders for my blood sugars but you could tell the doctor had not done an IV for a while. I was just fine the next day.
I was back and forth about using it today. I was “this close” to using it. Liam refused to eat or drink which made it worse, but everytime I said “I’m going to have to use the Glucagon then”, he would say “No shot”…and would agree to eat more carbs. But I was back and forth about actually using it and it was on my mind. It would have been the first time in the, over 3 years, I would have had to use it.
Regarding food poisoning, my wife and I were discussing the possibility that this was actually what made him throw up so violently 2 nights ago. He was just miserable…but it was only about 6 hours. After he threw up a lot and slept through the night, the next morning he said he felt great. But to have this low issue 2 days afterward, could/would that be normal for a food poisoning situation?
We have a frozen lunch pack that we send him to school with that contains no-carb and carb foods that need to remain cool (such as pepperoni’s, cheese sticks, etc.,) and I had noticed at the end of the day that the foods were not warm, but they also weren’t as cold as I wish they would be either. And so I started adding an extra frozen block inside the pack to help keep things cool throughout the day. But we had been just keeping/re-refrigerating the foods after taking them out of the frozen pack…maybe we shouldn’t do this?
I haven’t experienced it for that long afterward, just for maybe the 12 hour period of the worst of it during pre and post puking. It’s a head scratcher…
That SUCKS. I hate days like that. Samson spent most of yesterday with no data, bouncing between high and low. He had to get 3 sensor changes because each one kept failing in the warmup. And a site change. And a bunch of ketone and finger pricks.
I HATE that our little guys have to go through this nonsense. Poor Liam. What a rough day.
we use mini-glucagon pretty regularly on Samson. I mean not regularly, but any time he has a stomach flu. It’s the only thing that keeps him up in the 2 or 3 days post-barfing.
Also i would not re-refrigerate the foods – I know plenty of people who write off food safety rules, but defrosting and re-refrigerating is not a great practice if you’re trying to avoid food poisoning. For carb-free snacks, ask them if there’s a refrigerator you can keep it in and not keep dragging it back home every day. Our school has snacks and so there is a fridge.
FWIW, I rarely get vomitous (I get a flu shot every year) but the last time I had the flu, I saw something similar, where I needed dramatically more insulin while sick (more bolus every few hours), then as soon as I was getting well my insulin needs were dramatically less so I was eating for 24 hours or so with miniscule insulin needs. I don’t know the presumably hormonal mechanism, but based on my experience it is something to watch for in the future.
A bit unrelated to the thread topic, but I have been waiting to hear about the release of the shelf-stable glucagon and still don’t know what is going on with that. Have you heard anything?
The nasal glucagon that just came out is stupid. No dosing options. The 5 year old or the 300 pound lumberjack would both get the same amount!
No matter how low you are, or no matter how big you are, one size fits all?!?!
I think that is extremely idiotic. No thanks Baqsimi, I’m gonna give your product a miss!
Sorry, I got side-tracked!
Anyway, the company is Xeris, and their shelf stable glucagon was in a phase 3b trial over a year ago. But I have not heard any updates. Have you heard?
haha, we got it for school. I guess if Samson is low enough and having a hypoglycemic seizure, giving him a mega-dose of glucagon is the least of our concerns – I’d be more concerned about someone not being willing/able to give him any glucagon.
But we’ll continue to use the injected glucagon for home when Samson’s sick.
Also I think Zealand completed a phase II B on the shelf-stable version, and Xeris may have started on their Phase III – but those were both I think for rescue Glucagon, not in a pump.
Yes, it makes sense for a school, since it is easier for them to give if they are not used to syringe injections. I was just talking about for home use.
But man, that full dose can skyrocket people. And then you gotta worry about recovering from the big spike, and that introduces a different set of problems.
