Tuesday, June 19, 2012

Illness and Diabetes

Karl's recovering from a cold, his first real cold since being hospitalized over a year ago. Man, oh man, did his blood-sugar levels go up! Bedtime readings were above 200 three days in a row.

Illness tends to raise blood-sugar levels in diabetics, and if there's dehydration involved, it gets much worse. Karl doesn't like our tap water, so we made sure the supply of bottled water and sugar-free drinks was unusually ample, using the lure of yumminess to overcome any reluctance brought on by lethargy.

Corrective doses at mealtimes were clearly not enough to bring his blood sugar back to normal, so we started a two-pronged strategy of increasing his long-acting Lantus dosage from 8 units a day to 10, and also added an extra 0.5 units per meal in addition to the calculated value. Both corrections together have gotten him into much better territory.

As things normalize, we'll first abandon the extra 0.5 units per meal and then back the Lantus off to suit. If Karl were to suddenly snap back to normal without warning, we might have to give a couple of small snacks to keep his blood sugar up, but it seems far likelier to me that he'll drift rather than snap back to normal.

I have not reviewed all my diabetes books for corroboration, since it's not rocket science to conclude that "if blood sugars are way too high, give more insulin."

We are also giving plenty of Insulow (alpha lipoic acid), which in some ways mimics the effects of insulin and also tends to reverse some of the damage of high blood sugars. While I suppose it's possible to overdo this, since alpha lipoic acid will lower blood sugars, and this could cause trouble if you're not paying attention, we've never seen any evidence of this. Karl normally gets 200 mg per meal, for 600 mg per day, but in his case giving twice this much has little effect on blood sugars. Apparently it's different for some people.

Karl didn't ask for cold medication. Dr. Bernstein's book paints a scary picture of aspirin, ibuprofen, and similar drugs, which can apparently  crater blood sugars unpredictably, and Tylenol, which is hard on the liver if you're dehydrated. Karl's pretty content with sugar-free cough drops as the only treatment.

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