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Low BG after GI bug ... or Adrenal issues?

Discussion in 'Parents of Children with Type 1' started by abdabs, Jan 25, 2013.

  1. abdabs

    abdabs Approved members

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    My daughter was admitted to the hospital after an ER visit last weekend. She vomited 10 times before the Zofran kicked in and spent the next 12 hours on IV fluids and glucose. It was clearly a huge stress on her body. They released us Sunday afternoon, and later that night she seemed to be back in good spirits. Her appetite has been *very* slow to return, though. In addition, when she does eat, any amount of insulin coverage will send her plummeting. Today we gave 4u Levemir (80% of her usual) and 50% of her Humalog. Each time we did the latter, we caught an impending low an hour later.

    Long story short, we talked to an Endo today and mentioned this. I assumed she would say, "Oh, that's the normal reaction after a GI episode". Instead, she ordered an AM Cortisol Test. Presumably for Addison's? I was too confused to ask the right questions.

    So, I have two main questions (in addition to the other million little ones):
    -- How long does it take your CWD for carb absorption to return to normal after a GI episode?
    -- Is there any relation to the vomiting and onset of Cortisol issues/Adrenal Insuff/Addison's? Meaning, would this be coincidence, or could the onset have caused the vomiting?
    -- What goes on in the AM Cortisol test? (How many bribes do I need in my bag? :cool:

    Praying this is just over-precaution!
     
  2. mmgirls

    mmgirls Approved members

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    Our first true stomach bug was truley a learning experience.

    EVERYTHING can just go out the window.

    I would switch to "correcting" instead of prebolusing until you get a handle of it.

    When you can not depend on those carbs that they will eat to actually show up in their BG then you need to take a step back and take it easy.
     
  3. mmgirls

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    Sorry, it can take a GOOD WEEK to recover from a tummy bug.

    i have seen it not only in my D kiddo but my non-D with Ketones. Even when they do eat they may not be absorbing carbs because of the tummy bug.

    I personally think that it is a jump of the gun on other tests if there are no other consistant issues that your kiddo is having.
     
  4. abdabs

    abdabs Approved members

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    Thank you. I like the idea of correcting... It's what we ended up doing for her dinner, which took 2 hours to present at all in her BG. Will try that all day tomorrow. Also think we will wait until Monday to see if it gets any better. If not, we can go in for the Cortisol test. I should have asked her on the phone if there was any great risk to waiting, but alas I did not. Will have to go with our gut!
     
  5. maciasfamily

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    I agree that it can take a while, good week or more, before body is back to normal. Think how crummy we feel and it still lasts for several days after getting better.

    As for the cortisol test, wait. We had it done for our son, and while it's not a big deal of a test, I think in your situation probably not needed.

    It would be different if this was out of the blue, but the fact that she has been sick would be the first clue to allow this bug to truly be over.

    Sometimes dr's not living in the day to day of it, really don't have any clue... :confused:
     
  6. mysweetwill

    mysweetwill Approved members

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    We dealt with the stomach bug for the first time in December. My son only had half a day of vomiting, but even then it was two weeks before he was back to his regular insulin regime. For the first week he needed no insulin for food, none whatsoever. When we started seeing 180s after meals we gave him 50%, starting into week two. Slowly he needed his regular doses again.
     
  7. susanlindstrom16

    susanlindstrom16 Approved members

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    My daughter had a stomach bug (her first since dx) in november and we also ended up in the ER. For almost a week after, she needed far less insulin than usual. I was hoping that she was entering a honeymoon phase, but no such luck. A little more than a week after the ER visit things were back to how they had been before the bug.
     
  8. abdabs

    abdabs Approved members

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    This was all really helpful. Quick question... in your experience do corrections also need to be reduced during this time, or is insulin sensitivity unchanged?
     
  9. mmgirls

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    for us corrections stay the same.
     
  10. sugarmonkey

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    DS had his first stomach bug in December. He only threw up once, but his BGs were wacky for over a week afterwards. Twice we took his pump off completely for about six hours and he still only reached 4.5 (81, a low for us is under 75). We didn't bolus for food for about four days. Hope things settle down for you soon.
     

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