HEALTH: Nutrition Q&A: Illnesses can cause problems for blood sugar levels / Sick Day Carb Foods (DIET, RECIPES)

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Nutrition Q & A: Illnesses can cause problems for blood sugar levels

By Mary Alice Gettings and Cindy Javor

Thursday, August 10, 2006

 

Q: I have had diabetes for many years. When I am not feeling well and

not eating very much, my sugars go up. Can you tell me why this happens

and what I should do when I am feeling ill?

 

A: Blood glucose (or sugar) often increases at the first sign of a cold,

the flu or an infection, even if you are eating less. This occurs

because of hormones that are released in response to an illness. These

hormones cause the liver to produce extra glucose that enters the

bloodstream; therefore, your blood glucose reading is higher than usual.

 

Because you are not eating as much, you might assume you should skip or

not take as much of your diabetes pills and/or insulin. The exact

opposite is true. Because of your high blood glucose, you need to take

what is prescribed and possibly more -- that is, with your doctor's advice.

 

To determine the amount of medication you need when you are ill, it is

important to test your blood sugars at least every four hours. Write the

readings down so that you have them handy if and when you contact your

physician.

 

It's also important to test your urine for ketones. Some of you might

remember the days when urine testing was the test used to determine if

your sugar was high. This has been replaced by the more accurate blood

sugar monitoring.

 

Ketones are produced in your body when you are breaking down an

excessive amount of fat for energy. It indicates that there is not

enough insulin in the body to get the sugar into the cells to produce

energy. If this is left untreated, it can be very dangerous and cause

death. While ketones are more common in type 1 diabetes, they can

sometimes occur in type 2. Make sure you have urine strips on hand in

case of illness. Your blood sugar strips cannot be used to test your

urine for ketones.

 

Many people complain that they can't eat when they are ill. If your

illness involves vomiting, diarrhea and/or a fever, you are at great

risk of becoming dehydrated. Assuming that you are unable to eat your

regular meals, you still need to consume the carbohydrate portion. Each

carbohydrate serving that is included in your eating plan is equal to 15

grams of carbohydrate.

 

For example, if your eating plan includes two carbohydrate servings for

breakfast, you would need to consume 30 grams of carbohydrate within an

hour or two of your regular breakfast time (45 grams of carbohydrate for

three servings and 60 grams of carbohydrate for four servings). See the

list of Sick Day Carbohydrate Foods.

 

In addition to these foods, try to drink plenty of calorie-free liquids

(at least eight ounces of water, broth or sugar-free drinks every hour)

to help keep you hydrated and lessen the chances of your illness worsening.

 

Call your physician if one or more of the following occur:

 

-Your blood sugar is over 300 on two consecutive blood glucose checks.

 

-You have moderate to large ketones in your urine.

 

-You are unable to consume liquids for six hours.

 

-Your fever is above 101.5 degrees Fahrenheit.

 

-You are experiencing severe abdominal pain or persistent diarrhea or

have vomited more than once.

 

The key to surviving sick days is being prepared. Make sure you have the

necessary supplies and food at home in case you become ill and are not

able to go out. To learn more about sick-day meal planning that is

individualized to your diet, set up an appointment with a registered

dietitian.

 

As of Jan. 1 of this year, Medicare will cover medical nutrition therapy

sessions with registered dietitians for people with diabetes (and also

those with kidney disease). You will need to have a prescription from

your doctor for this coverage. For a registered dietitian in your area,

check the Pittsburgh Dietetic Association's Web site at

www.eatrightpittsburgh.org and click on " Nutrition Services. "

 

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SICK DAY CARBOHYDRATE FOODS

 

(Each contains 15 grams of carbohydrate):

 

4 ounces regular soda

4 ounces apple juice

1/2 cup regular Jell-O

1 cup soup

1 popsicle

1/2 cup ice cream

1/4 cup sherbet

6 crackers

1 slice dry toast

 

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(Mary Alice Gettings and Cindy Javor are registered dietitians who work

for Penn State Cooperative Extension. If you have a question about

nutrition, you can reach Ms. Gettings in Beaver County at 724-774-3003

and Ms. Javor in Allegheny County at 412-473-2540. )

 

http://www.post-gazette.com/pg/06222/712340-34.stm

 

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