The effects of a cold on a Type 1 Diabetic



Monday was a normal day, my son was staying home with a cold. My wife had hers going as well, and my almost 2 year old was fine like me. No issues yet for the two of us.

With kids you expect to get the cold dragged back from school, we take our vitamins, get our flu shots, and teach our kids cleanliness and safe germ practices (sneeze into your arm, don’t cough on your hands, wash your hands). We’re by no means germaphobes, but there’s a reason to be safe in my household.

For some background, I’m a Type 1 Diabetic since the age of 13. I’ve always used syringes and taken care of my own dosage, once the best dosage was determined by a doctor of course. My doctors have been very good throughout the years, and they instructed me on the best way to maintain my blood sugars. They give me control over the dosage and trust that I am able to moderate it well. I’ve always kept tight control over my disease and have maintained an A1C around 6.0 – 6.5.

The new insulins, such as Tresiba, are very good at keeping a consistent blood sugar with little wavering, and Humalog is a great fast acting insulin. This post won’t be about the price of insulin, although that’s a tragedy in itself, but it is about how a simple cold virus can drastically affect how your body handles insulin.

The Scale

Normally when I would go high, meaning my blood sugars would increase beyond 175, I would take about 1 more unit of Humalog for every 50-75. This is called a sliding scale and it usually starts with a baseline number, which you would subtract from or add to given your blood sugar level at the time.

Scale:

  • < 60 mg/dl = 4-5 units humalog
  • 60-80 = 5-6 units
  • 80-150 = 7
  • 150-200 = 8-9
  • 200-250 = 9-12
  • 250-350 = 12-14
  • 350-400 = 14-15
  • > 450 = 15 max

The general rule, for me, is that for every 100 I am over target (counting all hundreds positions) I will take 1-2 extra units of insulin. If I’m at 300 then I will take 7 + (3*2) = 13. A little leeway is given for the type of food I’m eating, so I may take more or less insulin at times.

This algorithm, if you want to call it that, is something that works great for me, and it’s something my doctor taught me, but it might not work for everyone. Talk to your doctor first. I have years of practice and know my body well. It’s also not an exact science, so you need to understand how you react to insulin before prescribing to a scale like this.

The Cold

Monday, February 4th, 2019
Coming back to the header image, this chart shows that on Monday, February 4th, 2019 my average blood sugars started to rise. Of course this is mostly undetectable to me as the chart that I’m seeing has much finer detail, so I’m seeing a few hours worth of data, not days worth.

I feel fine at work and go home to the family. When I get home my son is on the couch sleeping under covers. He’s chilled and groggy. My wife is more or less the same.

In order, my son got the cold first, then my wife got it about a day later. My youngest and I were spared a day or two but it would soon hit us as well.

Tuesday, February 5th, 2019
The next day, Tuesday, I went into work again feeling fine. As I left home I thought I could feel a burning in my chest, but figured I could get through the day. At Noon I was raiding the medicine cabinet and at 3PM I was heading home. This one was hitting hard from the start.

You’ll notice that each tick in the image represents 1 day, and Tuesday night is when I got the full brunt of this cold. It hit with chills, burning chest, massive headache, sweating fever, and leg bone aches that reminded me of the Flu.

Wednesday, February 6th, 2019
I knew when I woke up at 2AM and moved to the couch, after taking some medicine, that I’d feel miserable for a few days.

If you’re not familiar with Type 1 Diabetes, it’s primarily an autoimmune system disorder. It tends to crop up in juvenile kids as their immune systems start to build up antibodies that attack the pancreas. This understanding is key when you consider that a virus will send your immune system into overdrive, producing an excessive amount of antibodies which indiscriminately destroy what they’re programmed to. For a person with Arthritis, their bones hurt worse. For a person with Psoriasis, their skin gains more blemishes, if you want to call them that. And for a Diabetic, their bloods sugars get worse and uncontrollable.

I’m not sure if normal people have high blood sugars when they get sick, but Diabetics do, or at least I do, and it sucks.

On Wednesday I had breakfast as usual, although it was forced down. My appetite had diminished to nothing. That day I did eat a little lunch and took insulin of course.

At dinner, around 8PM I was at 367.

I knew that the high blood sugar was due to the cold, and I remembered what happened when I previously had the flu, so I decided to take 15 units of Insulin and wait a few minutes to verify the blood sugars coming down.

As an aside, 8PM is not late for me since that’s my normal dinner time. I work in Seattle and commute over 1.5 hours one-way, so I get home rather late.

When people do something like this with normal glucometers they’ll test their blood every 15 minutes. I, however, have a Freestyle Libre which I use with the Diabetes M app on my phone. This allows me to take a reading at any time by hovering my phone over a device attached to my arm. The device records minute-by-minute changes in my blood sugar, and my phone downloads the whole set at once, showing me a graph. This allows me to see whether I’m trending up, down, or stable, plus the graph shows me the readings.

This device has proven incredibly useful, but when a new one is first installed it tends to need 3 calibration readings before the phone tightens down the algorithm. I take a high, a low, and a mid blood sugar reading manually and input those numbers into Diabetes M along with whatever the sensor recorded for the time.

367 + 15 units + time

Naturally you would think 15 units should drop anyone like a ton of bricks. I had waited about 45 minutes at least by now and I should be at around 2-hundred-something. The next time I tested I was at 318.

At this point I decided to let the insulin go and make sure to test my blood regularly. Sadly, during this time my blood sugars never went below 280 whenever I checked it.

By the end of the night I took another 5 units of insulin, didn’t eat anything, and got it to drop to and stabilize at 239 mg/dl.

Hunger didn’t seem to be an issue when my body didn’t care about insulin.

Thursday, February 7th, 2019
Thursday I woke up with an incredible sinus headache, bones that felt broken, and blood sugars that went UP at night into the 300s again!

I did a similar routine – took a decent dose of insulin based on my scale, ate a small breakfast, and rested on the couch. I felt in better shape than the previous day and I slept through the night, although better than trash is just polished trash.

This day, however, I had to do a phone screen for work. This is a normal interview process which takes an hour. During the screen I started getting chills and decided at the end of it I would crash on the couch again. I didn’t even get a chance to fill out the report that day I was so exhausted from 1 hour of extraneous work.

This day I didn’t eat lunch or dinner. I was surviving on about 500 calories of crappy breakfast cereal and skim milk. Now this might sound like first world problems, but for a diabetic it can be a serious issue if allowed to persist too long. This is why getting treatment or vaccines is so necessary, so normal people don’t spread diseases to immune-compromised individuals. A cold is about 3 days of mild heck, but a Flu can be a week of living hell.

Friday, February 8th, 2019
Friday morning I forced myself to eat breakfast once again. It seemed as though the pounding headache was gone but the sinuses were still numb. My teeth still felt like the bones protruding out of Doomsday’s face.

If we take a look back at the graph, we might notice something happening in the trend line… it’s getting lower.

We’re now at the second to the last horizontal tick mark and the line’s steadily coming back to normal. My body is beginning to accept insulin again and my average numbers are back in my control.

By this day I still didn’t quite have my appetite, so I still skipped lunch, but around that time, as I lay on the couch with my arm covering my sweating feverish head, suddenly the sinuses cleared up and I was sitting up without feeling irresponsibly ill. It was as if my body had finally won!

My appetite was finally coming back as well, and before bed I took 3 units of insulin and ate 2 Pocky candies. A hearty meal that could sustain a pissant.

Saturday, February 9th, 2019
Saturday is the end of my story. My cold was on its way out, and I was left with a deep smoker’s cough – although I’m not a smoker (my 7 year old has it as well!) – and lightheadedness. I’m not quite sure why this particular cold ends with lightheadedness, but my wife had it so I knew it was part of the routine.

My blood sugars had stabilized, and my face, due to another lucky autoimmune disorder called Psoriasis, was left in tatters. A couple days of cream will fix the blemishes but my wife will have to live with the rest of it for a lifetime.

I hope you enjoyed my story as I tried to make it informative and fun to read. It’s a bit like a journal for me as well, as I can use it for future reference.

This was one of the hardest colds I’ve ever had, but I’m glad to have the technology today to keep careful control over it. I hope that people take care of themselves, get vaccinated, stay away from work when you’re sick, stay home from school, and get well.

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