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Type 1 Diabetes: How I Prepare for Flu & Stomach Bug Season

Vomiting dehydrates you quickly and severely disrupts your blood glucose management; IV fluids and glucose at the ER is your only option

Stomach bugs (like Norovirus) and a real bout of the flu were never something I recall dealing with as an adult…until I was pregnant and had children. Suddenly, these viruses were being brought into my home thanks to my adorable little children in their adorable little preschool full of adorable little germs.

Now, after 4 years of experience with contracting nasty 24-hour stomach bugs every goddamn winter, I know how to prepare for that brief but potentially devastating day. 

*If you do believe you have the flu — not a stomach virus — call your doctor ASAP about this new flu treatment for people with diabetes.

When a person with type 1 diabetes has a stomach bug or flu

As a person with type 1 diabetes, if you contract a virus that causes you to vomit repeatedly, you need to go to the ER to get intravenous fluids and potentially glucose. 

If you puke repeatedly, and cannot keep fluids or food down, and try to “tough it out” at home…you will eventually be overwhelmed by ketones and likely find yourself in DKA within 12 hours. You may also battle with severely low blood sugars depending on how your insulin is adjusted before and during all that puking. 

RULE: If you cannot keep fluids down, you need to go to the ER for support. 

You’ll only be in the ER for a few hours if you go shortly after that first bout of puking. If, however, you wait at home, trying to “tough it out,” and you don’t go until you’re in DKA the next morning, you’ll be at the hospital a lot longer

Just go to the ER as soon as you know you have a stomach virus or flu, get rehydrated, and get out of there within a few hours.

Here are 2 things I make sure to have in my home at the start of the flu and stomach bug season.

Emergency Glucagon Kit (check the expiration date!)

I’ve never needed one of these glucagon kits for their initial purpose: for someone else to administer when you’ve lost consciousness or the ability to drink/chew because of severe low blood sugar.

But I have needed a glucagon kit!!   When I was 8 months pregnant, I had just eaten Christmas dinner with my in-laws, and 2 hours later started vomiting like crazy. But there were 15 units of insulin in my bloodstream and none of the food I ate had been fully digested. And then I puked all of it up and out. An ideal opportunity for severe hypoglycemia!

My blood sugar was 45 mg/dL and I couldn’t even consume a single glucose tab without violently vomiting again.

Yes, we drove like hell to the hospital to get saline and intravenous glucose, but it would’ve been far less of an emergency if I’d had a glucagon kit to inject myself with. I would’ve given myself a partial dose of the glucagon, and driven at a normal speed to the hospital to get intravenous fluids to address the issue of dehydration. 

Now, at the start of every winter, I make sure I have an up to date emergency glucagon kit. 

If you don’t have one, simply ask your doctor for a prescription to get one ASAP. 

TIP: Tape an insulin syringe to your glucagon kit. You can use this draw out the glucagon (after following the directions and mixing the powder with the liquid), to easily inject a smaller dose of glucagon. If you’re conscious and using this kit during a stomach bug, you likely don’t need the full dose. It’s also a lot easier to inject via an insulin syringe than the mega-needle that comes with the kit.

(I tried to get one of the newer types of glucagon but my pharmacy doesn’t carry it yet.)

Pedialyte and Gatorade (not the sugar-free versions!)

After you get home from the hospital, and your blood sugar is stable and you’re done puking, you’ll need to continue hydrating. But you probably won’t want to eat any food yet either. 

Drinking a mixture of Pedialyte and Gatorade will give you not only electrolytes, sodium, and zinc, it will also give your body some sugar. You do not want to consume zero calories after you get home from the hospital. This could easily lead you to develop ketones again. Your body needs fuel. Sipping a combination of these two beverages will prevent those ketones.

I don’t drink Pedialyte straight because it’s gross! It has a thickness to it that I find pretty unbearable. By mixing it with Gatorade, it’s enjoyable to sip after a day of puking and being in the hospital. 

And yes, you need insulin for the carbohydrates in these beverages but likely a lot less than usual because you aren’t eating any other calories. Work with your healthcare team to discuss your insulin dosing adjustments during or after you are discharged from the ER.

What about anti-vomit medications?

Zofran is an example of a prescription medication that is intended to prevent puking. 

But here’s the thing: 

  • First, if you have a real stomach bug, it ain’t gonna work. 
  • Secondly, you’re gonna puke it up before it’s ever digested, which circles back to my first point — it ain’t gonna work.

At the hospital, you can receive anti-vomit medications like Zofran intravenously, or — even more fun — in a capsule that is inserted into your bum. (Yup, you read that right.) 

My point is: having Zofran pills at home isn’t likely going to keep you from vomiting if you get a stomach virus or the flu. You’re going to puke. And you’re going to need a trip to the ER to get rehydrated intravenously.

Stomach bug and flu season is a b*tch if you live with type 1 diabetes. It comes with a degree of danger and emergency that those insulin-producing friends of ours simply don’t have to deal with.

Get your flu shot. Get your glucagon kit. Get your Pedialyte and Gatorade, and get to the hospital if you start puking and can’t keep fluids down. 

Ginger Vieira has lived with Type 1 diabetes and Celiac disease since 1999, and fibromyalgia since 2014. She is the author of 4 books: Pregnancy with Type 1 Diabetes, Dealing with Diabetes Burnout, Emotional Eating with Diabetes, Your Diabetes Science Experiment. Ginger creates content regularly for Diabetes Strong, Healthline, HealthCentral, DiabetesDaily, EverydayHealth and her YouTube Channel. Her background includes a B.S. in Professional Writing, certifications in cognitive coaching, Ashtanga yoga, and personal training with several records in drug-free powerlifting. She lives in Vermont with two kiddos and two dogs.

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