Gastroparesis flare up

I have been dealing with gastroparesis for the last few days. This is the worst it’s ever been. I have been crying constantly. All my settings on my pump aren’t working. Now when I bolus it takes twice the amount to bring my sugar down. I have been trying to control my sugar but it isn’t easy. I have been doing some yoga poses hoping it will help. Can anyone offer me some advice?

Sorry you’re suffering with GP. I’ve experienced some milder symptoms and can appreciate some of what you’re dealing with.

Am I understanding your situation correctly? Your blood glucose is too high and won’t correct easily.

The first thing I would do is to try to drink more water. GP can dehydrate you and makes controlling glucose harder.

Then I would change infusion sites as a pre-emptive move. I would deliver any corrections with a syringe but make sure to write down what you do for later reference.

I would try to eat lightly and favor the foods you know are easier on your digestion. I would not fear missing a meal or two and give your gut a break.

Keep up with hydration and drink some bone broth if that is possible. That will help with hydration, sodium consumption and some limited nutrition.

Watch your glucose closely as any insulin corrections can sneak up on you.

Try to rest and get a good night’s sleep if you can.

Good luck!

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Thankyou for your advice. I watch my sensor and see when it’s rising past my target I will give a little more insulin. I only do a shot when I am above 13mmol. I have been eating soft foods and chewing them carefully. I am avoiding fat, fiber & red meat. I am taking what I usually eat at a meal and splitting it. I also have some Boost nutritional drink. I am more concerned with the highs than the lows. I correct the lows but sometimes it leads to a high. I have read alot about gastro and the last time I dealt with this I can’t remember. It’s been that long. I haven’t vomitted yet so I guess that’s a good thing. I also am taking ginger supplements and I also am on domperidone. I get very frustrated from not feeling good.

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Terry, do you find that Loop aids in this? Mine does some more aggressive postpranial to help restore BG when I miss calculate. But, I have no idea how this works with gasteo. Such a difficult problem.

I started to feel a little bit better last night. I didn’t even have any trouble falling asleep. I don’t think I will go back to the way I was eating before especially at supper. They say the american diet goes against us as our digestion slows as we age and also in the evening when that is most person’s biggest meal. They say to try and make your biggest meal at lunch.

I think the dynamic every-five-minute insulin delivery adjustments definitely helps with delayed digestion. Having said that, even though I was given a gastroparesis diagnosis back in 2012, I’m uncertain at this point as to the extent that it affects my metabolism. My GP may be mild or more likely combined with small intestine bacterial overgrowth (SIBO) to confound things.

I’ve been treating SIBO for several months now and have witnessed some progress.

Sorry for the digression. In any case, I think dynamic insulin dosing helps in many ways since we all differ from each other and even from meal to meal in our absorption of nutrition. Have you noticed that Loop will often only give a portion, say 2/3, of the calculated insulin dose up front and then delivers the rest as needed?

Glad to read that things have eased for you @Dee_Meloche. I agree that minimizing, or even eliminating, the evening meal might help you and also enable better sleep.

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@Dee_Meloche This technique has worked well for me. Not only is lunch my biggest meal of the day, it’s my only meal of the day (I’ve been a one meal a day / OMAD person for at least the past 15 years).

I’ve also adjusted my eating window to 30 minutes - between 2:30-3:00pm. I find this leaves me at least 6-8 hours to digest before I go to bed at night.

By the way, I had severe gastroparesis for 6-8 years in the 80’s, so I know how terribly uncomfortable (painful) it can be. In those days we were prescribed Prepulsid (cisapride), a drug which was withdrawn from the market or had its indications limited due to incidences of serious cardiac side-effects.

For no reason in particular, my gastroparesis resolved itself and I’ve had no recurrence since the early 90’s.

Bravo, Jim! I am going to stay on 2 domperidone a day and if I need to see my doctor. Like someone on this site said, that the study(cardiac problems) they did with domperidone was unrealistic. 2 pills a day are alot better than starving to death or needing a GI tube for feeding. Your quality of life goes way down with gastro. Also after I eat I have been doing deep breathing and doing twisting movements to my abdomen area to stimulate the digestive organs. I have also been chanting uummmmmm. They say that helps with the vagus nerve and controlling bloodsugars, especially after meals. I am happy that I am feeling a bit better.

Don’t know if I have DP but do have digestive problems. I have been doing this frequently for a long time without any loop, just my Animas Ping. I find that an extended bolus like that more closely matches the insulin action of a nonD person. Besides, it enables me to cancel a portion of the bolus if it seems to be too much. I also don’t eat at least 4 to 5 hours before bedtime. All of this helps with my wonky digestion.

Good advice. I think I will adjust my time that I eat supper to like 2 or 3 PM. My hubby eats a 3 meal a day and lots. I can’t eat like he does anymore.


Before I started using Loop back in late 2016, I dosed every meal with an immediate bolus to cover carbs followed by an extended bolus over several hours to cover 50% of the protein grams and 10% of the fat grams as “carb equivalents.”

Like you, I would often monitor the post-meal glucose levels and sometimes pull the plug on the extended bolus when appropriate. What I didn’t do and Loop now does, is to discount the immediate carb bolus and move it to the extended bolus phase. If I were to go back to standard pump therapy, I would experiment with this.

So Loop considers the entire bolus as extended and then dispenses as needed? I couldn’t do that on a standard pump without checking BG every 5 minutes. But something to consider…

No. Loop delivers about 2/3 of the carb-based bolus immediately and then folds the remainder of about 1/3 into the extended bolus.

Please explain “discount the immediate carb bolus and move it to the extended bolus phase.” Please reword so I can better understand your meaning.

For example, if Loop intends to deliver 3 units, based on the meal carbs, it will usually deliver 2 units immediately and then deliver the final one unit over an extended period.

And it does that automatically! You know, a few years ago I read of a study done in Poland where they found that precisely that kind of bolusing was most effective. The percentages were not quite the same, but close. I have been trying to find that study on line for the last couple of years but it has eluded me. I wonder if that kind of bolus extension is built into any of the new product algorithms.

In order to avoid spikes after consuming carbs and lows I am watching my sensor when it rises and bolussing. Do you think this is a good idea?

Yes, I think that is a good idea. Watching is good and responding appropriately is better. It is the basis for Dr. Ponder’s Sugar Surfing. Have you read that book?

No I haven’t. I am more worried about getting enough nutrition throughout the day.

So I had a difficult night last night. I went low and I had 3 jellybeans. That didn’t seem like it was working so I grabbed some orange juice. 13c to be exact. Then I got 2 arrows on my dexcom saying it was rising so I bolussed to try to stay ahead of the high. 10.9mmol. Then 2 hours it was telling me I was 5.0 and was dropping. Grrr. So anyway, by that time, it was time to get up. I ate breakfast and went on the treadmill to help my digestion and the highest it went was only 8.7mmol. I started to fall again so I had more orange juice but small amounts. I was watching my sensor and have come to the conclusion that it takes about 15m to start rising. 7:11 am was the last time I was low. Trying to avoid lows without spiking too high. Very difficult! What does everyone else have when they have this condition and a low?