I spent the day in the ER two weeks ago for an episode of really bad vertigo. They didn’t want me to eat anything for fear I would be nauseous. Over the course of several hours, I watched my blood sugar on my dexcom slowly rise. When it got to about 277, I though I should try to do a correction. My daughter was with me so she went and told the nurses what I wanted to do. She came back after a minute and told me they said not to do anything because they were about to give me more fluids. I wondered what difference that was going to make. But, sure enough an hour later after the bag of fluids, my blood sugar was down around 200. I thought, wow! That was better than any correction I would have made.
Is this true? You tend to run higher numbers when you are not adequately hydrated?
I’m chronically dehydrated. I rarely feel thirsty so I never drink. Not sure why that is but it sometimes causes me other problems too.
@Cinderfella,
This is somewhat of a tricky question because someone could give you an answer of either “yes” or “no”, and either one would be somewhat correct.
But I think this answer is better, because it is more complete.
If you increase your fluids, either by drinking a lot of water or by having an IV bag, you are increasing the amount of blood volume you have. But you are not doing anything to lower the total amount of glucose in your blood. (Although, yes, you do lose some of the glucose when you pee it away. But let’s disregard that for the moment, because that is not the best way to remove glucose!)
The units for a glucose check are given in units that are an amount of glucose in a certain amount of blood. In the U.S. this is commonly given as milligrams of glucose per deciliter of blood.
So as a simple example, suppose someone was severely dehydrated and they had 4.5 liters of blood in their body. If they also had 11.25 grams of glucose in their blood at that time, their blood sugar number would read 250 (mg/dL).
Now suppose they got an IV and their blood volume increased to 5 liters. But they still had the exact same amount of glucose in their blood, 11.25 grams. Now their BG number would read 225 (mg/dL).
Even though the person in this example did not reduce the amount of glucose in their blood (it is still 11.25 grams), just because they increased their blood volume (it went from 4.5 liters to 5 liters), their BG went down from 250 to 225.
During the summer if My BG has gone high without reason and my site is okay then I assume I’m dehydrated even if I’m not very thirsty. I drink electrolyte drinks such as coconut water and my BG will usually come down on it’s own without bolusing. If you are on a low carb diet then you will be more prone to electrolyte loss. Carbs actually help you retain electrolytes .
Please keep in mind that the accuracy of a CGM reading also MAY be affected due to severe dehydration. Since the CGMs work with interstitial fluid, a lack of moisture in the body may affect how that reading takes place. When I complained to my MD about the inaccuracy, sometimes, of my G6 readings, he told me to be sure that I am drinking enough water to be fully hydrated. I seriously doubt that most of us, unless we consciously do so, drink the full amount of water recommended for us each day. As temperatures rise, be sure to stay hydrated!
Our daughter has had many surgeries over the years since she has many medical issues beyond T1D. She’s also had DKA twice. With any hospitalization she’s had an IV. Inevitably it brings her BG down, sometimes even too much.
Also, a dietician told us, during the first year of her diagnosis with T1D, that our daughter should drink a lot of water if she begins to go high.
It seems that being hydrated, whether due to an IV or due to drinking lots of water, can help lower the BG.
I’ve worked places that recommend patients drink a lot of water if BG is high and no doctor is available to write an order for insulin. It does seem to work to an extent.
Muscles and the liver can also absorb glucose without insulin, to an extent. So could it also be that water helps the rate/efficiency at which the liver and muscles do this? (It’s one of the hypotheses I’ve had about why water might help, but not sure if it’s really true. What you say makes sense as well. Maybe both? Or even other things, too? Anyway, interesting…)
I echo Sherry Ann on her comment about Dexcom readings and interstitial fluids. I am curious–you said you watched your Dexcom readings slowly rise during your ER visit. Was there also a blood glucose check done with a finger stick around the same time?
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