March 9, 2011

Things That Make You Go Hmmmm!

So, I've been wondering....

Do showers or baths have an effect on your (or your child's) blood sugar?


I have noticed that Ally seems to have a spike in blood sugar after taking a hot shower or bath.  It is not an immediate spike, but she will end up high a couple of hours later.  I noticed this almost as soon as she started pumping.  Since she disconnects her pump while she showers, I thought that possibly its because she is missing the basal dose of insulin (the insulin that controls blood glucose levels between meals and overnight).  Then I started limiting her shower time to no more than 10 minutes.  10-15 minutes disconnected from the pump would not normally make her have a blood sugar spike.  Didn't matter.  Hmmm...

I have started noting in her log book when she showers and here is a brief example of what I'm seeing.  For these examples, I looked at 4 days in a row, same time of day.

Day 1    BG before shower  80....3 hours later 207
Day 2    BG  (no shower) 146....3 hours later 160
Day 3    BG before shower 128...3 hours later 242
Day 4    BG  (no shower) 107...3 hours later 98

As you can see, on the days that she did not shower at this time of day, her BG was relatively close 3 hours later.  On the shower days, she spiked significantly.  Hmmm...

 (As I'm typing this, I am thinking that I need to go back and look at her CGM graphs from those days to see when the spike is occuring.  Is it just one hour later or two+ hours after the shower?  That might give me some more insight.)

We all know that blood sugar levels are influenced by so many factors.  I have also considered this.

I mean, in the mornings we are dealing with the dawn phenomenon.  (Our body secretes hormones in the pre-dawn hours which cause our bodies to be more insulin resistant.  Your pancreas would naturally release a little more insulin if it were a properly functioning pancreas.  We have to adjust Ally's basal rate to deliver a little more insulin during these hours.)  It has taken some hard work (and often continues to be a challenge) to manage Ally's morning blood sugars while avoiding a drastic spike in blood sugar after eating breakfast.  Hmmm...

The liver stores sugar in the body.  Stress can cause the liver to release sugar into the bloodstream which would raise blood sugar levels.  Is the hot shower water a "stress" on Ally's body?  Hmmm...  

My COMPLETELY un-medically-educated brain has a theory.  It (my brain) sees this possible scenario:  Ally wakes up in the morning, takes a shower, boluses for breakfast carbs & eats...HUGE SPIKE!  Is the shower causing her body to be resistant to the insulin which she is getting for her breakfast carbs, thus causing her to have these spikes later when the food is breaking down into sugar?

MedicineNet.com defines Insulin resistance (IR) as a condition in which the cells of the body become resistant to the effects of insulin, that is, the normal response to a given amount of insulin is reduced. As a result, higher levels of insulin are needed in order for insulin to have its effects.
I did run this theory by the "professionals" at our endo visit today.  Funny thing...they think my brain is fried!  Just kidding.  They said that they would almost expect the opposite; that a hot shower or bath increases blood flow, getting that insulin really flowing, thus lowering blood sugar.  Hmmm...

What are your experiences with Type 1 Diabetes, insulin and hot showers?  (Let's keep it related to blood sugar numbers, ok!)

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13 comments:

  1. Sugar Boy spikes too!!!!!!!!!!!!!

    I thought I was losing my mind! Glad to know someone else has experienced it!

    Now, what to do about it??

    Hmmmmmm

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  2. The shower/bath phenomena is very common. Though I have seen it both ways...lows all the time after, or highs all the time after. Do you pump with Medronic? If you do I have a really cool tip that will keep her from missing the basal! Let me know!

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  3. @Meri, yes Medtronic! MiniMed Revel.

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  4. Sorry, no special insight to lend, but I love reading how your mind is working. I'm a sucker for all this science!

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  5. We are on the Omnipod, so we don't disconnect anything for bathing- but is she missing her basal while she's in there?

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  6. If I get overheated, whether shower/bath/exercise my BG goes up.

    I have just started on an oral Type 2 medication to help my body better absorb the insulin, despite being a type 1. My Doc says that after a while T1 D patients can become "resistant" to their injected insulin, and it's still new, but it's becoming a new trend in treatment.

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  7. Wonder if time of day plays a factor. If she showers at night, do you notice the spike?
    My son tends to go low after baths...but he bathes at night.
    Hmmmmmm????

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  8. we have the same post bath/pool/shower high...no matter how long it happens EVERY time.
    I'd love to here Meri's tip.

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  9. I would wonder too if it happened if she took her bath at night. Nothing like diabetes telling you when you can bathe. K told us that if she was going to take a long bath or swim we could give the missed basal as a bolus before disconnecting, that way she won't miss any basal.
    What is funny we were told that if you took a warm or hot bath it would make the insulin absorb quicker. I wonder if she goes low because the insulin works super fast and then she doesn't have enough to then cover the food? Just a thought.
    You are like me always wanting to know the why... K has told me several times you might not always have a good explanation, but she loves that I sit and try to figure things out.
    Kelly Harp :)

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  10. Hmmmm - I like the way your brain works. I need to be more observant. I'll be interested to read more comments from others. :)

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  11. We were told that a warm bath will make the insulin work faster and absorb more - his docs said not to give him a shot of insulin within a half an hour of bathtime. We do baths at night, and often he'll go low if we've dosed him to close to bathtime.

    On the flipside, when he was having highs while sick, we'd dose him and plop him in the bath immediately to help the insulin absorb faster. Maybe try having her shower at night?

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  12. I haven't really noticed a trend with showers/baths...now I'm curious. But we were told when she was on injections to wait on baths/showers for an hour or so after the injection due to the warmth causing increased bloodflow and faster absorption. Interesting that she's seeming to have just the opposite!

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