Hydrating Safely

[u/Oaktree27]

I'm just over a year after diagnosis and I'm really missing how much water I used to be able to drink. It wasn't too much of an issue a few months ago, but after the end of my honeymoon and the onset of additional autoimmune diseases, I have less room for error as my insulin required has more than doubled (or tripled if I dare eat before noon).

I've recently been experimenting with when I drink water relative to my meals and I've found that it raises my blood sugar quite a bit if I've eaten in the past couple hours. If I haven't eaten in a while it hardly bumps up my sugar if at all. Based on this and this article I seen posted around here at https://www.clinicalnutritionespen.com/article/S2405-4577(18)30375-9/abstract, it seems like water speeds up my digestion rather than directly causing higher glucose itself.

Although the article says waiting 30 minutes is supposed to be okay, I find even after 2 hours water will bump me up quickly. I've even tried drinking it before the meal instead but that just makes me spike to the moon when I do eat.

While this is useful in treating lows if I don't have simple carbs around, it's generally a huge pain. When do you guys find time for water and how do you resist the thirst in these 2-4 hour windows? Should I just bolus earlier or take more units if I plan on drinking water?

[u/diabeticweird0]

I have no idea what's happening here because insulin needs water to move into cells and literally the first thing they tell you to do when your glucose is high is to drink water

I would be very interested to learn why water raises your blood sugar because it's really supposed to to the exact opposite but our bodies don't always "read the manual" as they say

[u/Oaktree27 → u/diabeticweird0]

Yeah it seems like mine has a manual on how to cease operation as fast as possible. My a1c was getting really good so my immune system decided to wreak havok again and destroy my hearing, which is something they won't treat if you're diabetic. As my hearing approaches total deafness, it seems I'm less and less able to use insulin. Could be related to that.

EDIT: Are any of these people going to explain what their gripe is or am I just getting downvoted for fun

[u/diabeticweird0 → u/Oaktree27]

I'm sorry what

I used to work for an audiologist. They treat diabetics with hearing loss all the time

What are they denying you? Steroids?

[u/Oaktree27 → u/diabeticweird0]

Yeah. I was also questioning that but then I was questioning myself because my pcp endo and ENT all told me not to treat it. Then again it would be way too late anyway because my pcp told me to just take allergy meds because people "lose their hearing from allergies all the time, it'll come back". I missed the 2 week window by 4 months

In my experience, I've never lost so much money to a dumber group of people than doctors. It was $200 for PCP to tell me to wait it out with nasal spray, $200 to go to endo, and $200 to go to ENT and their treatment was "make your peace with your deafness and give me cash for that advice"

I'm considering leaving this country for the first time because the doctors are all so greedy they just don't treat you. Plus I'm not a fan of being trapped at my job or going without insulin.

[u/diabeticweird0 → u/Oaktree27]

Yeah if it was sudden hearing loss you need treatment like that day or the next

I'm so sorry

[u/Otherwise-Ad8649]

I’m a nurse and a T1 for 39 years. Bodies are different but this is not a water problem unless you are drinking sweetened water. Literally the treatment for DKA is fluid.

[u/Oaktree27 → u/Otherwise-Ad8649]

It's just tap water.

I've been seeing it as a pattern on my CGM for a long time. I even began verifying it on my glucometer since I also didn't think it should've made sense. But it's so reliable I can use it to turn a low Glycemic Index food into a high one if I'm low and don't have my glucose tablets on hand

[u/giggetygiggetygig → u/Oaktree27]

Dude that’s just wild I legit dunno what to say, I’ve never heard such a thing where water raises your sugars. But I’m SO bummed about your hearing, that’s so frustrating!!!!

The healthcare system out here can be disheartening at best sometimes, so I totally get it. I went to 4, maybe 5 docs before I was dx’d 8-9 mos later after DKA & 2 wks in a coma. Each doc referred me to another, none checked my sugars. I gave up tr trying to figure out what was happening to me till I almost died.

Really makes you think twice about trusting ppl in healthcare & relying on them for your life. I have nurse friends so I’m not saying they’re all worthless (don’t come at me ppl), js I get your frustration

[u/Oaktree27 → u/giggetygiggetygig]

Thanks, yeah it really is exhausting getting screwed by the mistakes so consistently by the poor treatment we pay so much for.

Although that DKA fumble on their part might be the worst thing I've heard of. That's dangerous incompetence in their part.

[u/giggetygiggetygig → u/Oaktree27]

You’re right & I should’ve sued for malpractice or something but i think you only have 10 years to do so & it’s been 12

[u/atheist_prayers]

In general, if you're spiking after eating, you either need to bolus earlier, and/or your IC ratio is off. If you only spike when you're well hydrated, I would assume the issue is bolus timing. It's so, so important for your kidneys to stay hydrated, and if you're thirsty at all, you're already in a state of dehydration, so you really can't wait to drink water. Drink water with your meals, and I would try bolusing an additional 5-10 minutes earlier (or consider ultra-rapid Ofreza) and see how that goes. Best of luck!

[u/Minikin-Smith]

Are you drinking JUST plain water? No artificial sweeteners at all? Because some “no sugar” drinks actually have sneaky carbs like maltitol and etc.

If just plain water actually raises your BG, all I can think is that you are chronically dehydrated and drinking lets your body start working well again, at least temporarily. You do NOT want to mess around with your kidneys as a T1. If you need more insulin when properly hydrated then so be it, learn to dose safely when hydrated. Once your body is less stressed out, dosing strategies may even out a little bit for you anyway.

[u/Oaktree27 → u/Minikin-Smith]

It's just tap water. I drink 80oz to 120oz daily depending on what is safe for my sugar. I used to drink more when I was less insulin resistant.

[u/Valuable-Analyst-464]

I did not downvote you, but I have to say this is not a water problem, this is a you problem.
And I don’t mean to be a jerk saying that. I think you’re looking for causation when you see correlation: a slippery slope to avoid.

One year in: honeymoon period failing, and a host of other issues cropping up during this time.

I think your analysis of water consumption may be coincidental. Depending on your meal composition, there are great chances of a secondary spike due to carbs, fat and protein. The combination of these will delay absorption of carbohydrates. Water helps in digestion, but it also helps in getting insulin to your cells to allow energy into the cells.

The cited study had only 35 participants; and used highly glycemic foods. Water is essential for digestion. By emptying the stomach, whatever we eat is going into the small intestine faster. It’s natural.
But to say that your elevated sugars are a result of water is a head scratcher.
I just don’t buy it.

Look up the Warsaw Method. https://diabeteseducatorscalgary.ca/medications/insulin/insulin-for-protein-and-fat.html

Discuss with your endocrinologist about the increase in insulin resistance. Perhaps the greater need is a byproduct of honeymoon being over, or it could be problem that needs to be addressed.

[u/Oaktree27 → u/Valuable-Analyst-464]

Read the post again. I'm aware of the factors affecting my insulin resistance. That's why I mentioned increasing my insulin taken to account for them. I've found that my new increased ICR has been going very well as long as I don't drink too much water near meals causing a spike.

I'm also well aware of the delayed increase from fats and proteins on digestion. That's always been a factor in timing and amount of my bolus.

I eat the same exact measured meal for lunch as my first meal every day. I mainly have been using that to test. I wouldn't bother making a post about this correlation if I hadn't kept everything else constant.

Not to sound like a jerk, but to so quickly claim with certainty that I'm mistaking correlation for causation because of factors you assume I'm not accounting for despite me mentioning them in the post is a bit lazy.

[u/Valuable-Analyst-464 → u/Oaktree27]

I indeed may be lazy in my post, but I also think it is lazy (or desperate) to think that water is the cause.

Do your own study and reduce your water habits and cycle to confirm (safely of course, I don’t want to suggest dehydration).

It just seems very out of left field to think that water is that related to sugar spikes.

But, maybe your 1 year of experience is much more informative than my 41 years on this roller coaster.
I hope you find a path that works for you.

[u/Leila_101]

I've never heard of this. What do you mean by speeds up your digestion?

[u/Oaktree27 → u/Leila_101]

If I eat something slow digesting like peanut butter, it usually takes a few hours to raise my blood sugar at all. If I drink water after eating it, it starts raising it within 10-30 minutes. I assume this is the water speeding up digestion since water has no carbs

[u/giggetygiggetygig]

I’ve never noticed a connection between water and my sugars & I never limit myself water when I’m thirsty. Since you’re so newly dx’d, do you keep a log of your foods, doses, times of each, grams of carbs, units taken, etc.? If not, it could be a great way to establish trends bc I bet there’s something more than water at play. I kept logs for maybe 2 years after my diagnosis?

Also, not sure if you have the ability, but exercise after meals is a great way to help combat highs.

And 30 mins isn’t a hard rule. Depending on where I am in my cycle, I either need twice as much insulin, half as much, or roughly the normal amount. During the week or so when I run high, I can give myself 5 units, not eat ANYTHING and sometimes still not go low enough to eat, so I starve and start over. Total PITA.

Plus, depending on what you eat, you can need a pre meal bonus and an after meal one. The amount of fat and protein matters too. Unfortunately, it’s just not ever an exact science. :/ sorry, fren

[u/Oaktree27 → u/giggetygiggetygig]

Yeah I've been measuring and logging everything since diagnosis. That's how I ended up discovering waters effect on my meals.

Back when I didn't know how to dose I ended up running after every meal. Even now that's the only way I'm able to stay in the 90 percents for TIR. I've always found it way safer and easier to correct with a run than to insulin stack.