Diabetes Management Challenges with an Ileostomy

I'm a type 1 diabetic who now has an ileostomy after rectal cancer surgery. I am suddenly having great difficulty keeping my diabetes in check. I keep fluctuating up and down. Just when I think I have it sussed, my blood sugar just spikes or plummets. I have changed my diet due to the ileostomy (less veg and fiber), and I have always drunk a lot of water. I am constantly tired but unable to sleep. Has anyone else had similar issues?

No idea on your situation, but I'd guess you'll have to change how you eat so you can hopefully maintain a fairly level number. Small, frequent meals so you don't spike/plummet eating bigger, less frequent meals. Just a guess, and probably the best answer you can get is from your diabetes doctor.

Hi.. I can only offer a suggestion as an ileo myself.

You stated you drink a lot of water? That's just water? To some degree, water helps but doesn't. You need a variety of fluids, less sugar, of course, but electrolytes. Vitamin-type water instead because being colon-less, you normally hydrate having it. And dehydrate without it.

Vitamins and minerals are needed as supplements. Do you have a stoma nurse or a specialty doctor to help?

Tiredness? They found that there may be a simple and easily curable cause—iron deficiency! Women need twice as much as men do. Not true in your case, perhaps, but good to check it out. The test itself is simple. Best wishes.

I'm TD3C... treated as T2.... I also struggle with tiredness and sleeping during the night... Of course, diets for us will be kind of hard to figure out... what works for diabetes sometimes doesn't with an ileostomy... First, if you haven't already... talk to whoever is handling your diabetes for some suggestions... diabetes is hard to deal with by itself; control it the best you can... My dietician has told me to eat what my body can handle... which annoyed me in the beginning..... Also, like I said already..... get some blood work done. Check iron and B12; mine have been low. Once treated, I've felt better.... And keep up with the fluids... we have a higher chance of having CKD for diabetes, plus the ileostomy doubles it..... there are all kinds of drinks out there... but do drink some electrolytes every day... especially when sick and when you have high watery output.... Again, blood tests will tell you all of this... should help some with the tiredness... the sleeping part, at least for me, has to do with blood sugar waves at night and into the morning... make sure you're checking it at night and not eating too late.... plus, having to go to the bathroom multiple times at night doesn't help.... but those are the top things for me that helped the most.

My Ostomy Journey: Bruce | Hollister

I think the tiredness and sleep problems may be related to the sugar levels spiking and diving.

You need to speak to your doctor and probably a nutritionist.

It's quite a challenge when you can't eat lots of raw vegetables. Before my loop colostomy, most of my diet was raw fruits and vegetables. After I tried the old diet for a few days and had liquid stool in my bag and pouring out of my fistula—a bloody nightmare. Now I have to cook vegetables and use canned fruits or juice—I eat an apple; I peel it first. It's been trial and error. I also drink lots of water and Gatorade Zero, as your colon is where most of the water is drawn from stool, and most of mine isn't being used. Since your colon is gone, it's a chore for you. Ask the doctor to check your blood and thyroid function to see if anything is out of whack.

I have type 2 diabetes, but I have had the same ups and downs as you have had. I think it's because of the fewer veggies and fiber that make it hard to have a balanced diet and keep blood sugar in check. My highs are not extreme, and my lows are not extreme, but there are some varying degrees of up and down. Pairing a veggie with a meal containing sugary foods or meats usually helps balance out blood sugar. But since you have an ileostomy, that is not always possible. I stick to a few veggies that I know can be digested and just keep repeating them over and over in my diet. Well-cooked broccoli, well-cooked cauliflower, beets from a can (low sodium), and occasionally carrots from a can, but my ostomy doesn't really like carrots, even soft ones. Iceberg lettuce is another one for me. I can have a salad with chicken on it, chickpeas from a can, and salad dressing, and be happy with that for a meal. Iceberg is the only lettuce I seem to be able to digest. Keep an eye on your sodium intake; you want enough but not too much. That can affect your sugar too. Stay hydrated not only with water but with electrolyte drinks as well. If you keep your electrolytes in balance, that will help you in all kinds of ways, including with your kidneys, but not just that. Your overall health impacts your sugar. Getting exercise, even when you are fatigued, can help with your sleep and give you energy. Try walking if you don't feel you can do more. A good walk can help stabilize sugar as well.