Food Poisoning Risks with Type 1 Diabetes
Editor’s Note: Kyla Schmieg (BSN, RN) is a practicing pediatric endocrinology nurse in Cincinnati, OH, USA, and someone with type 1 diabetes, working on the same unit she was diagnosed at 26 years ago.
Food poisoning risks with Type 1 diabetes
Diabetics, in general, are known to have sluggish immune systems. This puts them at greater risk for acquiring infections, including food borne illnesses. It’s a good idea for everyone to be cognizant of food borne illness when dining out or preparing food; it’s a must for people with type 1 diabetes.
Especially when traveling, someone with type 1 diabetes (T1D) must be extra cautious as new bacteria are introduced with the exposure to different foods and preparation standards. (ALWAYS carry glucagon when traveling in case a severe bout of food poisoning drops blood sugars quickly. Conversely if it elevates due to infection, have ketone strips to test for ketones in the urine, markers of diabetic ketoacidosis (DKA).
How do you prevent food borne illness?
- Check for cleanliness (of restaurants or suppliers)
- Closely examine packaging to make sure it isn’t damaged or open
- Keep raw foods separate from other foods
- Perishable foods should not be left at room temperature for more than two hours (one hour if over 90°F) FDA
Why are the risks higher?
Diabetes can cause the body to have a delayed reaction when recognizing a foreign body or bacteria. This can result in the food borne pathogen lingering in your digestive system for awhile prior to it being recognized. This delay in the immune response affects your body’s ability to keep the pathogen in check. Elevated blood glucose levels in people with diabetes also affect this process because high blood sugar can suppress white blood cell function. White blood cells are what your body uses to fight off infection.
Gastroparesis
A common digestive complication for diabetics is gastroparesis. It’s also referred to as delayed gastric emptying. With this condition, the movement of ingested food from the stomach to the small intestine is dramatically slowed down or even stopped. According to the U.S. Department of Health and Human Services, diabetes is the most common cause of gastroparesis. This is because elevated blood glucose levels can affect the nerves in the stomach and their ability to move things through the digestive system.
In diabetics, the delay in the body’s ability to recognize and fight infection coupled with the slowed motility of food through the digestive tract is a recipe for disaster. If a food containing a food borne pathogen is eaten, it could sit in your immune system for a bit prior to being recognized as bad. During this time, the bacteria could be multiplying. If you also have a digestive system that is sluggish in moving things along, this means the bacteria will be in the system even longer.
Symptoms of food poisoning & treatment
- nausea
- vomiting
- diarrhea
- fever
- abdominal cramping
If you are having these symptoms, or may think you have food poisoning, you should contact your physician right away in order to form a plan to treat it. Any infection can cause huge problems for people with diabetes. Infections can cause high blood sugars which affect the body’s healing process and put you at risk for DKA. Test for ketones, and if traveling, be sure to pack ketone strips in case of this.
Also, if you are nauseous and not able to eat or drink anything, this will affect your blood glucose levels, possibly dropping them to dangerous lows. Especially if you have insulin onboard and are unable to keep blood glucose down, you may need to use glucagon. Always have glucagon on your person, especially when traveling in foreign countries where risk of food poisoning is higher.
A great resource if you want more information on food safety and guidelines is www.foodsafety.gov. The website includes a list of food recalls and storage prep and storage tips to prevent food borne illnesses.
The Stomach Flu Away-from-Home—Prepare your College T1D by Bonnie O’Neil
A story about food poisoning in a foreign country: What Saved my Son’s Life by Bonnie O’Neil
