Sick day management in diabetes

sick dayNow that we have past the winter solstice and the days are supposedly getting longer again, I thought it may be a good time to address sick day management in diabetes. This time of year is notorious for colds and flus and generally the novelty of the new year has worn off, work stressors have piled up and the end of the year is still far away! So, what is different for people with diabetes when they are sick?

Living with diabetes can be challenging enough on a good day. But, when you’re sick, managing diabetes becomes even more difficult. Illness can cause your blood glucose levels to rise, and if you have type 1 Diabetes this can lead to a serious complication called diabetic ketoacidosis (DKA). You can prevent this from happening!! You ideally should work this individual plan out with your health care team but here are a few simple guidelines:

While you may feel tired and listless, your body is working hard to fend off the germs or injury that is making you sick. Your body is also burning a lot of calories, and using other resources, as it works to fight the illness. You need to provide your body what it needs to get well.

Here are some sick day management tips:

Measure your blood glucose levels frequently:  A general guideline is every 3 to 4 hours – it is wrong to just assume they will be high so why test then. Your doctor may want to increase treatment for the period that you are sick so knowing levels will be essential to work out any increases effectively and safely

Measure your ketones: If your blood glucose level goes higher than 15mmols on two occasions, use a ketone strip test to see if you have diabetic ketoacidosis. This may prevent you from needing emergency care if treated early enough.

Keep taking your diabetes medications and/or insulin:  It almost seems logical to think you don’t need your medications or as much insulin when you aren’t eating normally—however, that is not true.  Because your body is working so hard to fight the infection – using medication as usual is vitally important! Any reason to stop should be discussed with your doctor as alternatives can be put in place if need be.

Make sure you know what medications to take:  Over-the-counter medications—for colds or the flu, for example—may affect your blood glucose levels.  Please discuss the over the counter preparations with the pharmacist before the purchase.

Make a list of foods and snacks to eat:  Even if you don’t feel like it, you must continue to eat when you’re sick and you have diabetes.  Know what foods you can eat—maybe, for example, you need to eat foods that are easy on your stomach.

Stay hydrated:  Drink water to stay hydrated.  Make sure if you don’t like water though, that you use low calorie or sugar free drinks unless you‘re running lower than 4mmols on your glucose tests- then you would need to switch to a drink that may contain carbs and then take note of the carb value of these drinks that you are  taking in.

Go to the emergency room if necessary:  This is important if there is extreme pain or vomiting and diarrhoea that does not resolve within a reasonable time period.  Listen to your body and take good care of it.

Because of the potential for hypoglycemia -low blood glucose- and other complications during illness, sick days are the very times to be more cautious about your diabetes. Allow your body time to relax and recover. Put your diabetes sick day plan together with your health care team so that you can devote time in getting well  when you need it.