Diabetes And Sick Days

Being sick can upset your diabetes management plan in a major way.  Not being able to eat, or take the insulin or oral medications you normally take is serious.  Also when you're sick your blood glucose can go too high or too low, virtually on it's own (while you're body is fighting the illness).

It's important to have a "sick day plan".  Don't wait until you're sick and then try to decide what to do.  This plan will help you to know what medicines to take, what to eat or drink, how often to test and when to call your doctor.
 

TAKING MEDICATIONS

Most likely, you will take your same insulin and/or oral medications.  If you're taking insulin your doctor might tell you to take a little more insulin in case your blood glucose levels rise.  If you're taking a long-acting & short-acting insulin, and find yourself not eating, you may only take the long-acting insulin on a sick day since you won't be eating too much.

If you're managing the diabetes with diet & exercise or taking oral medications you may need to take a little Regular insulin to help with the high blood glucose levels associated with being sick.  Your doctor may even want you to keep a vial of Regular insulin on hand just in case you
ever get sick.

If you decide to take other medications to help with your illness ALWAYS check to see if the medicine contains sugar.  This "hidden sugar" can cause your blood glucose levels to rise.  Decongestants and some cough syrups may also cause your blood glucose levels to rise.  Taking aspirin and some antibiotics may lower your blood glucose level.  You may want to ask your doctor or pharmacist about how certain medications might affect the blood glucose level.
 

WHAT TO EAT & DRINK

Try to eat foods from your normal meal plan.  If you can't stick to the usual foods, follow your sick-day plan.  Try to include foods that are easy on your stomach.

Try to eat foods with about 15 grams of carbohydrate every hour or so.  If you have a fever, and you're throwing up or have diarrhea, you may lose too much fluid and become dehydrated.  Try to drink a cup of fluid each hour.  If your blood gluocse is over 240 try to drink sugar-free liquids
like water, tea, sugar-free ginger ale, or even broth (chicken, beef or vegetable).  If your blood glucose is less than 240 try to drink liquids with about 15 grams of carbohydrate in them.

Here is a list of foods that contain 10-15 grams Carbohydrate:
 
 

• Orange & Grapefruit Juice         1/2 cup        10 grams carbohydrate
• Gelatin or Jello, sweetened         1/4 cup        10 grams carbohydrate
• Ginger Ale                                  1/2 cup        10 grams carbohydrate
• Grape Juice                                1/4 cup        10 grams carbohydrate
• Milk                                              1 cup        12 grams carbohydrate
• Ice Cream                                   1/2 cup       15 grams carbohydrate
• Cooked Cereal                            1/2 cup       15 grams carbohydrate
• Slice Of Toast                                1              15 grams carbohydrate
• Soup                                           1/2 cup       15 grams carbohydrate
• Rice                                            1/3 cup       15 grams carbohydrate
• Sports Drink                                  1 cup       15 grams carbohydrate
• Applesauce                                 1/4 cup       15 grams carbohydrate
   

TESTING

Your body releases hormones when it's sick. These hormones elp your body fight disease, but they can also make your blood glucose levels go up.  These hormones make it more difficult for your body to use insulin.  If you don't have enough insulin in your blood or you can't eat, you'll
probably feel weak.  Your body may start to break down it's own fat for energy.  When your body does this, it produces waste products called ketones.  Having a large amount of ketones in your body can be dangerous.

Test your blood glucose level AND test your urine for ketones when you're sick.  You will need to test more often than usual.  If you have Type I diabetes (or a Type II taking insulin) you might need to test yourself every 3 to 4 hours.  If you have Type II diabetes you might need to test
3 to 5 times per day.
 

CALLING YOUR DOCTOR

When should you call your doctor?  Call your doctor if you've been sick for two days and don't feel yourself getting any better.  Call if you've been throwing up or have diarrhea for more than 5-6 hours.  Call if you have moderate or large amounts of ktones in your urine or if you have any
chest pain, breathing difficulties, fruity breath (as sign of diabetic ketoacidosis), a dry mouth or cracked lips, or if you're not sure of what to do to take care of yourself.