All people with Diabetes should know how to manage an episode of illness and to seek help if they are unable to manage their blood glucose levels. If you are ill, it affects your blood sugar levels. Following sick day rules may help you prevent the development of Diabetes crises.
- Drink fluids : To replace the fluid lost through high blood glucose, fever, vomiting and
diarrhoea, you should drink 250 ml of sugar free, caffeine free fluids every hour and Every third hour drink 250 ml of soups
- You should check blood glucose every 2-4 hours when sick and report high blood glucose levels to your doctor. As infection can increase BSL.
- Never skip medications (Insulin or oral antiglyceamic agents): Often people think that since they are not eating, they should not take the medications, when in fact they need more. Unless you do not experience hypoglycaemia, medication should be taken.
- Often when you are sick, you may not feel like eating. Since the body needs energy to fight off infection, carbohydrates in particular are needed.
- If you are unable to eat regular meals, you can consume liquid or soft foods that equal 15 gm of carbohydrates every hour or 50 gm every 3-4 hour. Foods like Soup, milk, fruit juice, soft drink, Sherbet etc.
- Urine should be checked for ketones if BSL is higher than 240 mg/dl. The presence of Insulin means that there is not enough insulin available and the liver is breaking down the fats. Urine ketones needs to be reported to the doctor.
- Insulin must never be discontinued until and unless there is severe Hypoglyceamia. Only the dose may require adjustments due to low intake of food or increase in BSL due to severe illnesses. Check your BSL and consult your doctor for correct Insulin dose.
- Keep all the important contact numbers (doctor, nurse, hospital, ambulance, close friends) with you.
- All diabetics should seek professional help of a doctor if:
-Uncertain of diagnosis
-Persistent vomiting or diarrhoea (3 episodes or more within 6 Hours)
-Unwell for 2 days and not getting better
-BSL remains above 270 mg/dl despite extra fluid and Insulin
-Moderate to large ketones persist, despite extra fluid and insulin
Understanding that illness impacts your Diabetes and how to treat it are the keys to getting through your sick days without any hazard.