Overview:
Managing diabetes and maintaining regular blood sugar levels are very important for diabetes patients. However, this becomes more important when a diabetic gets sick. (For example, if a diabetic suffers from: cold, flu, sore throat, infections, or injuries. Also, if they are undergoing certain treatments for severe dental diseases, surgery, or psychological stress). It is always advisable to devise a plan with the doctor on how to deal with such diseases beforehand.
Impact of illness on blood sugar levels:
When you're sick, your body suffers from stress, so it releases hormones that help it fight the illness. However, these hormones also raise your blood sugar level and reduce the efficiency of insulin.
Sick-day guidelines for managing diabetes:
- Insulin and diabetes medications:
- It is important for diabetics to keep taking their medications and insulin doses while sick; however, they may need to apply the following adjustments:
- Type 1 diabetes patients: may need to increase their insulin dose.
- ype 2 diabetes patients: can keep on taking their usual medications, or they may need to take insulin for a temporary period of time as instructed by the doctor.
- Nutrition and fluids:
- Patients are advised to drink a glass or half a glass of water or a sugar-free liquid every hour to avoid dehydration.
- Patients are also advised to maintain meal-times, and not skip any meals, even if blood sugar levels are high.
- Measuring blood sugar levels and ketones:
- It is recommended for patients to measure their blood sugar level at home every 4 hours and record the results. It is also important to measure ketone levels as follows:
- Type 1 diabetes patients: should measure their ketone levels every 4 hours, because they are more likely to increase during illness.
- Type 2 diabetes patients: should only measure their ketone levels if their blood sugar is higher than 300 mg/dL.
- Medications to treat symptoms of short-term illnesses:
- The patient may want to take extra medications when they are sick (like cough medicine). In this case, it is always important to check the label of the medication before buying it to see if it contains sugar. Many medications taken for short-term illnesses can affect blood sugar levels, even if they don't contain sugar. For example, aspirin in large doses can lower blood sugar levels. For this reason, it is advisable to ask the pharmacist or the doctor about which medications to avoid.
When to see a doctor?
- If the patient’s blood sugar is higher than 250 mg/dL despite taking additional insulin doses during illness;
- If the patient’s blood sugar continues to rise over 240 mg/dL before meals, despite taking diabetes medications, and if it lasts for more than 24 hours;
- If the patient starts exhibiting symptoms of ketoacidosis, dehydration, or other serious complications;
- If the illness or fever lasts for more than 2 days without improvements;
- If the patient has been vomiting or had diarrhea for more than 6 hours;
- If the patient has moderate to large amounts of ketones in their urine; or
- If the patient is uncertain of what to do in order to take care of themselves during illness.
Diabetics may need to receive medical care at hospital if they experience:
- Difficulty swallowing;
- Persistent vomiting;
- Persistent rise of blood sugar levels;
- Persistent rise of ketone levels; or
- Abdominal pain, and difficulty breathing.
Clinical Education General Department
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