Sick Day Guidelines

When you have diabetes, not feeling well affects you’re eating patterns and how your blood glucose reacts to your usual dose of diabetes medications. Your blood glucose levels may rise because of the release of stress hormones when you are sick. This may make your diabetes harder to control and why it is important to plan ahead and be prepared.

SICK DAY SUPPLIES YOU SHOULD HAVE IN THE HOUSE AT ALL TIMES:

• Fluids that contain sugar- regular colas, regular juice, jell-o, popsicles
• Fluids that have NO carbohydrates or sugar- diet colas, bullion, water, sugar free jell-o and popsicles.
• Sugar-free medicine for cough, fever, nausea and congestion.

GUIDELINES FOR BLOOD GLUCOSE LEVELS BELOW 250mg/dL

• Monitor blood glucose levels every 2 hours, 24 hours a day.
• Drink lots of fluids
  • Try to drink 8 oz slowly, every hour.
  • Approximately ½ of the fluids should contain carbohydrates
• Continue basal insulin. Even if you are not eating, you need basal insulin and may need corrections.

GUIDELINES FOR BLOOD GLUCOSE LEVELS ABOVE 250mg/dL

• If blood glucose levels are above 250mg/dL, give correction bolus of insulin. This would be the ‘no-meal’ scale. Correction boluses can be given every 4 hours as needed.
• Drink 8 oz slowly of no- carbohydrate or sugar-free liquids every 30 minutes.
• Recheck blood glucose levels in 1 hour
• If glucose levels are increasing, call the office or go to the emergency department.
• If glucose levels are decreasing, continue the above steps.

WHEN SHOULD I SEEK MEDICAL ATTENTION?

• blood glucose levels are more than 250mg/dL before meals and stays there for more than 24 hours
• You have vomiting or diarrhea for more than 6 hours
• You have a fever for a couple of days and aren’t getting any better
• If you have signs of ketoacidosis (DKA) such as dehydration, drowsiness, abdominal/chest pain, difficulty breathing, fruity odor to breath, dry cracked lips, mouth or tongue.
• You are not certain of what to do to take care of yourself.