When you are sick, your body reacts by releasing hormones to fight infection. But these hormones raise blood sugar levels and at the same time make it more difficult for insulin to lower blood sugar. When you have diabetes, even a minor illness can lead to dangerously high blood sugar. This may cause life-threatening complications, such as diabetic ketoacidosis in type 1or a hyperosmolar state in type 2 diabetics. Sickness can include minor intercurrent illnesses like fever, cold, sore throat, vomiting, diarrhea, food poisoning, pneumonia and foot infections.

Sick Day Rules

People with diabetes should be taught how to manage an episode of illness and seek health if they are unable to manage their blood glucose levels.

Drink Fluids

• Every hour you can sip sugar-free & caffeine-free drinks e.g. green tea, black tea, herbal tea, nimboo pani & thin butter milk
• If your blood sugar is running low (below 70 mg/dl) you may need to drink some fluids that have sugar in them e.g., fruit juices, sharbat, rooh-hafzaa, milk with sugar, lassi, etc.

Check Your Blood Sugars

• Check your blood sugars every 2-4 hours
• Report any high blood sugar results to your Doctor or Diabetes Educator

Never Skip Your Insulin or Medications

• Insulin must never be discontinued until and unless there is sever hypoglycemia
• Take the usual dose of Intermediate or Long acting Insulin
• You may need to take frequent doses of short or rapid-acting insulin if your blood sugar is high or ketones are present (Strictly with Doctor’s Advice)
• You should take your pills(OHA) as usual
• If you vomited your pills do not take any more pills & report this event to your Doctor or Diabetes Educator
• Sometimes your Doctor may want you to take insulin for a short period of time instead of pills until your blood sugar comes down & you start to feel better

Check Your Blood or Urine for Ketones

• If your blood sugar stays higher than 240 mg/dl
• Blood or urine ketone levels should be tested every 4 hours until readings are negative

What do I do if I don’t feel like eating? One can replace the carbohydrate portion of a meal with an equal amt of carbohydrate from Semi Solids or liquids Foods containing approx. 15 – 20 gms of carbohydrate e.g.or 1 Cup Fruit Juice (No water) or1 Cup Custard or1 Glass Milk + 2 Tsp Sugar or 1 Cup Fruit Yogurt or 1 Cup Porridge or 3 Glucose Biscuits or 1 Small Bowl Fresh Fruits

Sick Day Supplies

• Thermometer
• Urine Ketone (Testing Strips)
• Glucometer (Testing Strips)
• Log Book
• Medications & Insulin
• Doctor’s & Diabetes Educator’s Telephone Numbers

Call Your Doctor Immediately

• Have trouble breathing
• Continuous Vomiting
• Continuous Diarrhoea
• Running Temp Over 101 Degree
• Weight Loss
• Have 2 Or More Blood Sugar Readings – > 240 mg/dl. Or < 70 mg/dl.
• Have Moderate Or Large Urine Ketones
• Have A Fruity Odor To Your Breath
• When In Doubt Call