Understanding Sick Days When You Have Diabetes

Sick days when you have diabetes

sick-daysWe have all heard to “drink plenty of fluids and get plenty of rest”when you have a cold or are sick.  When you have diabetes there are more things you need to consider.

When a cold virus invades your body, different natural disease fighting hormones are produced to try to fight the illness.  The release of these products within your body can cause your blood sugars to increase.  You may not feel like eating, drinking or taking your medications when you are sick. Even without eating and drinking, when you are sick your blood sugars may increase.  If you skip your insulin or diabetes pills when you are sick your blood sugars may increase even more. Although it may be tough when you are sick, it is important that you try to consume carbohydrates, take your medications, and check your blood sugars more frequently to avoid complications or emergencies.

Make a “sick plan”with your health care provider before you get ill. This means knowing exactly what to do, what to eat, when to test, and knowing when to call your provider.  Create a logbook specifically for sick days if you don’t already use one.  Include what your blood sugars are, what medications you took, what your temperature was, how much and what you ate and drank, as well as any other symptoms you may have experienced.  This will be useful if you need to call your provider for medication recommendations.

Check your blood sugars at least every four hours and record your results.  If your blood sugars remain high, greater than 240 mg/dl, and cannot be controlled despite taking your medications, contact your provider as soon as possible.  If you cannot reach your provider, have trouble breathing, or you have symptoms of high blood sugars such as increased thirst and urination, or nausea and vomiting, go to the emergency room as soon as possible.  In addition to checking your sugars, check your urine or blood for ketones.  This is especially important if you have type 1 diabetes or your blood glucose is greater than 240 mg/dl.  Ketones are a sign of your body breaking down fat instead of sugar to use for energy because there is not enough insulin.  Call your provider if you have greater than 0.6 mmol/L of ketones in your blood or moderate to large ketones in your urine. There are glucometers and urine testing strips on the market that will check for ketones.

Take your medications, both pills and injections.  Do not skip them, even if you are not eating, unless your provider has told you otherwise. You may actually need more medication when sick to help with higher blood sugars.

Make sure you drink plenty of fluids, whether you are eating or not.  Fever, vomiting, diarrhea, and high blood sugars can cause dehydration.  The best thing to do is to try and drink a glass of fluid every hour while you are awake, or as often as possible.  If you are eating,then you can drink water or other sugar free drinks.  If you are unable to eat, however, you should alternate with liquids that contain sugars or carbohydrates such as juice or regular soda. Sipping on plain broth or soup a few times a day will also help aid in replenishing sodium that you may have lost.

It is important to consume carbohydrates even when sick.  Stick to your normal diet if you can.  If solid food seems like too much, trying eating softer foods or drinking fluids that contain carbohydrates.  These can include apple juice, regular soda, sports drinks, pudding, jell-o, yogurt, and popsicles.

With these rules as a guide, you can manage your diabetes more easily when you are sick.  At any time, if you require further information about diabetic sick days, contact your doctor or diabetes care provider.

This Article is Brought to You By:
Our DDP Guest Writer’s Staff,
Andrea LaCarubba, PharmD Candidate 2014, School of Pharmacy-Boston, MCPHS University
Jennifer Goldman-Levine, PharmD, CDE, BC-ADM, FCCP‎, Professor of Pharmacy Practice, School of Pharmacy-Boston, MCPHS University, Boston, MA, Clinical Pharmacist, Well Life Medical, Salem, MA

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