Sick day management at a glance
- Never omit your Insulin,even if you can’t eat. You may need additional insulin,but do not take additional oral hypoglycemic pills.
- Test your blood sugar every 4 hours.If you need help ask for it.
- If you have juvenile diabetes test your urine ketones every 4 hours.
- Drink clear liquids (at least 1/2 cup every hour), and eat light foods if you can.
Rest.Do not exercise during an illness.
Call your doctor if you have any of these:
- An obvious infection.
- Illnessess lasting more than 2 days.
- Vomiting or diarrhea for more than 8 hours.
- Blood sugar over 400 in two consecutive tests.
- All urine tests positive for large amount of sugar.
- Moderate to large unit ketones with blood glucose level over 200mg for more than 8 hours.
- You feel very ill or experience pain.
- You have extreme fatigue,shortness of breath or dizziness
Guidelines for insulin dosage during sick days
In accordance with your test results it may be necessary to take more fast acting Insulin.The guidelines given below are for people using 40-50 units per day.Remember to retest your blood glucose after 3 hours.Review Insulin requirement and take appropriate action.
If there is no acetone in the urine
- 90-160 mg/dL:No additional Insulin.
- 180-250 mg/dL:2 extra units of fast acting Insulin.
- 250-350 mg/dL:4 extra units of fast acting Insulin.
- 350-450 mg/dL:6 extra units of fast acting Insulin.
- 450 mg/dL: Inject 6 units, contact your doctor immediately.
If acetone is present and blood glucose more than 180 mg/dL.
Add: 10 units of fast ating Insulin for 2 + (++) acetone.
Add:15 units of fast ating Insulin for 3 + (++) acetone.
if you are on oral medications watch out for signs of low blood sugar durng any illness that causes you to vomit or prevents you from eating and drinking normally.The pills that you took continue to work and lowers your blood sugar even more.Try to replace missing carbohydrates by eating soup,toasts or candies.Testyour blood sugars and if it is below 120 or urine for sugar call your doctor.
Food for sick days
- If you are too sick to follow your meal plan,try to replace the carbohydrates with liquids or soft foods.
- Small,frequent feedings may be easier to tolerate.
- Try to drink 4 ounces of clear liquids such as tea,apple juice,or diet soda every hour.
- void spicy foods.
Nausea,vomiting and diarreha
- When you experrience these symptoms,take smallpieces of crushed ice,or 1-2 ounces of regular cola every 30 minutes.
- If you can keep this down,try adding soup or both,tea and clear juices.
- People with diabetes get colds,allergies and upset stomachs just like without diabetes.Over the counter medicines for these aliments may contain ingredents that may raise or lower blood glucose.Read the label beforeyou purchase or use any of these medicines.If you are not sure consult your doctor immediately.