Sick Day Management
The change of seasons can bring cold and flu season to mind. Having diabetes doesn’t mean that you will get sick more often than someone who does not have diabetes; however, taking precautions to try and prevent illness are extremely important. Steps such as frequent hand washing, covering your mouth when you cough or sneeze, never sharing food or drinks, and getting the flu shot are vital to the prevention of illness. If you do get ill with a cold or flu, it can cause problems with your diabetes. You may not want to eat anything, your blood sugars fluctuate, you just want to sleep, or you’re vomiting. What do you do to prevent dehydration or ending up in DKA? The first thing to do is call your Diabetes Team for help. If vomiting or ketones are present, then activate the emergency pager. Blood sugar testing should be done often, as well as maintaining hydration. Insulin injections should never be missed, and be prepared to take extra insulin to correct high blood sugars or clear ketones according to suggestions from the Diabetes Team. Use the table below for helpful hints when feeling under the weather:
If you are able to eat:| BG Testing | Ketone Testing | Food and Beverage | Novolog or Humalog | Lantus or Levemir | Follow- Up | |
| Negative or Trace Ketones | Every 2 hours | Every trip to the bathroom | Usual meal with extra water or sugar free drinks | Dose per carbs and blood sugar as usual | Usual dose (never skip long-acting insulin) | Call Diabetes Phone Hour for routine adjustments |
| Small, Moderate or Large Ketones | Every hour | Every trip to the bathroom | Usual meal with extra water or sugar free drinks | Dose per carbs and blood sugar plus additional insulin if directed by Diabetes Team | Usual dose (never skip long-acting insulin) | Follow the directions of the Diabetes Team |
If you are unable to eat:
| BG Testing | Ketone Testing | Food and Beverage | Novolog or Humalog | Lantus or Levemir | Follow- Up | |
| Unable to Eat but Able to Drink with Negative or Trace Ketones | Every 2 hours | Every trip to the bathroom | Drink lots of fluids; if blood sugars are below 150, drink carb containing fluids | Correct high blood sugars only | Usual dose (never skip long-acting insulin) | Call Diabetes Phone Hour for routine adjustments or call the Diabetes Team if ketones become present |
| Unable to Eat but Able to Drink with Small, Moderate or Large Ketones | Every 2 hours | Every trip to the bathroom | Drink lots of fluids; the Diabetes Team may instruct you to drink fluids containing carbs | Correct high blood sugars only plus additional insulin if directed by Diabetes Team | Usual dose (never skip long-acting insulin) | Follow the directions of the Diabetes Team |
| Unable to Eat or Drink | Every hour | Every trip to the bathroom | Not applicable | Correct high blood sugars only plus additional insulin if directed by Diabetes Team | Usual dose (never skip long-acting insulin) | Follow the directions of the Diabetes Team; you may be instructed to go to the ER |
