It’s crucial to know how to manage your diabetes during illness. This guide will help you understand how to adjust insulin doses, other medications, and monitor your blood sugar and ketone levels. These steps are essential, especially if you are hospitalized or require steroids as part of your treatment.

Always inform the healthcare professionals treating you that you have diabetes and explain how you manage it.

How Illness Affects Diabetes

Illness, infections, and stress can cause your blood sugar levels to rise dangerously. The body’s defense mechanism releases more glucose into the bloodstream when fighting illness or infection, which can lead to high blood sugar, even if you’re not eating much. Unlike people without diabetes, whose bodies can compensate by producing more insulin, your body may struggle to do so. This can make your illness more severe.

The symptoms of having diabetes can add to those of your illness or infection and make it much worse.

Vomiting or diarrhea may cause your blood sugar levels to drop, as your body isn’t absorbing food properly.

Dehydration and Diabetes

If you’re unwell with a fever or vomiting, dehydration can become a serious risk, especially with diabetes. Severe dehydration, coupled with high blood sugar levels, might require hospitalization. It’s vital to stay prepared and follow these guidelines to manage your condition while sick. Share this advice with a friend or family member who can support you if you’re unable to manage alone.

Sick Day Rules – Managing Diabetes When Sick

• Stay calm and contact your diabetes team for advice if you’re unsure what to do.

• Continue taking your diabetes medication, even if you don’t feel like eating. Some medications may need adjustments, so consult your doctor or pharmacist right away.

• Your insulin dose might need to change when you’re sick. Talk to your healthcare provider about how to manage this.

• If you check your blood sugar at home, you’ll need to do so more frequently—at least every four hours, even during the night. Be mindful of the symptoms of high blood sugar (hyperglycemia).

• Stay hydrated by drinking plenty of unsweetened fluids and eating small, frequent meals.

• If you have type 1 diabetes, monitor your ketone levels, especially if your blood sugar rises above your target range (typically over 14 mmol/L). Check ketones regardless of your blood sugar levels when you’re sick and contact your healthcare provider if you detect ketones.

• If you’re taking SGLT2 inhibitors (SGLT2i) and become unwell, temporarily stop using them and consult your healthcare team. These medications can increase the risk of developing diabetic ketoacidosis (DKA) when you’re unwell.

• Keep eating or drinking if possible. If you can’t keep food down, try small amounts of carbohydrate-rich snacks or drinks. Sip sugary drinks or suck on glucose tablets or sweets to maintain your energy. Let fizzy drinks go flat if needed to make them easier to drink.