Most everyone gets sick once in a while; it’s not uncommon to get a cold or flu or another illness. However when you have diabetes, your body sees a sickness as a form of a stress and releases hormones to fight the disease. These hormones can elevate BG and interfere with the effects of insulin.
It is very important to learn how to manage your sick days. You need to come up with a strategy so that when trouble strikes, you’ll be ready.
1. Make a sick-day plan.
Set up a special sick-day notebook where you write down your plan. Alternately, you can write it on a sheet of paper and tape it to the fridge. In it, include the following information:
1) How often to check BG and ketones level (for the type 1);
2) Write a list of medications that you have to take;
3) If you take insulin, how to adjust the dosages; you need to consult your doctor for this;
4) What kind of food to eat on your sick days;
5) Contact info for your doctor, dietitian, and diabetes educator;
6) Contact details for a family member or a friend who can help
2. Check blood glucose levels more often.
When you’re sick and your body is under stress, it releases hormones to fight the disease. This can boost BG levels, so it’s important to keep close tabs on BG numbers. Your doctor might recommend checking BG more often in this situation which is important to know in advance so that you can plan more efficiently.
3. Check your urine for ketones.
KETONE is a chemical that is produced when there’s a shortage of insulin as it happens with the type 1, and the body breaks down fat for energy. The presence of ketones in the urine is a sign that your body is using fat for energy instead of using glucose. Ketone test kits are available at the pharmacy. This is more typical for the type 1; I have a type 2, and was never told to do that. In fact, I never knew about the existence of this test up until this writing.
4. Keep taking medications.
Continue taking your meds, whether the regular diabetes pills or even use insulin for a short period of time. This needs to be discussed with your doctor.
5. Drink plenty of water.
A rule of thumb is 8×8 for us women. This is 64 fl oz or half a gallon. This translates to roughly 8oz of water every hour you’re awake.
6. Stock up on sick-day snacks.
It’s not uncommon not to have an appetite or have difficulty keeping food down when you’re sick. To prepare for this, have a stash of nonperishable foods, preferably clear liquids such as vegetable or chicken broth, clear soups, gelatin, apple juice or sherbet / frozen juice bars.
7. Stock the medicine cabinet.
Keep a stock of diabetes-related supplies such as glucose meter, lancets and test strips on hand as well as thermometer and over the counter meds. If you feel that you want to take extra meds, always check the label of any OTC meds to see if it contains carbs. If it does, ask a pharmacist about the sugar-free alternatives.
Be aware that some meds can affect BG levels. For example, aspirin in large doses can lower BG levels. Some antibiotics can lower BG levels in people with type 2 if they also take diabetes pills.
The goal is to consume up to 2 carbs per snack and 3-4 carbs for a meal.
8. Call your doctor if the following happens:
– you have a fever for a couple of days and it doesn’t go away
– you’ve been vomiting or has had diarrhea for more than 6 hrs
– BG level is above 240 before meals and stays there for 24 hrs or more
– you have signs of dehydration, ketoacidosis or other serious symptoms such as chest pain, trouble breathing, fruity-smelling breath, moderate to high urine ketone levels, or dry & cracked lips & tongue.
BOTTOM LINE, knowing what to do in advance is extremely helpful in handling critical situations to help efficiently manage your diabetes when you get sick.