What will you do when you get sick?

ByDonna Itzstein, Pharmacist CDE           

The weather’s getting colder, the days are getting shorter and cold and flu season is upon us. Do you have a sick day plan ready in case you get an illness or infection such as the common cold, gastro or a respiratory infection?

When your body is fighting an illness, it is under stress. And when stressed your body releases hormones which causes extra glucose to flow into the bloodstream. Raising the glucose available to the body generally gives you the energy to fight infection. However, when you live with diabetes this is not helpful. Higher blood glucose levels (BGLs) can dehydrate you and delay your recovery.

Follow your sick day plan if: You feel unwell or have any signs of sickness or infection ORYour blood glucose levels are higher than 15mmol/L for 6-12 hours or more

If you haven’t already got one, it is time to talk with your health team about designing a sick day action plan. Your plan will depend on whether you live with type 1 or type 2 diabetes.

Type 1 diabetes

People living with type 1 diabetes can check ketones during sick days or when blood glucose levels are 15mmol/L or higher. A positive result for ketones is anything over 0.6mmol/L. Ketone testing uses a different type of monitoring strip in a blood glucose monitor designed to also test for both glucose and ketones. Not all blood glucose monitors can measure ketones, if you are unsure about yours, check with your pharmacist or diabetes educator.

Ketones are formed in your body when you do not have enough insulin. They are the result of the breakdown of fat into glucose. This extra glucose doesn’t result in extra energy as you still require insulin to use glucose. A buildup of ketones in your body is toxic and can result in diabetic ketoacidosis (DKA).

If you live with type 1 diabetes your sick day action plan will include checking blood glucose and ketone levels. You are likely to require extra insulin doses during sick days so keeping enough insulin at home ‘just in case’ is always a good precaution. Understanding how much extra insulin to take when your BGLs are high is also important. Your GP or diabetes educator will be able to guide you with this and it can be added into your sick day action plan.

For people living with type 1 diabetes: If your blood glucose levels are above 15mmol/L for 6 – 12 hours or more, check your blood glucose and ketone levels every two hours

Type 2 diabetes

If you live with type 2 diabetes you may be required to stop some of your diabetes medications temporarily if you are vomiting or have diarrhoea. Most medications will continue as normal, so take the opportunity next time you visit your GP or pharmacist to ask about your medications. If you use insulin you may need to increase your dose while you are ill. Do not change your insulin dose unless your GP tells you to. Remember that if insulin is increased temporarily, the dose will decrease again when you become well. If you cannot eat as you normally do, you may experience low blood glucose levels and may need to have foods available, such as jellybeans or lucozade, to treat hypoglycaemia. Follow this link for a sick day action plan.

For people living with type 2 diabetes: If your blood glucose levels are above 15mmol/L for 6 – 12 hours or more, check your blood glucose levels every two hours

What to include in your sick day action plan

• The phone number of someone you know you can contact when you are not well
• A reminder to keep hydrated
• A note of what to do with your medications
• A list of emergency contacts
• Details on how often to check blood glucose and ketones
• When to seek urgent medical care

Other tips for sick days include

• Continue to eat and drink as usual if you can
• Make sure your blood glucose monitor is in good working order and you have enough strips
• Hand sanitizers and creams on your hands may give you inaccurate readings. Wash your hands and dry them thoroughly before monitoring
• Keep a complete record of your blood glucose levels.
• Blood glucose levels elevated due to illness cannot be reduced by exercise. Exercise at this time will add extra stress to your body. Sick days are a time to rest and hydrate.
• Keep a thermometer, rehydration treatment, hypo treatment, and pain and fever relief medication ready

If you have enquiries regarding this topic or general questions please contact us on 1800 637 700. Call 000 in an emergency.