Getting sick with everyday illnesses is something we all have to deal with, although when one is living with diabetes, everyday illness can affect blood glucose levels. This means when unwell, it can be much harder to keep blood glucose levels within an ideal target range. This is because your body releases stress hormones to fight the illness, that cause your liver to increase the amount of glucose in your blood. At times making it tricky to stop your blood glucose levels from rising too high.
Being unwell and having high blood glucose levels can put you at risk of severe dehydration, in which you can feel drowsy and confused. In some cases, some people may require urgent medical help. Therefore, it is important to take care when unwell and have a personalised sick day action plan (created with your doctor or diabetes educator), and a sick day kit ready to go.
What should be included in a sick day kit?
It is important to have a sick day kit prepared for when you may become unwell. This kit should include:
- A list of important medical information, e.g. Medicare number, NDSS number.
- A list of your current medications and doses
- Pain relief medication
- In-date ketone testing strips
- Short or rapid acting insulin (if you take insulin as recommended by a medical professional)
- Insulin syringes or pen (if you take insulin as recommended by a medical professional)
- A diary to record results of your monitoring
- Food containing glucose, or glucose gel or tablets
- Phone numbers for medical and personal support
- A thermometer
- Hypo treatment
- A copy of your sick day action plan
- Any items as recommended in your sick day action plan
Make sure you check your kit regularly to ensure no items are out of date and replace items as they are used. If you are unsure what items you should have in your kit, you can discuss this with your diabetes educator or doctor.
What to do when you’re sick
Put that plan into action
Sick day action plans should be followed immediately if you are feeling unwell or your blood glucose levels are higher than 15 mmol/L for 8–12 hours or more.
If you do not yet have a sick day action plan, make an appointment with your diabetes educator or doctor to create one.
Let someone know you are feeling unwell
Keep a friend or family member in the loop and let them know you’re unwell. You can tell them about your sick day action plan in case you need any assistance and if possible, have someone stay with you or check on you often.
Monitor your blood glucose levels more frequently
Check your blood glucose levels every 2 hours or as outlined in your sick day action plan and record these levels. Once your levels are back to your recommended range, you can return to your normal monitoring schedule.
Continue taking your diabetes medication or insulin
Continue taking your regular medication doses. If you have vomiting or diarrhoea, most medications can continue, with some exceptions. If vomiting and diarrhoea is lasting more than a few hours or there is multiple episodes, consult with your diabetes educator or doctor.
Creating a sick day action plan with your diabetes educator or doctor will tell you how to continue your medications while sick.
Keep drinking and (if possible) eating
Keeping up your fluid intake is essential and will lower your risk of becoming dehydrated. Keeping up your carbohydrate intake by eating is also important in reducing your risk of hypoglycaemia.
Don’t be afraid to ask for help
Reach out to your diabetes educator or doctor with any questions or uncertainties about your sick day action plan.
Please seek medical help immediately if you experience any of the following:
- Feeling confused or drowsy
- Deep, rapid breathing or shortness of breath
- Chest pain
- Unable to keep food or fluids down, or have vomiting, diarrhoea and/or stomach pain for longer than a few hours
- Signs of dehydration, e.g. intense thirst, confusion, not passing urine or weakness
- Blood glucose levels continuing to rise, even while following your sick day action plan
- Blood glucose levels that cannot stay above 4 mmol/L
- Are not well enough to follow your sick day action plan
- A ‘fruity’ smell to your breath (this is a sign of ketoacidosis)
Don’t forget to develop your sick day action plan if you haven’t already
Sick day action plans are personalised step-by-step instructions on how to manage your diabetes when ill. This is developed with your doctor or diabetes educator and should be reviewed with them every 1-2 years.
Once you have your sick day action plan, you can tell your friends and/or family about the support you may need when unwell.