Sick Day Management
day management is important for people with diabetes in order to avoid
hospitalization. Those not normally requiring insulin, may need insulin
during times of illness.
take insulin or diabetes medication (often extra insulin is required,
but if vomiting or diarrhea are present, less insulin may be needed.)
Omission of insulin is a common cause of ketosis.
blood glucose frequently. For those with type 1, check every 4 hours
and for those with type 2, check 2-4 times a day. All people
with diabetes should test their blood glucose at home when ill, even
if they do not monitor at home at other times.
for urine ketones every 4 hours. (type 1 diabetes)
to eat usual amount of carbohydrate (CHO), may be divided into smaller
meals and snacks. Soft food or liquids may be easier to consume.
having difficulty eating, eat or drink 15 grams of CHO every hour or
45-50 grams of CHO every 3-4 hours.
is rare, yet may occur with nausea and vomiting of short duration without
and prescription medicines, along with herbal therapies can contribute
to hyperglycemia and hypoglycemia.
weight changes (loss may signal dehydration) and breathing problems.
extra water or sugar-free, caffeine-free fluids (8oz every hour when
for Sick Day Management
(4 oz) cup juice
cup sugar-free pudding
cup (8 oz) Gatorade
cup (8 oz)skim or low-fat milk
cup (4 oz) regular pop
cup ice cream or frozen yogurt
cup regular gelatin
oz light yogurt
cup unsweetened applesauce
- 1 cup cold cereal (unsweetened)
cup hot cereal (unsweetened)
squares graham crackers
cup mashed potatoes
calorie-free, caffeine-free liquids in place of meal.
15 grams of CHO in place of meal. Also, probably need additional liquid
from water or calorie-free caffeine source.
to drink or eat usual mealtime CHO amount. If vomiting occurs after
insulin administration, may need to sip sugar water every 20-30 minutes
to maintain a blood glucose of 100-180 mg/dl.
100 mg/dl and vomiting persists
Insulin for Illness (no nausea/vomiting)
usual dose of intermediate-acting (NPH, Lente) or long-acting insulin
doses of rapid-acting (humalog, novolog) or short-acting (Regular) insulin
may be needed due to elevated BG levels or the presence of large or
or short-acting insulin may be given every 1-4 hours.
is dependent on severity of illness.
most illnesses, 10% of total daily insulin dose can be safely given
as a supplemental dose.
BG > 300 mg/dl with large ketones, 20% of total daily dose can
be given as a supplemental dose.
need to be individualized for each patient.
hyperglycemia persists, additional doses of rapid or short-acting insulin
may be needed throughout the day.
to Call a Physician
greater than 100 degrees for 24 hours
hyperglycemia (over 300 mg/dl)
diarrhea (more than 8 hours)
and unable to take fluids for over 4 hours
longer then 24 hours
abdominal pain (more common in type 1)
breathing (more common in type 1)
to large ketones (type 1)
unexplained symptoms (if in doubt, contact your health care provider)
influenza vaccination yearly.
pneumococcal vaccination. If receive first dose prior to age 65, give
another single revaccination at age 65 if 5 or more years have lapsed
since the previous dose.
- Eat a healthful
- Get plenty of rest.
- Stay hydrated.
- Don't smoke.