How to manage your diabetes when sick
Posted Nov 26, 2009 By EMC News
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EMC News - November is Diabetes Month, and since this November people with and without diabetes are experiencing the H1N1 pandemic, it seems appropriate to address how someone with diabetes should manage if and when they become ill. 
Lorraine Payette, St. Lawrence EMC
Dr. Brian Jones receives the Keeper of the Islands Award from Don Mills at the Gananoque Chamber of Commerce's 54th Annual Awards on November 20.
The key message is to prepare before you become sick.
Discuss a sick day plan with your health care provider.
When you are sick, your blood sugar level can change quickly. The plan can help you keep your blood sugar under control when you experience a fever, vomiting, nausea, diarrhea, coughing, head congestion or any infection.
Before buying an over the counter remedy, speak with your pharmacist about options available when you have diabetes.
Medication: Discuss with your health care provider but usually it is recommended to continue taking your diabetes pills or insulin when you are ill.
Make sure you have a thermometer in the house to be able to check if you have a fever.
Monitoring: It is recommended that you test your blood glucose every two to four hours when ill. (Make sure you have a minimum of 2 weeks supply of lancets and monitor strips. Talk to your health care provider about increasing the repeats or the supply of your prescription of monitor strips). Let your blood sugar reading guide what food or liquid your body requires. It is key that you drink plenty of fluids. See the list under Plan for Liquids for examples of what choices to make.
Plan for Food: If you can't eat your usual meal, remember your body still requires 150 g of carbohydrates over the course of 24 hours when you are sick. Have one serving of a food containing 15 g of carbohydrate every hour while awake. Examples of foods and liquids containing 15 g of carbohydrate: half a cup of juice, two cups chicken noodle soup, half cup regular (not diet) soft drink, one popsicle stick, one-third cup regular jello, one slice of toast, four to eight crackers.
Plan for Liquids: Drinking liquids is very important, especially if you are losing fluids due to fever, vomiting and diarrhea. Let your blood sugar reading be your guide to choosing liquids. If your blood sugar is over 14 mmol/L, drink water, broth, or sugar-free soda. Talk to your health care provider about checking for ketones when your blood sugar is over 14mmol/L particularly if you have Type 1 Diabetes. If your blood sugar stays over 14, contact your health care provider. If your blood sugar is in the target range of 4-7mmol/L choose a drink that will provide the carbohydrates your body requires. Try half cup juice, half cup regular not sugar-free soda, one popsicle stick, two cups chicken noodle soup.
If you experience Hypoglycemia (low blood sugar): If you experience a blood sugar reading of less than 4mmol/L, remember to treat the same way you would if you were not sick. Your body is telling you it needs extra sugar so treat with dextrose tablets if you have them (talk to your pharmacist about purchasing these and clarify depending on the brand, how many you would need to take). Otherwise, treat with æ cup juice or regular soda. After treating, wait 15 minutes and recheck your blood sugar. If it remains less than 4, retreat again. If you are now in the target range of 4-7mmol/L, and it is more than an hour until you plan to eat anything, try to have an additional snack that includes a carbohydrate and protein (i.e. cheese and crackers). If unable to tolerate, include at least an additional snack of 15 g carbohydrate to ensure your blood sugar stays in target.
Call your health care provider if:
- You've been sick for two days and are not getting better,
- You've been vomiting or had diarrhea for more than six hours,
- Your blood sugar is staying over 14 mmol/L.
Go to the Emergency Department if:
- You have chest pain, trouble breathing or breath that smells fruity.
If you have further questions about your diabetes, please contact the Rideau Valley Diabetes Services in Smiths Falls at 613-284-2558 toll-free 1-877-321-4500 or in Brockville at 613-498-1555.
