Diabetes and sick days
Feeling unwell?
When you are unwell, your body’s increased production of stress hormones will cause blood sugar levels to rise. Common causes of sick days include: colds, flu, sore throat, gastric upset, diarrhoea and urinary tract infections.
During periods of illness, you need to take special care. Keep by the phone a list of contact numbers for your doctor, diabetes nurse, hospital and ambulance. If possible, have a friend or relative come and check on you. Seek medical advice if you are ill and not getting better.
Type 1 diabetes and sick days
- Continue to take your usual dose of insulin.
- Never omit or reduce your insulin dose when you are sick. More insulin is often needed rather than less at this time.
- Contact your doctor or diabetes nurse for advice about increasing your dose of short acting (clear) insulin. You may also need extra doses of this insulin, e.g. 2 to 4 units every 2 hours.
- Eat according to how you feel and what food you can tolerate.
- If you cannot eat your usual meals, have small low-fat snacks at regular intervals throughout the day, e.g. toast, crackers, boiled rice, soup, low-fat custard or ice-cream.
- If you cannot eat food, have sips of fluid every few minutes. High blood sugar levels, vomiting and diarrhoea can all lead to dehydration.
- If your blood sugar level is more than 12 mmol/L, have unsweetened fluids like water, clear soups, weak tea, or diet lemonade.
- If your blood sugar level is less than 12 mmol/L, have sweetened fluids like ordinary lemonade, cordial or apple juice.
- Test your blood sugar level more frequently, e.g. every 2 to 4 hours and record all results.
- Test your urine for ketones every time you pass urine.
- Contact your doctor or go to hospital if:
- your blood sugar level remains more than 17 mmol/L;
- moderate to large ketones are present in your urine;
- you cannot keep down any food or fluids.
- In type 1 diabetes, high blood sugar levels or illness can lead to a serious condition called ketoacidosis. There will be moderate to large ketones in the urine. You may also notice:
- breathlessness;
- abdominal pain;
- nausea and vomiting;
- sweet fruity smell on the breath; and
- drowsiness.
This is a medical emergency. If you have these signs, contact your doctor or go to a hospital emergency department immediately.
Type 2 diabetes and sick days
- If you take diabetes tablets or insulin, continue your usual dose.
- If you cannot eat your usual meal, try eating small, frequent snacks. Suitable snacks include: toast, crackers, boiled rice, soup, banana, low-fat custard or ice-cream.
- Drink plenty of fluids. High blood sugar levels, vomiting and diarrhoea can all lead to dehydration.
- If your blood sugar level is less than 15 mmol/L, drink fluids such as ordinary lemonade, apple juice, cordial or sweetened tea or coffee.
- If your blood sugar level is more than 15 mmol/L, drink unsweetened drinks such as water, mineral water, diet lemonade, weak tea or clear soups.
- Test your blood sugar level more frequently, e.g. every 2 to 4 hours and record all results.
- Contact your doctor, or go to a hospital emergency department, if:
- your blood sugar level remains more than 17 mmol/L;
- you cannot keep down any food or fluids; or
- you become drowsy.
Last Reviewed: 10 July 2003
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