When you are sick, either having cold, cough or fever, vomiting or diarrhoea, diabetes is probably the last thing you want to worry about. However, everyday illnesses or infection can affect your blood glucose levels, so you need to be extra careful with managing your diabetes on the sick days.
What happens to the body during sickness, if one has diabetes?
When you have diabetes, even a minor illness can make it harder to keep your blood glucose in the target range. Illness puts the body in a state of stress. To deal with this stress, the body releases hormones that help to fight disease. But downside of these hormones is that they raise blood glucose levels by increasing amount or glucose produced by the liver and make it difficult for insulin to do its job effectively. If not treated quickly, blood sugar levels can go dangerously high and lead to serious complications.
The best way to prevent a minor illness from becoming a major and life-threatening complications is to work out a plan of action for sick days ahead of time. So, you can discuss your personalised sick-day plan and keep your management kit ready with help of your diabetes care team. This will allow you to manage your diabetes better and recover from your illness without complications.
Here are some general guidelines to deal with sick-days:
Check your Blood Sugars More Often
Each type of illness can affect a person’s blood glucose differently. Check your blood sugar every 2-4 hours, especially if you have vomiting. Make sure you check your blood glucose levels at least 3-4 times a day. Keep a record of your readings, if your sugars are consistently high then consult diabetes care team immediately.
Take Your Medications/Insulin as Advised
When sick, do not skip or stop taking your diabetes pills or insulin. As your blood sugar may continue to rise because of your illness. Perhaps you might need some dose adjustments to compensate for high blood glucose levels or to avoid low blood glucose if you can’t eat. Consult with your diabetes care team, to create a sick-day adjustment plan for food and medications.
Check your Ketones
When you are sick and have high blood sugars, the presence of ketones in the urine becomes a matter of concern. To feel safe, when your blood sugar is higher than 240 mg/dL or advised by a doctor, get checked for ketones in urine and report their presence to the doctor. If you are unable to check ketones at home and feeling symptoms like fruity smell breath, vomiting, cramps or confusion call your health care provider immediately or go to the nearest Emergency Care Centre.
Keep Yourself Hydrated and Maintain Your Diet
Try to eat your meals and snack as normal as possible. Drink plenty of fluid to keep yourself hydrated and to replace the fluids that the body loses due to high blood sugars, fever, vomiting or diarrhoea. Options for fluids could be tea, milk, lemon water, chaach (buttermilk), daal (pulse), vegetable or chicken soup or broth. If you are unable to eat normal meal then take something which you can better tolerate like khichri, dalia, oats, upma, mashed potato, noodles, custard, milk and biscuit or bread etc. If you are unable to consume anything or manage your diet, talk to your diabetes care team about customised diet plan and medication adjustment.
When to See a Doctor?
During illness, there are a number of situations that warrant immediate medical attention. If you have fever for couple of days or having problems in breathing. If you have ketones in urine or fruity odour or if feeling drowsy. If you have had at least 3 episodes of vomiting or diarrhoea and/or abdominal pain then, consult your doctor. Of course, if you have any questions or concerns about adjusting your medication or insulin dosage and persistently high sugars then don’t hesitate to call your health care professional.
What all items you need to keep in a sick days kit?
You won’t feel like running out to the store when you are sick. So always be prepared for Sick Days by having a few supplies in the house including:
- Written handout with clear instructions: “My Sick Day Plan with Emergency Contact Numbers”
- Medication or Insulin supplies
- Ketone testing strips (blood or urine)
- Blood glucose meter, battery, lancets and strips
- Hand sanitizer
- 1 pack of sugar-free and sweetened beverages e.g. diet /regular soft-drink, fruit juice, sport drink, vegetable soup or both
- Glucose tablets or powder to treat low-sugars
- Over-the-counter medications as advised by your healthcare provider (i.e. fever, cough, cold, pain, diarrhoea or vomiting).
Check your kit every six months to make sure it is till date and restock your kit for items that are consumed.
Some Tips to Stay Healthy and Prevent Sick-days
It’s natural that one can get sick once in a while. But you can keep yourself from getting sick more often than necessary.
- Take care of personal hygiene. Wash your hands frequently, especially after coming in contact with other sick people
- Take your flu shot on time. Diabetes, over a time may reduce the ability of the body to fight diseases and puts you at an increased risk for developing common flu.
- Keep your blood glucose levels within your target range. It will reduce the risk of illness and infections.
- Do regular follow-ups with your diabetes-care team. It will help you stay on top of your diabetes and prevent chances of getting sick.
- Eat a healthy and balanced diet. Include fresh, seasonal and colorful veggies and fruits to boost your immunity.
- Manage your stress and get quality sleep. Regular physical activity and enjoying hobbies you like are great ways to keep your body and mind healthy.