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Effective Sick Day Management

For people with diabetes, a bout with cough, cold or low-grade fever is no simple matter. It could increase their blood glucose levels making them more susceptible to graver conditions. When we are sick, our body produces certain hormones which help fight off the illness. However, these hormones can raise blood sugar levels, thus disabling the effects of insulin.

On the other hand, illnesses that cause vomiting, diarrhea and dehydration need more attention, as they may trigger diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS). These conditions may warrant hospitalization if not treated properly and promptly. Being alert and armed with knowledge can help you go a long way in planning for your sick days. Here are some helpful do-it-yourself tips on effective sick day management.

DOs:
Know when to call your doctor. When you are sick, it is best to know when to call your doctor. Some signs that should warn you to seek medical attention are: blood sugar level that has been higher than 240 mg/dL for over 24 hours or lower than 70 mg/ dL; urine ketone level that is moderate to high; diarrhea or vomiting; sleepiness or inability to think clearly; dry, cracked lips or tongue, and fever over 101 degrees Fahrenheit or 38.3 degrees Celsius.

Regularly check blood sugar and urine ketone levels. For those with type 1 diabetes, it is suggested that you check your blood sugar level and urine ketone levels every four hours. While for those with type 2 diabetes, it is best that you check four times a day.

Know what to eat. Try to stick to your diabetes meal plan to maintain blood sugar stability. However, with nausea, vomiting and diarrhea, it may be tough to eat your usual fare. You may need to take 45 to 50 grams of carbohydrates every four hours to prevent ketone development and low blood sugar attacks. Here’s a list of more tummy-friendly foods that contain about 15 grams of carbohydrates: 1 cup clear soup, 1/2 cup regular gelatin, 1/2 cup non-caffeinated regular soft drink (like 7-up or Sprite), 1 double-stick frozen fruit popsicle, 1/2 cup unsweetened applesauce, 1/3 cup apple juice, 1 cup sports drink (like Gatorade or Pocari Sweat), 6 saltine crackers, 3 graham crackers, 1 slice dry toast, 1/2 banana.

Let a friend know you’re sick. If you have diabetes, wear a medical tag to let people know of your condition when an emergency arises. When you are sick, it is also very important to let others know, especially those who can give immediate help like neighbors, friends and relatives.

Be prepared. Keep medication, insulin, blood glucose and ketone test strips, emergency phone numbers, a thermometer, sugar-free cough or cold preparations handy. Talk to your doctor about your sick day management plan and agree on how to manage your blood sugar and other medical conditions during sick days.

DON’Ts:

Stop your medications. Take your medications as usual if you are eating normally. Missing your insulin or other medications can lead to ketosis. If you are unable to keep food or liquids down, you will need to adjust medicine doses, so call your physician.

Self-medicate unwisely. Over-the-counter medications and herbal remedies may contain sugar and alcohol and thus may wreak havoc on your blood sugar levels, so read the labels carefully. Medications like ibuprofen and paracetamol may be harmful for people with kidney and liver problems respectively. Decongestants may also raise blood pressure. When in doubt, get your physician’s okay.

Avoid fluids. To prevent dehydration especially when you have nausea, vomiting and diarrhea, drink at least 240 mL of water or non-caffeinated calorie-free liquid such as broth every hour while you’re awake.

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