“Sick Days” can make diabetes more difficult to manage.
This is because hormones which stimulate the immune system, can also cause insulin resistance, resulting in higher blood glucose levels.
You may also find yourself less active, which can further increase your blood glucose, while poor appetite and nausea/vomiting can disrupt normal eating patterns and digestion.
Sick Days Include
- Infection: dental, urinary tract, skin, respiratory, etc.
- Nausea and/or vomiting
- Cold or flu
- Severe headache
Have a sick day kit which includes healthcare team contact numbers, foods & fluids, thermometer, over the counter medications for fever, diarrhea and vomiting, extra insulin, extra pump & monitoring supplies (ketostix & strips).
Check your blood glucose regularly.
Check urine or blood for ketones every 2-4 hours if you have unexplained blood glucose values over 250 mg/dL or are feeling ill even if blood glucose values are normal.
Contact Steady if pre-meal blood glucose remains above 250 mg/dL after making two high blood glucose corrections or if urine ketones measure moderate or large (or blood ketones 0.6 mmol/L).
Never stop taking insulin-even if vomiting and unable to eat.
Your body often needs more insulin during illness and might need a higher basal rate!
This is the perfect time to program a Temporary basal rate as you may actually need 10, 20 or 30% more insulin when ill.
Seek immediate medical attention if the following occurs
- Vomiting occurs more than once, and you are unable to keep food down
- Diarrhea persists longer than six hours.
- You took correction doses of insulin AND
- Blood glucose > 250 mg/dL on two consecutive measurements over 2-3 hours.
- Urine ketones moderate or large (or blood ketones 0.6 mmol/L) on two consecutive measurements.
- Fever of greater than 101 F.
- Signs of DKA such as nausea, abdominal pain, vomiting, deep, rapid breathing.
- Signs of dehydration are significant (5 lbs.) weight loss, very dry mouth or tongue, cracked lips, change in mental status such as feeling unusually sleepy or inability to think clearly.
Palo Alto Medical Foundation: Pre Pump Education Packet