KTVN Channel 2 - Reno Tahoe News Weather, Video - Your diabetes sick day plan

By Jenilee Matz, M.P.H., Staff Writer, myOptumHealth

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You don't feel like doing much of anything when you're sick. This is your body's way of telling you to take it easy. But don't put your diabetes care plan to rest, too.

Controlling your diabetes when you're sick is crucial. If you don't carefully manage your blood sugar when you're ill, you could end up with a serious health condition. Following a diabetes sick day plan will help prevent complications.

Diabetes and illness

When you're sick, your body releases extra hormones to fight infection. Sometimes these hormones can reduce the effectiveness of insulin and cause blood sugar and sometimes ketone levels to spike.

When you are ill, you are at increased risk of getting:

• Diabetic ketoacidosis. This occurs most often in people with type 1 diabetes. It can also happen in someone with type 2 diabetes. When you are sick, or your blood sugar is out of control for some other reason, dangerous compounds called ketones can build up in your body. It can come on quickly - within hours.
• Hyperosmolar hyperglycemic state (HHS). This happens more frequently in people with type 2 diabetes. HHS is dangerously high blood sugar levels without the presence of ketones. It usually takes days or weeks to develop.

These conditions are caused by having too little insulin in your body. You develop very high blood sugar levels and become severely dehydrated quickly. This can lead to seizures, shock, coma and even death.

Benefits of having a plan

It can be a challenge to keep blood sugar levels under control when you're sick. Having a plan in place to manage your diabetes on sick days will help you:

• Keep blood sugar and ketone levels under control.
• Spot signs of a blood sugar emergency early so you can get prompt medical care.
• Ease your mind when you become sick. Stress can affect blood sugar levels, too.

1. The plan

Create your personal sick day plan before you get sick. Meet with your doctor to outline the specifics of your plan as soon as you're diagnosed with diabetes. The plan will include such things as how often to check blood sugar and if and when to check for ketones. Consider these factors when developing a plan with your doctor:

• Check your blood sugar levels often.You will have to monitor your blood glucose levels more closely when you are sick. Check blood sugar every two to four hours or as frequently as your doctor suggests.
• Test for ketones as directed by your doctor. Some doctors advise testing when blood glucose levels are above 240 mg/dL. Check for ketones using urine testing products that are made for measuring ketones.
• Keep taking your insulin and medication as prescribed. Do not stop taking your insulin or diabetes medicines when you're sick - even if you are vomiting - unless your doctor instructs you to do so. You may actually need to take extra insulin when you're fighting an infection. Do not take more unless your doctor tells you to do so, though.
• Eat regularly, even if you have no appetite.Try to eat as closely to your normal eating times as possible. Aim for 50 grams of carbohydrates every three to four hours. This will help keep your blood sugar levels stable. Soup may be a good option if you feel queasy.
• Take in plenty of fluids, especially if you're vomiting or have diarrhea or a fever. You can easily become dehydrated if you do not drink enough liquids. Sip fluids slowly instead of drinking an entire glass at once if you have an upset stomach.
• Be wary of over-the-counter (OTC) medicines. Some OTCs can affect blood sugar levels. Ask your doctor which ones are safe options for you.

2. Know when and where to get help

Call your doctor if you:

• Can't take your oral medications or have diarrhea for more than six hours
• Test positive for a moderate to high level of ketones
• Have a blood sugar reading above 240 mg/dL
• Have a fever higher than 101.5 degrees F
• Have very low blood sugar levels
• Can't or don't know how to take care of yourself
• Do not feel better after a few days

Go to the emergency room if you are sick and have any of the following symptoms of ketoacidosis or HHS:

• Extreme thirst or dry mouth
• Frequent urination
• Lack of appetite
• Nausea, vomiting or stomach pain
• Dry or flushed skin
• Fruity smelling breath

Call 9-1-1 if you:

• Are having any trouble breathing or visual problems
• Are confused, dizzy or lightheaded
• Have passed out or had a seizure

3. A word on prevention

The best plan is to not get sick in the first place. Make sure to get your flu shot and pneumonia vaccine. And be sure to wash your hands regularly. Managing your diabetes well and keeping blood sugar levels in check are also essential for good health.

Even if you do take these precautions, you may still get sick every now and then. So, it's best to have your diabetes sick day plan ready.

View the original Step-by-step: your diabetes sick day plan article on myOptumHealth.com 

SOURCES:

• American Diabetes Association. Hyperglycemic crises in diabetes. Diabetes Care. 2004;27(Suppl 1):s94-s102. Accessed: 07/23/2009

• American Diabetes Association. When you're sick. Accessed: 07/22/2009

• University of Michigan Health System. Type 1 diabetes: sick day management. Accessed: 07/23/2009

• American Diabetes Association. Surviving sick days. Accessed: 07/23/2009

• Laffel L. Sick day management in type 1 diabetes. Endocrinology and Metabolism Clinics. 2000;29(4):707-723. Accessed: 07/23/2009