Sick day rules - A Healthcare Professional perspective

If you have diabetes you need to take good care of yourself when you have a cold, infection or other illness. Being sick often raises your glucose levels and more insulin is often required. As you start to feel better and the glucose level returns to your usual range the insulin dose can be reduced, often to the original dose. It is important that you do not stop insulin when you are unwell or you could become very ill and require emergency hospital treatment.

If your glucose level is 14.0mmol/l or you feel unwell refer to the guidelines on the treatment of high glucose levels and consider increasing the basal rate, insulin carbohydrate bolus and sensitivity factor (correction bolus). Continue taking your insulin and do not disconnect from the pump.

• Test your glucose level every 1 – 2 hours
• Document your glucose results clearly
• Whilst ill aim for glucose levels between 4.0 to 10.0 mmol/l.
• Check for blood ketones as soon as the illness starts.
• If you do not feel like eating, replace your solid food with a sugary drink e.g. sipping fruit juice, eating ice-lollies or soup.
• If you can’t eat at all, drink liquids such as water or sugar-free squash
• Extra water and sugar-free drinks are important to avoid dehydration especially if feverish and passing a lot of urine.  Try to drink at least 150ml of water or other calorie free liquid every hour while awake

Consult your healthcare team if:

• You have ketones
• You are vomiting or too nauseous to eat and drink
• Your glucose level remains 14.0 mmol/l or above
• Your condition does not improve
• If you are not sure about the action to take
• If you think the illness needs medical treatment such an antibiotic or if you think the illness is getting out of control.

Click here to download our guidelines for Treatment of High and low Glucose Levels and Sick days. These guidelines are to be used with the advice from your healthcare team