Having diabetes does not mean you are likely to fall ill more often than anyone else. However, there are some precautions you should take when you are sick in order to avoid acute complications of diabetes especially if you have type 1 diabetes. Part of the body's natural response to the stress of an illness (such as an infection or injury) is to make more sugar. In people with type 1 diabetes this may lead to very high blood sugar levels and a condition known as diabetic ketoacidosis. (Please refer to the leaflet on ketoacidosis for further information.) During periods of illness you may experience loss of appetite and reduce your intake of food. Many insulin treated patients reduce or stop insulin due to concerns about hypoglycaemia during intercurrent illness.
If your blood glucose is continuously more than 17 mmol/l or if you are vomiting, test your urine for ketones. Ketones may appear in the blood and urine due to starvation. They also can indicate a lack of insulin. The presence of ketones in the urine may be a warning of developing ketoacidosis and should be acted upon. Remember ketoacidosis is a life threatening emergency which needs to be identified and treated quickly.
Try to drink 4-6 pints of sugar-free liquids (water, tea) throughout the day.
If you don't feel like eating, replace your solid food with soup, milk, ice cream, fruit juice, sugar, honey, fruit juice.
Follow these general guidelines.
Blood glucose |
|
less than 13 mmol/l |
continue with your normal dose of insulin |
13 - 22 mmol/l |
take 2 units extra of insulin with each injection, even if you are unable to eat anything |
greater than 22 mmol/l |
take 4 extra units of insulin, even if you are not able to eat |
Reduce your dose of insulin back to your usual dose when blood glucose returns to normal.
You or a member of your household should seek assistance in the event of any of the following. Speak to your Specialist Nurse or your GP. If in doubt always seek advice - it is better not to leave it too late!
Dr Nishan Wijenaike, Consultant Physician
West Suffolk Hospitals Diabetes Service
Revised June 2005