Coping with Illness

Always continue to take your insulin if you are sick or have a fever even if you are not eating. Under these circumstances you may need to reduce your insulin dosage.

If you get sick

Illness, especially illness with a fever, can quickly affect your blood sugar and lead to ketoacidosis. This is a dangerous condition, which you must handle immediately, even though you are sick. Remember to take your temperature, test your blood sugar and check your urine/blood for ketones at least every 2 to 3 hours when you are sick.

Your blood sugar level is high

If you have a fever and your blood sugar is over 15 mmol/l, take 2 to 4 units of short-acting insulin in addition to your usual insulin dose in order to prevent the formation of ketones.

You have ketones in your blood/urine

If you have both high blood sugar and ketones in your blood/urine, you must continue to take a small dose of short-acting insulin every 2 – 4 hours until the ketones are gone and the blood sugar is below 10 mmol/l. You must also remember to drink a lot of liquids. Take small amounts of sugary drinks such as juice at regular intervals to maintain the blood sugar level, as well as plenty of water or sugar-free drinks.

If you are vomiting

If you are vomiting and your blood sugar is low, it is very important that you eat or drink something sweet. Try sucking on glucose or hard-boiled sweets or drinking small mouthfuls of sweet liquids.

If your blood sugar is low because you are vomiting, some ketones may appear in your blood/urine. These are called “starvation-ketones.” These ketones are not dangerous. They disappear when you eat, not by taking insulin. It is often necessary to take less insulin when you are vomiting.

Never stop taking insulin

You may need to adjust your insulin dose or take a different type of insulin when you are ill. If you have a fever, you may need more insulin that usual. Even if your appetite is poor, your blood sugar may be normal or high. Your diabetes team may have recommended a sick day regime which you should follow.

You always need to take insulin

You should never be afraid to call your diabetes team for help. Always call if you are vomiting or have a severe stomachache. Remember that taking care of your diabetes is only one part of handling illness. You may need to see a doctor for medication, such as antibiotics, or other treatment. Your diabetes team is there to help!