Wednesday , December 19 2018
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Sick Days Guidelines Diabetes

DIABETES SICK DAY MANAGEMENT GUIDELINES

Managing diabetes is a challenge every day. We want to make managing diabetes easier. Having diabetes does not mean you are likely to fall ill more often than anyone else. However, there are some precautions you should take. Person should have individualized plan of care prescribed by the health care team to use during illness. Monitoring is an essential part of diabetes management, but this even more vital during the stress of illness.

  • Self-Monitoring of Blood Glucose Level – It is important to self monitor blood glucose levels more frequently during illness, often every 2 to 4 hours. If pre-meal blood glucose values stay greater than 250 mg/dl, then test for urine ketones and contact your health care provider
  • Ketones– Urine Ketones should be monitored when you feel sick or when blood glucose level is greater than 250 mg/dl. Test for ketones every 2 to 4 hours.
  • Insulin – Do not stop taking insulin, even if you are vomiting and unable to to eat. Additional regular insulin may be required, based on self-monitored blood glucose levels.
  • Nutrition/Fluids – Adequate fluid intake and carbohydrates are essential during illness. Eating 10 to 15 grams of carbohydrate every 1 to 2 hours small quantities of fluid every 15 to 30 minutes is usually sufficient to prevent dehydration and ketoacidosis. Clear broth, tea and ice chips are usually well tolerated.
  • Do not miss your meals
  • If appetite is poor take light and easy to digest foods like rice/juice/khichadi
  • Foods and beverages containing about 15 grams of carbohydrate are as follows-
    • 1 regular whole Popsicle
    • 1/2 cup apple sauce
    • 3/4 cup regular soft drink
    • 1/2 cup ginger ale
    • 1/2 cup orange juice or apple juice
    • 1     cup gatorade
    • 1/2 cup regular gelatin

When you notify your health care provider

  • Illness that persists more than 24 hours
  • Severe abdominal pain
  • Temperature greater than 1000 F, oral
  • Persistent diarrhea
  • Persistent ketones or large ketones
  • Vomiting with inability to consume fluids for more than 4 hours
  • Blood glucose levels difficult to control or moderate to high levels of ketones in urine
  • Shortness of breath or chest pain
  • Acute visual loss
  • Blood glucose levels are low
  • Blood sugar levls are very high
  • If you become drowsy and confused
  • Other unexplained problems
  • If you are worried