Nottingham Diabetes - Sick Day Rules (Printable version)

Sick Day Rules

During illness or infection your blood glucose often rises even though you are not eating.

Never stop taking your insulin or tablets.
Don't guess - test.

Also test urine for ketones if possible

If you stop or reduce your medication your diabetes may go seriously out of control. Never stop taking your insulin or tablets.

If you cannot eat, substitute meals with simple foods like:

Soup and bread

Milk pudding, custard or small measure of ice cream

Breakfast cereal and milk

Fruit yoghurt

Dietary supplement, e.g. Complan or Build-up

If you can only manage fluids, sip one of the following every two hours:

1/2 glass lucozade

1 glass ordinary lemonade

1 glass fruit juice

It is important to drink at least 5 pints of fluids per day. Make this up with sugar free drinks or water.

Test your urine or blood for glucose four times a day. If your tests are high in glucose and you are feeling ill, especially if you are vomiting get help immediately.

Ring the Diabetes Centre for advice during office hours:
(Monday - Friday 9am - 4.30pm)

City Hospital (0115 9627621)

Queen's Medical Centre campus (0115 9709215)

IF YOU ARE ON INSULIN, A GUIDE TO HOW TO ADJUST YOUR DOSES WHEN YOU ARE ILL IS GIVEN BELOW

During illness or infection your blood glucose often rises even though you are not eating.

Measure your blood glucose at least four times a day: before breakfast, lunch, evening meal and at bedtime even though you don't feel like eating.

Continue your normal dose of insulin, but at each of your blood tests if blood glucose is:

1	below 10mmol/l	Take usual dose of insulin

2	between 10 and 15 mmol/l	Take 6 extra units of quick acting insulin

3	3 between 15 and 20 mmol/l	Take 8 extra units of quick acting insulin

4	4 more than 20mmol/l	Take 10 extra units of quick acting insulin

These figures are a guide only. If normally on large doses you may need more insulin than stated.

Remember - the presence of moderate to large amounts of Ketones means that your diabetes may be going seriously out of control.

If unwell and your blood glucose is more than 20mmol/l on more than two consecutive tests or you are vomiting or you have moderate/large amount of ketones or you don't know what to do seek medical advice now.

Ring the Diabetes Centre for advice during office hours:
(Monday - Friday 9am - 4.30pm)

City Hospital (0115 9627621)

Queen's Medical Centre campus (0115 9709215)

Out of hours please contact your GP.