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Things to do When You Are Sick

By Nina Nazor

Have an emergency tool kit

You should have an emergency tool kit at hand with some items you could need if you are sick like:

·  Your Diabetes Care Team telephone numbers

·  Antidiarrheal medications

·  Tylenol or Advil

·  Cough syrup (sugar free)

·  Cold medications

·  Antacids

·  Strips or tablets to measure ketones

·  If you use insulin, rapid acting insulin like Humalog or Novolog with syringes

·  Blood glucose monitoring supplies with new batteries

Read the label before you purchase or use any over-the-counter medication. If there is a warning that people with diabetes should check with their doctors before using the product, do so. Also, look for the inactive ingredients to make sure the medication does not contain sugar, corn syrup or any other source of carbohydrates. Try to have one of these kits at home and also at work or school.

Take your diabetes medications

If you take insulin, never omit your insulin, even if you can't eat. You may need additional insulin, or you may need to reduce the dose of insulin if your blood glucose is low or if you cannot eat or have diarrhea or vomiting. It all depends on your blood glucose levels, that’s why you must check your glucose frequently.

If you take pills, and you have vomit or diarrhea, you must be aware of signs of low blood glucose. The pills you took before getting sick keep working to lower your blood glucose even if you don't eat.

Test your blood sugar every 4 hours.

Your blood glucose can go up and also down suddenly, and you should be aware of too high or too low blood glucose levels. Stress caused by the illness can bring your blood glucose up while not eating enough, diarrhea or vomiting can bring it down. Your body knows there is an emergency, and your adrenal glands release adrenalin and cortisol which make your liver release glucose into your bloodstream, thus, making your blood glucose high.

Test your urine for ketones every 4 hours

If you have type 1 diabetes, test your urine for ketones every 4 hours. If ketones start going up, you can be in danger or developing ketoacidosis, which is a complication of diabetes caused by the buildup of by-products of fat metabolism (ketones), which occurs when glucose is not available as a fuel source for the body.

The symptoms of ketoacidosis are:

·  Frequent urination or frequent thirst for a day or more

·  Fatigue

·  Nausea and vomiting

·  Muscular stiffness or aching

·  Mental stupor that may progress to coma

·  Rapid deep breathing

·  Fruity breath (breath odor)

·  Headache

·  Decreased consciousness

·  Breathing - rapid

·  Breathing difficulty - lying down

·  Low blood pressure

·  Appetite - loss

·  Abdominal pain

Drink plenty of liquids and eat light foods

Avoiding dehydration is key when you are sick, it is even more important than eating. If you have diarrhea or vomiting, you must make sure you get adequate fluids. You need water and salts or electrolytes, so you can use sports beverages like Gatorade, fruit juices with water, milk or chicken broth. Try to be aware of the symptoms of dehydration like urinating less than normal and having dry mouth. Try to drink at least one cup of decaffeinated fluid every hour and according to your blood glucose levels, use fluids containing sugar or sugar free.

About food, do not force yourself to eat, if you can eat try to eat something like fresh fruit and vegetable soup, chicken noodle soup or anything light that will provide you with nutrients, fluids and electrolytes. Another food option are saltines or graham crackers, toast, frozen yogurt, ice cream or jell-o.

Rest. Do not exercise during an illness.

If you exercise when your blood glucose is high you might put more stress on your body causing your liver to release more glucose to the bloodstream and then you will have even higher blood glucose levels with all the consequences of hyperglycemia.

Also, the presence of ketones may cause blood sugar levels to rise even higher with exercise. So, if you are sick, rest!

Call your Diabetes Care Team

Call your doctor if:

·  You have an obvious infection with symptoms and fever

·  Your illness lasts longer than 2 days

·  You have vomiting or diarrhea more than 8 hours

·  Your blood sugar is over 400 mg in two consecutive tests

·  You have moderate to large urine ketones with a blood glucose

·  level over 200 mg for more than 8 hours

·  You feel very ill or experience pain, especially abdominal pain

·  You have extreme fatigue, shortness of breath, or dizziness

Try to plan ahead what to do if you are sick and discuss your plan with your Diabetes Team.