Lesson #6

In sickness and in health

It is important to take good care of yourself and to continue to manage your diabetes when you are sick — when you have a cold, flu, infection or other illness.

When you are sick, you should take the following steps immediately:

• Tell your doctor that you are sick.
• Test your blood sugar every 2 to 4 hours and write down the results of the test.
• Keep taking your diabetes medicine.

Even if you can't keep food down, you still need to take your insulin. If you're taking diabetes pills, you may have to switch to insulin instead. Here are some tips to help you take your medicine and eat when you are sick.

• If your blood sugar is too high, drink plenty of non-sugary fluids such as water, caffeine-free tea, sugar-free ginger ale, or broth. In this case, try to avoid sugar-sweetened soda and fruit juices.

• If you can't eat your usual food try eating crackers, Jell-O, popsicles, or soup.

• If you can't keep food down at all, however, you need to drink something that has sugar, such as ginger ale.

• If you have trouble keeping food down, your blood sugar levels will consequently be lower. Therefore, your insulin requirements may be different. You should consult your physician about dosage when you cannot keep food down.

Testing your urine for ketones will help you monitor your diabetes when you are sick. You should test your urine every four hours when you are sick. If your results indicate moderate to large amounts of ketones, you should contact your doctor right away.

If you have type1 diabetes, you should check your blood sugar every 3 to 4 hours and test your urine every 3 to 4 hours. If you have type 2 diabetes, you should test your blood sugar every 6 hours and test your urine if your blood sugar is over 240. You should also test your urine for ketones when:

• Your blood sugar is over 240.
• You can't keep food or drink down.
• You are losing weight.

What should you do with the test results? If your results show small amounts of ketones in your urine, you should drink a glass of water every hour and continue to test your blood sugar and ketones every 3 to 4 hours. If there's no decrease in the amount of ketones, you should call your doctor immediately.

If you notice any of the following symptoms, you should contact your doctor or seek medical care RIGHT AWAY:

• If you've been sick for 2 days and are not getting better.
• Your blood sugar is over 300 for two tests in a row.
• You find large amounts ketones in your urine.
• You can't keep fluid down for more than 6 hours.
• You feel sleepier than usual.
• You have trouble breathing, chest pain, and fruity breath.
• You can't think clearly.
• You throw up more than once.
• You have diarrhea for more than 6 hours.
• You have an infection.
• You have a dry tongue and cracked lips.

If you have to go to the hospital or emergency room, remember to tell the doctors and nurses right away that you have diabetes so they can administer care quickly. They should also notify your doctor.

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