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Sick Day Rules For Type 1 Diabetes

Coping when you are Ill

Treated With Multiple Daily Injections

It is very important that you know what to do when you are ill. We refer to this as "sick day rules".

Remember - Never stop taking your insulin.

When you are ill your body becomes much more resistant to the insulin you produce or take by injection. This means your blood glucose levels can raise. You therefore need to monitor your blood glucose and ketone levels and decide if you need more insulin. It is likely that you will need to increase your insulin dose (see flow chart for guidance).

Although you may not feel like it, it is very important to monitor your diabetes closely to prevent diabetic ketoacidosis developing.

We divide the sick day rules into those for:

Minor illness- where blood glucose may be within normal range or raised but ketones remain negative ( e.g. minor viral infection or minor injury)

and those for

Severe illness- where blood glucose is raised and ketones are present ( e.g. chest infection or high temperature). For advice on how to manage either of these conditions, see over.

Tips for staying safe during Illness:

  • If you are vomiting, you do not need to eat until you feel well enough to try, but keep sipping fluids to prevent dehydration.
  • If you not feel like eating normal meals, try to eat foods that are easy to digest, e.g. soup, ice-cream, milk, puddings.
  • If your blood glucose falls below the normal range, sip sugary drinks eg fruit juice, sweetened tea, lucozade or ice lollies.
  • Adjusting you insulin doses will help to control blood glucose levels (see guidance in the flow charts below)
  • If you have an infection that is not resolving, you should make an appointment to see your GP to determine whether you need further treatment.
  • If you continue to vomit, are unable to keep fluids down, and/ or cannot manage to reduce your blood glucose or ketone levels you must contact the hospital as an emergency.

For information on the Feeling Unwell Flowchart read the Flow Chart Page

For information on Interpretation of ketones during illness read the Ketones Page

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