Diabetes Sick Day: How to Manage Being Sick With Diabetes
Sickness is a part of life. From time to time, everyone comes down with something, whether it’s a runny nose or a more intrusive infection. Luckily, the human body is equipped to handle these invaders, but depending on your general state of health, it can take some more time and effort to get back to your normal self.
Diabetes brings an extra challenge to the table. When your body is fighting an illness, your metabolism — which is already compromised by insulin resistance — can suffer, setting your blood sugar off balance. Your regular diabetes management techniques could fall short, leaving your body in a vulnerable state.
It’s important for every diabetic to know the dangers that come with illness, and how to sidestep serious complications from the very start. A few smart adjustments and close attention to symptoms can help you cope with the illness without a visit to the emergency room.
A Dangerous Chain Reaction
When you get sick, your body reacts to that stress by releasing various compounds. Under normal circumstances, these defenses fight off the disease with few side effects. The same process occurs in diabetics, but diabetes makes those side effects much more difficult for your body to manage:
- Infection triggers a hormone response. When your body recognizes a foreign invader, it releases a hormone called glucagon. Glucagon can fight off the invading organism, but it will also raise your blood sugar level.
- Hormones raise blood sugar and interfere with insulin. As your blood sugar and body temperature soar, your insulin loses its effect — another side effect of glucagon. Taking the same amount of insulin will no longer keep your blood sugar in a healthy range.
- High blood sugar quickly leads to more problems. The process of hormone-release, blood sugar spike, and insulin interference is quick, and that can bring on symptoms of hyperglycemia very soon. Unfortunately, the danger doesn’t stop there — life-threatening situations can develop in a matter of hours.
Complications to Watch out For
The stress of illness and the chain of events that follows can set the stage for two serious diabetic conditions:
Ketoacidosis
When your body can’t produce enough insulin to balance blood glucose levels, you may accumulate blood acids called ketones. Once this process is underway, diabetic ketoacidosis can develop within 24 hours. Although this syndrome is more common in type 1 diabetics, it can also occur with type 2 diabetes.
Ketoacidosis brings an array of uncomfortable symptoms. From nausea to weakness and confusion, the full-body discomfort can be severe.
However, there are also some very specific symptoms, major red flags that your diabetes is out of control: excessive thirst, frequent urination, and fruity-scented breath are some of the most common.
HHNS
In the very worst case, you could develop hyperosmolar hyperglycemic nonketotic syndrome (HHNS). This is when your body tries to rid itself of the extra sugar through your urine.
You’ll begin to urinate more and more, and eventually, you’ll become severely dehydrated. Seizures follow, and if you don’t get treatment soon, coma and death.
The good news is HHNS is relatively rare (it occurs most often in older type 2 diabetics), and is very preventable. Good blood sugar control should be your top priority, and since even a simple virus can interfere with your diabetes, you may need to be more vigilant as the illness runs its course.
Making a Good Sick Day Plan
Monitoring your blood glucose is your top priority until you kick the sickness. You should be taking measurements every few hours in order to catch a glucose spike before it spirals out of control. If your blood glucose level is higher than 240 despite taking extra insulin, it’s time to contact your medical team.
However, if your blood glucose level isn’t in the danger zone, there is plenty you can do at home to manage your illness and your diabetes simultaneously.
Making a Good Sick Day Plan
By creating a “sick day plan" ahead of time, you’ll know exactly what to do when trouble arises.
Here are some important elements to consider when drawing up your plan:
Specific Instructions
It’s easy to jot down general guidelines, thinking you’ll remember the details when the time comes. Unfortunately, that’s rarely the case.
Give yourself an advantage by detailing the symptoms to look for, the measurements to consider, and the precise steps to follow should you come down with an illness.
If you have type 1 diabetes, know when to test your urine for ketones (some type 2 diabetics may need to do this as well). It’s also a good idea remind yourself on paper to check your temperature regularly, and to eat carbohydrates every three to four hours.
What to Take and What to Avoid
You may need to take a larger dose of insulin when you’re sick. Ask your doctor exactly how much extra to take, and keep taking it even if you can’t keep food down.
As for cold and flu medications, not every product is created equal: ask your doctor which brands are sugar-free (and so won’t interfere with your blood sugar), and which ones could lower your blood sugar too much (like aspirin and some antibiotics).
How to Eat to Help Your Body Recover
Do your best to stick to your regular menu plan — as long as your body allows. Fever, vomiting or diarrhea calls for extra fluids, especially water and maybe some other non-caloric drinks.
If you can’t keep food down, opt for liquids that have carbohydrates: juice, broth, electrolyte drinks, and if your tummy can handle them, yogurt drinks. Remind yourself of this on your sick day plan.
When to Call Your Doctor or an Ambulance
A little extra rest, relaxation and hydration can go a long way — in many cases, a stretch of good self-care will get you back in good health shortly. However, diabetes can make any illness much more unpredictable, so prepare for the worst (while you hope for the best).
Know when signs and symptoms require medical intervention, and mark these in your sick day plan:
- Temperature over 101 F
- Vomiting or diarrhea lasting more than six hours
- Symptoms of ketoacidosis or dehydration, like chest pain, very dry mouth and cracked lips, trouble breathing, and breath that smells fruity
- Confusion, vision problems, or weakness on one side of your body
- You don’t feel in control of your illness
Never take chances with your health when diabetes is involved. If you leave dangerous symptoms for too long, HHNS could be right around the corner, and that will make things much more complicated. If you begin to feel worse, drink a big glass of water each hour and monitor your symptoms; if that doesn’t help, call your doctor for advice on what to do next.