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Sick Day Guidelines When You Have Type 2 Diabetes HF#4307

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Any type of illness can raise blood sugar.  You may think that your blood sugar will be low because you are not able to eat or drink.  When you’re sick, stress hormones are produced in the body, which raise blood sugar. Therefore, your blood sugar level may be high when you are ill even without eating. Blood sugar levels may become hard to control.

 

Please review the causes of high blood sugars and warning signs and symptoms you may have.

 

 

Causes of High Blood Sugars

Any illness, infection, surgery

Missed or skipped insulin or diabetes oral medicine

Physical or emotional stress

Some medicines may increase the blood sugar levels

 

Warning Signs and Symptoms of High Blood Sugar

Increased thirst – your body needs extra fluids

Increased urination – your body’s way of getting rid of extra sugar

Fatigue – your body’s cells are not getting enough sugar or energy because you lack insulin.

Weight loss – your body is burning fat for energy.

Dehydration – due to increased urination, vomiting, diarrhea, and fever

 

Preventing High Blood Sugars When Sick

 

___ Monitor More Often: Check your blood sugar every two hours.

 

___ Adjust Medicines

           

      Oral Medicines:      If you are able to eat, you may continue taking your oral medicines for diabetes.  If you are not able to eat, stop taking the medicines until you feel better.

 

       Insulin:    You may need to take different doses of your insulin when you are sick.  This will depend on whether you are eating or not.  It will also vary by what type(s) of insulin you take.

 

 

Insulin

 

Always take your insulin, even if you are not able to eat your usual meal plan.  Your doses may change when you are sick.  See the tables below to learn more.

 

Guidelines When Not Eating

 

Types of Insulin You Take

Doses To Take When Sick and Not Eating

NPH
  • Take ½ dose of NPH

Lantus® (glargine)
  • Take usual dose of Lantus®

 

Detemir (Levemir®)

 
  • Take usual dose

Regular
  • Take Regular insulin every 4 hours using chart below after checking your blood sugar, even through the night.

Novolog®, Apidra®, or Humalog®
  • Take Novolog®, Apidra®, or Humalog insulin every 2 hours using the chart below after checking your blood sugar, even through the night.

Premixed Insulin (70/30, 50/50, or 75/25)
  • Take ½ of usual dose and call health care provider.

 

 

Guidelines When Eating

 

Take your usual dose(s) of basal insulin (NPH, Levemir®, or Lantus®).

 

Take  your usual dose of basal insulin (NPH, Levemir®, or Lantus®).  If you take Regular, Humalog®, Apirda®, or Novolog® to cover your meals, continue doing so.  Add extra insulin using the chart below if your blood sugars are 120 mg/dl or higher.

 

Correction Insulin Chart

 

Blood Sugar

Regular, Humalog®or Novolog®Insulin

Less than 120

no insulin, but recheck blood sugar in 2 hours

120 – 170

2 units

171 – 220

4 units

221 – 270

6 units

271—320

8 units

321 – 370

10 units

greater than 370

12 units and call doctor or health care provider

 

Nutrition Guidelines

 

Prevent dehydration

  • Drink water and other liquids.
  • Take small amounts of fluid every 10 minutes (8 ounces per hour is best).
  • With vomiting and diarrhea, your body loses electrolytes like potassium and sodium. Replace these losses with bouillon, soups, sports drinks, and juices.

If you cannot eat your normal meals, replace carbohydrates with foods that have sugar.

  • Non-diet soda
  • Jell-O® 
  • Pudding
  • Juices
  • Popsicles
  • Sports drinks
  • Cooked cereals
  • Soups or bouillon
  • Crackers or toast
  • Sherbet or ice cream

Hint: Sodas that are warm and flat are better tolerated than cold, carbonated sodas. 

 

 

When To Call Your Health Care Provider

 

If you are not able to control your blood sugar, call your health care team. When you call, be ready to tell us:

  • How long you have been sick
  • Current symptoms
  • Blood sugar levels
  • What you have been able to eat and drink
  • Your temperature (whether or not you have a fever)
  • Name and dose of insulin(s) and/or oral diabetes medicine

 

Health Care Provider’s Name & Telephone Number

 

__________________________________________________

 

Discuss with your health care team what to do when they are not available and when to use the Emergency Room.

 

The Spanish version of this Health Facts for You is #7151. 

 



The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.

Last Updated: 02/08/2011

Copyright © 04/16/2010 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#4307

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