sick day rules?

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bev

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Hi all!

Sorry i havent been on for a few days - i have joined a childrens site - thanks to adrienne - but i will be back to this one as i would miss you all!

Anyway, i have heard a few people talking about 'sick day rules'? Can you tell me what these are - luckily Alex hasnt been sick yet so i havent had to deal with it!🙂
 
My understanding of 'sick day rules' is that if the blood sugars are going up, and the insulin doesn't seem to be doing any good, that implies there is an illness brewing that has yet to be felt but the body can already feel. It is the illness stopping the sugars in the blood getting into the cells. So you have to increase the dosage of insulin to counter the raised blood sugar levels. My DSN told me to add 4 extra units of insulin at mealtimes if my blood sugar is above 13 mmol but below 22 mmol. So if I normally take 7 units for a meal I'd take 11 units. Then if my blood sugar levels are above 22 mmol then I take an extra 8 units. If my blood sugar is below 13 mmol however, I don't add any extra units.

Thankfully I've never had to use 'sick day rules' but that day will come.
 
The sick day rules as taught on DAFNE involve some common sense (check blood sugar every 2-4 hours, check ketones, drink sugar free liquids (NOT lucozade as this makes blood sugars shoot up). There is also an element of calculation and taking percentages of daily insulin dose in addition to your usual ratio if eating, and ALWAYS taking background insulin. The percentages they suggest may seem daunting to some people and it is best to only try and do this if you have had it explained preferably on an education course. I would say even then, it is best to be in contact with your diabetes team if you are not totally confident. It is really tough managing your blood sugars when you are ill and not feeling up to calculating and checking. Some people are nervous about taking lots of insulin if they are not eating but it is necessary.
 
Sick day rules were never taught to me properly, but I was told to never stop my insulin. For me I just approach each illness as it comes and act accordingly. Sometimes when I'm ill I get lots of hypos, others I am high.
 
sofaraway said:
Sick day rules were never taught to me properly, but I was told to never stop my insulin. For me I just approach each illness as it comes and act accordingly. Sometimes when I'm ill I get lots of hypos, others I am high.
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Interesting - I've been getting quite a few hypos lately and have started with a sore throat. I thought 'I can't be ill, I'm having hypos!', now I see it's possible!
 
Yeah it does happen to me, and my DSN said although it's not the usual way but it's possible as you are buring up more glucose fighting the illness. Havne't worked out yet which types of illness make me high and which low yet.
 
Thanks to all!

Hopefully Alex wont have too many sick days - but if he does then at least i wont panic now - and i now understand why you have to keep up with the insulin!🙂Bev
 
Sick Day Rules

Never stop taking your insulin
Test Your BG 2 hourly
Test for Ketones
Drink plenty of fluids (water, sugar free drinks)
Rest (no strenuous exercise)
Eat regualr meals if you are able, if not have meal replacement drinks such as milk, ice-cream, fruit juice and other non diet drinks

This is the list i was given, hope its of help :D
 
I'm another one who goes low when unwell.
Mine is due to lack of cortisol. So if I become unwell I lower my insulin and eat steroids 🙄 It hasn't made me bionic yet though.
 
I too tend to go low when I'm ill. Having done dafne I follow the dafne sick day rules but as my sugars rarely increase I tend to not have to change much when I'm ill. I've only (apart from diagnosis) had ketones once and that was with gastroenteritis which makes a lot of sense. I was in France at the time and had to call the doctor to the hotel who prescribed me more medication than I've ever seen in my life! So pleased I had insurance!
 
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