Sick day rules

[everydayupsanddowns]

Thought these might be helpful... Always good to know what to do in times of illness.

Type 1 / LADA

Sickday rules pdf

Sick day rules flowchart from Leicester diabetes centre. Particularly useful for people with Type 1 Diabetes during the Coronavirus outbreak.

www.t1resources.uk

Type 2

Sick day rules - type 2 diabetes – GPnotebook

An article from the diabetes and endocrinology section of GPnotebook: Sick day rules - type 2 diabetes.

gpnotebook.com

General good advice and things to bear in mind

Diabetes when you're unwell

It's important to know how to manage your diabetes when you're ill. Some people will know this as diabetes sick day rules. You'll need to know how to manage your insulin doses and other diabetes medications, as well as monitoring your blood glucose (sugar) and ketone levels along with diet. This...

www.diabetes.org.uk

Please note! These are suggestions and general principles only not medical advice. Call NHS 111 for more specific advice, and if in any doubt contact your GP, DSN or Clinic.

 

[Neens]

At my HbA1c* review I asked my DN.
She said if you have symptoms call 111 and follow advice. If you have fever call 111 but obviously state diabetic/high risk/ under lying health issue and at that point you would be more likely to be taken to hospital for recovery rather than self isolation.

* https://forum.diabetes.org.uk/boards/threads/hba1c-results-happy.85645/

 

[Deleted member 25429]

Thought these might be helpful... Always good to know what to do in times of illness.

Type 1 / LADA

Sickday rules pdf

Sick day rules flowchart from Leicester diabetes centre. Particularly useful for people with Type 1 Diabetes during the Coronavirus outbreak.

www.t1resources.uk

Type 2

Sick day rules - type 2 diabetes – GPnotebook

An article from the diabetes and endocrinology section of GPnotebook: Sick day rules - type 2 diabetes.

gpnotebook.com

General good advice and things to bear in mind

Diabetes when you're unwell

It's important to know how to manage your diabetes when you're ill. Some people will know this as diabetes sick day rules. You'll need to know how to manage your insulin doses and other diabetes medications, as well as monitoring your blood glucose (sugar) and ketone levels along with diet. This...

www.diabetes.org.uk

Please note! These are suggestions and general principles only not medical advice. Call NHS 111 for more specific advice, and if in any doubt contact your GP, DSN or Clinic.

Thanks for posting this I was only diagnosed type 1 last year and what has worried me is sick days as I haven’t had to deal with this yet . My employer has banned me from the office so working from home for the next few weeks . Going to miss the banter and don’t like being classed as vulnerable. At least they are showing a caring side

 

[trophywench]

Going to miss the banter and don’t like being classed as vulnerable. At least they are showing a caring side

I know exactly what you mean there, it grates, doesn't it? But of course, we are a bit! Have they done that for anyone will eg asthma or heart issues too? - cos I'd think they are more at risk than you are! Not saying 'us' cos I've been retired 20 years so more at risk for just being flippin old without owt else. And that can be and is, equally personally annoying!

 

[Deleted member 25429]

I know exactly what you mean there, it grates, doesn't it? But of course, we are a bit! Have they done that for anyone will eg asthma or heart issues too? - cos I'd think they are more at risk than you are! Not saying 'us' cos I've been retired 20 years so more at risk for just being flippin old without owt else. And that can be and is, equally personally annoying!

Thank you so much for understanding. I do try every day to make sure it doesn’t affect the way I live my life but sometimes I suppose I have to give in and accept that it does .

 

[Grannylorraine]

Thanks for posting this I was only diagnosed type 1 last year and what has worried me is sick days as I haven’t had to deal with this yet . My employer has banned me from the office so working from home for the next few weeks . Going to miss the banter and don’t like being classed as vulnerable. At least they are showing a caring side

I am pleased your employer has take this sensible option. I am in the total opposite situation, the team I work with have all been given special permission to work from home by our manager, I on the other hand have not been included in this special measures, despite being able to work from home, I emailed my boss (he is in Germany), to ask whether I had just been left off as an oversight, or should I continue to go into the office, pointing out that I am an asthma and diabetes, he has totally ignore me, and I feel angry that the man that sits next to me, the men that sit on the next 4 desks to me can all work for home, yet until I am told otherwise the only diabetic in the team is having to go in to the office. I know I might not catch the virus.

I am pleased that at least some employers are caring, so your boss and company get a gold star from me. While mine gets a big thumbs down. Sorry for my rant but I was really upset yesterday and the guys who can all work from home today, said to me I don't understand why you are getting so upset, there is no reason to panic. I will at this point say we work in a huge open plan office of about 300 people, so could still be lots of people in the office.

@everydayupsanddowns thanks for posting these sick rules for us all.

 

[SB2015]

Thanks for posting this Mike.
Good to flag them up just in case.

 

[trophywench]

Leading question, cos I dunno who else to ask (not having a pet doctor in the house)

You know how just sickening for various lurgies causes a lot of diabetics to have higher BG for a few days before they actually come down with whatever they were sickening for - is this something that would be likely to happen with 'this lot'? Some spokesman over the last days/weeks said on TV when describing what it does to the body, which sounded informed and I was listening cos it was when still in 'only' China so new News said whilst affecting lungs and hearts, there was always a lot of inflammation present with it. I took this to mean internal inflammation rather than coming out in visible swellings.

Hence if it is what my interpretation told me - would it show in BG before we start the constant dry cough etc?

 

[Deleted member 25429]

I am pleased your employer has take this sensible option. I am in the total opposite situation, the team I work with have all been given special permission to work from home by our manager, I on the other hand have not been included in this special measures, despite being able to work from home, I emailed my boss (he is in Germany), to ask whether I had just been left off as an oversight, or should I continue to go into the office, pointing out that I am an asthma and diabetes, he has totally ignore me, and I feel angry that the man that sits next to me, the men that sit on the next 4 desks to me can all work for home, yet until I am told otherwise the only diabetic in the team is having to go in to the office. I know I might not catch the virus.

I am pleased that at least some employers are caring, so your boss and company get a gold star from me. While mine gets a big thumbs down. Sorry for my rant but I was really upset yesterday and the guys who can all work from home today, said to me I don't understand why you are getting so upset, there is no reason to panic. I will at this point say we work in a huge open plan office of about 300 people, so could still be lots of people in the office.

@everydayupsanddowns thanks for posting these sick rules for us all.

I work in our head office so it is a very busy office . It’s not all good as they still can’t give me a quiet clean room to go at lunchtime to inject . I don’t think people that aren’t diabetic realise what is like to live with it day to day . When first diagnosed I was scared to leave our office just in case something happened. My husbands company know I’m diabetic , they have told him to work from home to reduce his risk as well . I hope they appreciate your situation and allow you to work from home x

 

[Jimmy2202]

Thought these might be helpful... Always good to know what to do in times of illness.

Type 1 / LADA

Sickday rules pdf

Sick day rules flowchart from Leicester diabetes centre. Particularly useful for people with Type 1 Diabetes during the Coronavirus outbreak.

www.t1resources.uk

Type 2

Sick day rules - type 2 diabetes – GPnotebook

An article from the diabetes and endocrinology section of GPnotebook: Sick day rules - type 2 diabetes.

gpnotebook.com

General good advice and things to bear in mind

Diabetes when you're unwell

It's important to know how to manage your diabetes when you're ill. Some people will know this as diabetes sick day rules. You'll need to know how to manage your insulin doses and other diabetes medications, as well as monitoring your blood glucose (sugar) and ketone levels along with diet. This...

www.diabetes.org.uk

Please note! These are suggestions and general principles only not medical advice. Call NHS 111 for more specific advice, and if in any doubt contact your GP, DSN or Clinic.

These sick day rules posters are most helpful. I shall print this out and stick up on the fridge.
I have a question regarding sick day rules though:
When you have to inject 10% or 20% extra of your TDD when ketones are present, is this just when you eat food or inject when not eating food aswell?

 

[everydayupsanddowns]

I have a question regarding sick day rules though:
When you have to inject 10% or 20% extra of your TDD when ketones are present, is this just when you eat food or inject when not eating food aswell?

Well… I didn’t write the guideline / flowchart but the way I read it, it sounds like it is in addition to the insulin you are dosing for foods?

Might be worth comparing with other similar documents?

 

[trophywench]

Yes, it's extra.

 

[Amity Island]

These sick day rules posters are most helpful. I shall print this out and stick up on the fridge.
I have a question regarding sick day rules though:
When you have to inject 10% or 20% extra of your TDD when ketones are present, is this just when you eat food or inject when not eating food aswell?

Hi @Jimmy2202

The NHS guidelines (see attachment below) state the extra "sick day rules" insulin is to be taken every 2 hours, "plus" your regular bolus for eating meals. See page 2 yellow, flow chart 3rd row. Also states you should keep eating if possible.

 

[Jimmy2202]

Most helpful

Hi @Jimmy2202

The NHS guidelines (see attachment below) state the extra "sick day rules" insulin is to be taken every 2 hours, "plus" your regular bolus for eating meals. See page 2 yellow, flow chart 3rd row. Also states you should keep eating if possible.

most helpful thank you

 

[Lucyr]

Can you follow the sick day rules when not “sick”. I’ve been feeling a bit off ( head feels a bit weird, nauseous but no particular illness eg cold or whatever) and high blood sugars (13-20) not coming down with normal mealtime corrections. I did get a notification last night of close contact with covid but my lateral flow test was negative. Did have a PCR last night just in case.

 

[PattiEvans]

Have you got the result of the PCR test yet Lucy?

 

[Lucyr]

Have you got the result of the PCR test yet Lucy?

I haven’t had the PCR results but two lateral flows were negative and don’t have any symptoms so don’t think I have Covid at the moment, though I’m concerned that my BGs say it’s brewing.

On the day of contact I was out in the town but everything I did (met a friend for lunch, boat trip, walk) were outside other than the bus there and back. It doesn’t tell you a time so not sure if the contact was outside or inside.

 

[Thebearcametoo]

Can you follow the sick day rules when not “sick”. I’ve been feeling a bit off ( head feels a bit weird, nauseous but no particular illness eg cold or whatever) and high blood sugars (13-20) not coming down with normal mealtime corrections. I did get a notification last night of close contact with covid but my lateral flow test was negative. Did have a PCR last night just in case.

You need the insulin you need. Keep checking your ketones if you’re over 16 before meals (some people are getting ketones with covid even with BG of 10 so that can be an indicator too). I would do a cautious correction dose and see if that helps or look at increasing your basal for a few days depending on which basal you’re on (some are more flexible than others).

 

[Lucyr]

You need the insulin you need. Keep checking your ketones if you’re over 16 before meals (some people are getting ketones with covid even with BG of 10 so that can be an indicator too). I would do a cautious correction dose and see if that helps or look at increasing your basal for a few days depending on which basal you’re on (some are more flexible than others).

That’s where I’ve got confused. The insulin I need is programmed into my expert meter but it isn’t working. I do have some ketones but not enough to cause me concern and am keeping an eye on those.

The part I’m stuck on is whether you can follow the sick day rules to increase insulin above your normal corrections, when you aren’t certain on whether your high bgs are caused by illness or not.

 

[trophywench]

Yes @Lucyr - certainly extra testing and myself, if 'normal' correction and/or bolus amounts aren't working for some unidentified reason - I just add extra myself and simply see what happens. You aren't by any means daft so I most likely don't need to tell you to add no more than 10% to any dose, nor to test test test having bolused more than the meter tells you to. If I'm anything over 10 to start with then a pound to a penny I'll need more than normal. (greater IR and all that jazz I assume)