Diabetes White Papers

Sick-day Management is the second in our series of white papers designed to provide you with the information that you need to better understand Diabetes.

Spring is in the air, and so are viruses

What people with diabetes need to know about sick-day management .

For most people, getting a cold or the flu or even a stomach virus is just an inconvenience. For someone with diabetes these illnesses can be life threatening. The good news is, they don't have to be. If you or someone you know has diabetes, make sure they know how to manage sick days. If you want to be a really good friend to yourself or someone else, make a copy of the article, SICK-DAY SUPPLIES Make Sure You're Prepared: by Margaret J. Holfacker, RN, BSN, CDE Diabetes Self-Management, November/December 2003 and give it to them. Better yet, make a sick day cabinet or box and put this article inside so it will always be there when you need it. Here are just of few of the things this article suggests you should do.

What is the concern about sickness and diabetes?

When a body becomes ill the body sees this illness as a stress. Any stress on our body releases stress hormones. These hormones, like epinephrine norepinephrine, cortisol, growth hormone and glucagon, provide the body with the extra energy it needs to heal itself by stimulating the liver to release extra glucose into the bloodstream. This is not a problem for a person that does not have diabetes, because the pancreas compensates for this extra glucose and your blood glucose level remains pretty constant so you can concentrate on sleeping or getting better. This is not as simple for a person with diabetes. Any fluctuation in blood sugar means extra work and preparation. Unfortunately, there are many people with diabetes that do not know or understand the effect illness or stress may have on their blood sugar control and things go terribly wrong. A stomach virus or flu can end up being a hospital admission.

 What should you do?

Be prepared. There is nothing worse than having to get out of bed, get dressed and go to the store because you are out of test strips, insulin, pills, tylenol or sugar free cough syrup or sugar containing foods. That's right sugar containing foods. For those times when you are just too nauseous to eat, or you have diarrhea and everything seems to be going right through you. Your doctor or educator will be able to advise on how much sugar containing foods you will need and how often you will need to eat or drink them. This will help provide your body with the energy source (glucose) it needs as fuel as well as the energy to repair itself and also maintain blood sugar levels. Many people make the mistake of stopping their diabetes medication, like their pills or insulin. They don't understand the effect of those stress hormones on blood sugar. For many people they will need to continue their diabetes medication or they may need to increase their medication for this time of illness. The first thing you should do is call your doctor. Tell him that you are sick and what your blood sugars have been. Next, monitor your blood sugars more frequently during this time of illness than you usually do. Every two hours may be necessary. More or less frequent depending on the illness. For example, after surgery may require more frequency and a cold not as frequent.

The next thing you should do is put together a sick box or cupboard. This is a special place that you keep all your sick day supplies. Just remember to keep these items current. There is nothing worse than doing all this work, planning and preparing and the day you finally need these things your strips are outdated or your crackers are stale. So check on it once in awhile.

What are some of the things to keep in this sick day box?

•  List of important telephone numbers: your health-care provider, pharmacy, insulin pump manufacturer, podiatrist, dentist, hospital, local emergency services, police, medical insurance company, relatives or friends you can call.

•  Pen and paper. It is important to record information you may need to report to as well as get from your health-care provider.

•  Thermometer, tissues, hand sanitizer (very helpful for those times you can't get up to wash your hands after sneezing and yet you want to wash your hands before you check your blood sugar). An 8 ounce measuring cup (this is needed to make sure that you are drinking 8 ounces of fluid every hour to prevent dehydration. This fluid may or may not contain sugar depending on your illness and your blood sugar control. Let your health-care provider advise you. Also don't forget a can opener. If you're unlucky enough to get sick during an electrical failure, a manual can opener can come in handy to open any canned foods you have planned for this time. Nothing should stand in the way of you health and safety.

•  Diabetes Supplies: This should be a back-up supply of your diabetes supplies. For example put a jar of test strips, ketone test strips, glucose tablets, syringes, insulin pump supplies, and glucagon. Glucagon is usually advised for people who inject insulin. It can be used as an emergency treatment for a low blood sugar when a person is unable to ingest food or drinks. If you use insulin, be sure to inform the people you live with or a neighbor who checks on you on how to administer glucagon and where it is stored prior to any emergency. Keep a copy of the instructions on how to prepare you glucagon injection in you sick-day box.

So get started and plan for the unexpected. I sure hope you will never need to use it. But as we all know, NEVER say NEVER!!

Good Luck

Lucille Hughes RN, CDE

Director, Diabetes Education Center

Long Beach Medical Center

For more information: American Diabetes Association web site: w ww.diabetes.org

Click here for a printable version of this article.