Be Prepared
Items to keep in your medicine chest for an emergency:
• aspirin, Tylenol
• Milk of Magnesia
• liquid antacid for heartburn or stomach upset
• paregoric for diarrhea
• rectal suppositories for vomiting
• cough syrup without sugar or alcohol
• throat lozenge without sugar
• thermometer
What is a sick day
Diabetes may be more difficult to control when you are ill. Sick means your blood sugar may be up when you have a cold, flu, a fever (temperature), an infection (toothache, urinary, vaginal), diarrhea (watery stool), vomiting (throwing up) or nausea. All may require a change in your daily routine.
Always plan ahead, ask your doctors what they want you to do when these things occur.
Remember, when you have elevated blood sugar you may have physical signs. These may include increased thirst and urination, weakness, blurry vision and nausea.
The basic check list for sick day:
• Check blood sugar and ketones (occur when blood sugar is high and fat is burned for energy) every 2 -4 hours. Ketones are usually produced with Type 1 and checked by a urine test.
• Check temperature at least every 4 hours.
• Continue taking your insulin and or oral medications; even if you can’t eat. Check with your doctor.
To prevent dehydration from diarrhea or vomiting drink at least 8 oz (1 cup) of fluid every hour. If vomiting- sip 1 oz of fluid every 10 minutes. Signs of dehydration may include dry mouth, thirst, dry parched skin or decreased urination. To replace the electrolytes (calcium, sodium and potassium) you have lost you may want to try broth, Gatorade® or juice.
Try eating or drinking 45- 50 grams of carbohydrates every 3 - 4 hours to prevent low blood sugar.
If your blood sugar is 250 mg/dl or higher and you are producing moderate to large amounts of ketones you need to limit your activity until you are back to normal.
Sometimes when you are sick, you will be using products that contain sugar, that’s OK. It may be a good idea to have these products available for this occasion.
Time to call the doctor when:
• blood sugar is over 250 for more than 6 hours
• ketones are elevated for more than 6 hours
• you are unable to eat normally for 24 hours
• unable to keep fluids down for 4 hours
• you have a fever over 101
• you are ill more than 24 hours
• you are dehydrated, have severe abdominal pain or other unexplained symptoms
• breathing problems
• change in mental status
When you call the doctor, have the test results ready, as well as a list of your symptoms and whether you are eating or voiding. If you can’t reach your doctor, go to the emergency room.
What to eat when your sick:
Stage 1
Symptoms: general sick feeling - heavy or spicy foods are upsetting
Foods to eat: follow general meal plan (avoid spicy or high fat foods) eat easy to digest foods
Frequency: eat at regular times
Stage 2
Symptoms: limited appetite but can eat small meals, sluggish, slight fever
Foods to eat: follow general meal plan but eat small more frequent meals
milk, eggnog, yogurt, custard, ice cream, sherbet, bread, cooked cereal, mashed potatoes, saltines, vanilla wafers, soup, applesauce, 1/3 cup apple, grape, prune juice, 1/2 cup orange, grapefruit, banana, Popsickle®, soda
Frequency: 5 times a day ( don’t worry about fat or protein), drink water, for liquids
Stage 3
Symptoms: fever, tired, occasional diarrhea, little or no appetite
Foods to eat: cream soup, plain yogurt, Popsickle, banana, ice cream, mashed potato, fruit flavored gelatin, juice, broth, regular soft drink
Frequency: take 1/2 to 1 cup of food or drink every 1 -2 hours, if have a fever sip unsweetened liquids every 10-15 minutes along with the above
Stage 4
Symptoms: severe nausea, vomiting, diarrhea, or fever
Foods to eat: orange juice, grapefruit juice, tomato juice, soup, broth, soda, Gatorade
Frequency: sip a tablespoon every 10 -15 minuites. If you can’t tolerate these amounts, call your doctor.
