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Lifestyle ... For Good Health

Nine Tips to Help Diabetics Stay in Good Control During an Illness

from Johns Hopkins Health Alerts

People with diabetes must be especially careful when suffering from an illness like a cold or the flu.

Not only does illness affect your eating, sleeping and exercise habits -- which are closely linked to blood glucose control -- but it may also cause the liver to release more glucose into the bloodstream.

At the same time, an illness decreases the sensitivity of cells to insulin and makes it more difficult for them to remove glucose from the bloodstream.

To minimize fluctuations in blood glucose levels, follow these sick-day precautions.

  • Inform your health care professional when you become sick. This precaution is particularly important if you are unable to eat regular foods, have diarrhea or vomiting for more than six hours, or have had a fever that has not improved for a couple of days.
  • Follow the treatment plan for the sickness. For example, take any necessary medications, such as antibiotics for an infection, according to schedule. If a doctor you have never seen before treats you, make sure he or she is aware of your diabetes.
  • Test blood glucose levels more often than usual. If you have type 1 diabetes, test levels of blood glucose and urine ketones every four hours, even during the night. If you have type 2 diabetes, testing blood glucose levels four times during the day is probably enough. Call your health care professional if blood glucose levels are consistently below 80 mg/dL or above 250 mg/dL.
  • Take your diabetes medication as usual, unless, of course, your health professional advises otherwise.
  • If you use insulin, keep a vial of rapid- or very rapid-acting insulin handy. You should take this precaution even if you do not take these types of insulin regularly.
  • Watch for any symptoms of dehydration, ketoacidosis or hyperosmolar nonketotic state. The symptoms of dehydration include dry mouth, cracked lips and dry or flushed skin. Ketoacidosis symptoms include nausea, vomiting and lack of appetite, while hyperosmolar nonketotic state is characterized by increased hunger, nausea or stomach pain. The most dangerous manifestations of both ketoacidosis and hyperosmolar nonketotic state are confusion and sleepiness that may lead to coma and possibly even death. Seek urgent medical care if these symptoms occur.
  • Prevent dehydration by drinking plenty of liquids. You should consume at least one large (8 oz.) glass of clear fluid each hour while awake -- water, tea, broth or other sugar-free beverages.
  • Try to consume a normal amount of carbohydrates. Eating many small portions throughout the day may help. Eat easy-to-digest foods such as gelatin, crackers, soup and applesauce.
  • Rest as much as possible. If necessary, get someone -- such as a family member or friend -- to help care for you.

This information is not intended to substitute for the advice of a physician. Click here for additional information.

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