Living with Diabetes is challenging. You need to be a lot stricter with your lifestyle, and you also need to monitor your body a lot more closely. Everyone falls sick from time to time, and Diabetics need to watch out for a few special things to keep themselves safe while they recover!

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WHAT IS DIABETES?

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Diabetes is a metabolic disorder in which your body doesn't process dietary sugar normally, due to a relative or absolute deficiency of the hormone 'Insulin'. Read our article on Diabetes to learn more!

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SICK DAY PLAN

 

Everyone with Diabetes should have a ‘sick day’ plan. This plan tells you what you need to monitor when you are unwell, and when you need to seek medical attention.

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FOOD INTAKE

 

When you are unwell, your appetite may be poor, and this puts you at a higher risk of developing a dangerously low blood sugar level. You need to maintain your food intake to avoid this happening.

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It would be best to stick with a full, bland meal, such as porridge, or rice and soup, with a small portion of boiled lean meat. Avoid anything oily or spicy, since such foods may make you feel nauseous while you are sick.

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If you cannot stomach an entire meal, you should try to focus on maintaining your carbohydrate intake. Take some bread or biscuits instead. You should also keep your Glucometer handy, and check your blood sugar level if you feel giddy, or like you are going to faint. If your blood sugar level falls below 4 mmol/L, you are having a hypoglycaemic episode - quickly take in a sugary drink like 'Milo' malt milk, and pop down to see your doctor.

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HYDRATION

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Apart from food, it is very important to maintain your hydration! Make sure you drink adequate amounts of water through the day. If you get dehydrated, you may start to develop a metabolic imbalance and head towards a Diabetic coma with high sugar levels. You will also run the risk of injuring your kidneys if you become dehydrated.

 

You can aim for approximately 1.5 L of water, although you may have some restrictions on the amount of fluid you can drink if you have heart or kidney disease. Your doctor can tell you more based on your medical condition.

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MONITORING

 

As a Diabetic, your blood sugar levels may become unstable when you are unwell. They can either swing to become extremely low or extremely high. Both are dangerous. While you are unwell, you'll need to monitor your blood sugar levels very intensively.

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You should monitor your blood glucose levels roughly every 4 to 6 hours. 

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Your blood sugar levels should be:
- Prior to a meal, your fasted sugar readings should be between 4 to 7 mmol/L. 
- 2 hours after a meal, your blood sugar readings should be between 7.8 to 11 mmol/L.

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MEDICATIONS TO

WATCH OUT FOR

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There are some medications that can be dangerous for you when you are sick, especially if you have a bout of food poisoning or are not eating well while you are unwell.

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METFORMIN

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Many Diabetics are on a medication known as 'Metformin'. This medication has been around for ages, and is incredibly useful in managing Diabetes. However, it has been known to raise the levels of acid ions in your blood when you are dehydrated, causing something known as 'lactic acidosis'. You need to take special care to maintain your hydration when you are unwell to prevent this from happening.

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Your risk of dehydration is especially high if you are vomiting or having diarrhoea, since you'll be losing a lot of fluids. If you have a fever, you'll also be losing more water through your skin, and can become dehydrated if you do not take the time and effort to actively hydrate yourself more.

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Do consider asking your doctor about your Metformin dosing when you are sick. Depending on how ill you are on that day, some doctors may actually recommend stopping the dose for that day, until you are able to hydrate yourself well. It really depends on your condition and how severe your illness is on that, day, so do check with your doctor first.

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PAINKILLERS

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There are a few different kinds of painkillers. One of them is known as an 'NSAID' - a Non-Steroidal Anti-Inflammatory Drug. This painkiller is very effective for a wife range of conditions, and is especially helpful in pain related to arthritis conditions. Some examples are Ibuprofen, Naproxen, Diclofenac, Arcoxia, and Celebrex.

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However, it does carry the risk of kidney injury, and this risk is higher when you are dehydrated. As a Diabetic, your risk of a kidney injury can actually be higher because Diabetes is known to affect kidney function and cause kidney problems, especially in the long run.

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If you are not eating very well because of a poor appetite, or you are losing more fluid because of a fever, vomiting or diarrhoea, you should try to avoid NSAIDs until you are able to hydrate yourself better. 

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Stick with milder, safer painkillers, like Paracetamol, Anarex, and topical medications. Just check in with your doctor about the painkillers you are taking!

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GLIPIZIDE

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There are several different kinds of oral medications that Diabetics may use, but some put you at a higher risk of getting hypoglycaemia (low blood sugar episodes), especially if your appetite is not good and you're not eating well on that particular day.

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Glipizide (and it's older version, Glibenclamide), are known to cause hypoglycaemia episodes, especially when your appetite is poor. You may need to skip your dose of Glipizide on a particular day if you are not eating well. Check with your doctor to see if he or she thinks this is a good idea as well.

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DAPAFLIFLOZIN

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This medication belongs to a group of medications that helps your body get rid of the excess circulating glucose in your blood by secreting it out in your urine. It carries a small risk of triggering a Diabetic crisis if you become dehydrated whilst taking it. Monitor yourself for the signs and symptoms listed below, and head to a hospital if you have them.

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BLOOD PRESSURE MEDICATIONS

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Some blood pressure medications are particularly useful for Diabetics because they help protect your kidney function, but these same medications can unfortunately also cause injury to your kidneys, especially when you are dehydrated. These medications are known as 'ACE-inhibitors', and 'ARBs'. Some examples include Lisinopril, Enalapril, Losartan, Telmisartan, and Valsartan. 

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Other blood pressure medications like diuretics also run the risk of causing a kidney injury when you become dehydrated. Diuretics help you control your blood pressure by making your kidneys excrete excess fluid out in your urine. Some examples are Frusemide and Hydrochlorothiazide.

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It may be a good idea to stop these medications when you are unwell, but only if your blood pressure is well-controlled. See your doctor when you fall ill, have him or her check your blood pressure, and make a shared decision together!

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TIME FOR A HOSPITAL

 

Despite your best efforts to take care of your health whilst you are unwell, unfortunately you may still develop a Diabetic crisis. 

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One of these is called Hypoglycaemia, and it happens when your blood sugar levels drop too low, usually because you are not eating well while you are unwell. If you feel giddy and as though you are about to faint, check your blood sugar levels on your home Glucometer - a level of less than 4 mmol/L indicates hypoglycaemia. Take a sugary drink or snack, and quickly see your doctor to get checked.

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You can also develop a Hyperglycaemic Crisis when your blood sugar levels rise too high and cause a metabolic abnormality in your body. This tends to happen more when you become dehydrated or are down with a serious infection. Look out for signs of persistent vomiting, confusion, lethargy, giddiness, or even fainting. Head to a hospital quickly to get some urgent tests done!

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WRAP IT UP!

 

As a Diabetic, you need to pay more attention to your health when you fall sick. Save the 2 cheat sheets below for some quick tips, and remember to see your doctor early on in your illness to get evaluated.

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