I’m not feeling well and my blood glucose levels have gone up. What should I do?

This is a common enquiry we get on our helpline, from people with either type 1 or type 2 diabetes. When you are unwell or have an infection, the body releases stress hormones, such as adrenaline and cortisol, as it prepares for the ‘fight or flight’ response. These stress hormones increase the amount of glucose going into your blood stream from the liver, as well as making it harder for insulin to work, which allows glucose to enter the cells and be used for energy. This is the body’s way of getting enough energy (glucose) in the blood to ‘fight’ the illness.

As our glucose levels increase, we need more insulin. So what does that mean for people with diabetes who may not be producing any insulin themselves, or may not be able to produce enough extra insulin? A sick day plan can help you.

A sick day plan is a plan that you follow when you have an infection, or when you feel unwell. The plan will guide you on how to manage your diabetes during this time and includes information on how often to check blood glucose levels, how often to check for ketones if you have type 1 diabetes, how much fluid to drink to prevent dehydration, what medications you may need to stop taking, and, most importantly, when to seek medical assistance.

For people who are using insulin to manage their diabetes, the sick day plan will guide you as to how much insulin to have and how often. This is particularly important for people with type 1 diabetes because if you don’t have enough extra insulin then you can develop diabetes ketoacidosis (DKA), which is a serious and life-threatening condition.

Whether you have type 1 or type 2 diabetes, having higher glucose levels, in this case due to illness, can cause dehydration as the body tries to excrete more glucose through the urine. Your sick day plan will suggest how much fluid to have each hour to try and prevent dehydration. Illnesses that cause vomiting or diarrhoea can drive your glucose levels too low because the glucose from food or drink may not be absorbed properly.

This situation can be difficult to manage, especially for people with type 1 diabetes, because they need to continue to have some insulin, or they may develop DKA. Again, how to manage this situation will be part of your sick day plan.

Next time you are talking to your GP or credentialled diabetes educator, ask them for a sick day plan. There are sample plans readily available, but they will need to be personalised for you according to the type of diabetes you have and the medications you are on. If you have diabetes, are unwell and you are not sure what to do, please seek urgent medical attention

You may be interested in attending one of Diabetes WA’s online webinars that focus on sick day plans and sick day management – we have specialised sessions for type 1 and type 2. Book by visiting our website or calling our helpline on 1300 001 880.