When your body senses the threat of infection it produces more glucose in the form of glucagon, a hormone that raises blood sugar levels. If you are diabetic, this extra glucose in the bloodstream can lead to dangerously high blood sugar levels. Therefore, it is important to continue taking regularly prescribed oral medications (for type 2 diabetes) and insulin (for type 1 or type 2 diabetes) when sick and to regularly check sugar levels to assess whether more insulin is necessary.
Check Blood Sugar Regularly During Illness? Levels may fluctuate
dramatically during an illness, so you need to check them throughout the day. When blood sugar levels are high -- above 300 mg/dL (16.5 mmol/L) -- it is also necessary to check for ketones in the blood or urine, which is a byproduct resulting from the body using fats as an energy source. You will probably have testing strips to use. The presence of ketones indicates diabetic ketoacidosis which is a dangerous build-up of acid in the body.
How Does Illness-Related Appetite Loss Affect Blood Sugar Levels? Normally your body is largely dependent on food to provide glucose to the bloodstream. Going without food for prolonged periods, particularly while continuing to treat diabetes with oral medications and/or insulin, can lead to dangerously low blood sugar levels (hypoglycemia) causing symptoms such as palpitations, shakiness, hunger, confusion, and even convulsions and coma. However, during illness or other stress, the body's own immune system triggers glucose production whether or not blood glucose is boosted by food intake. In fact insulin requirements, are typically higher on sick days without food than on regular days with normal meals.
Even if you can't eat solid food, it is important to maintain an adequate intake of fluids to prevent dehydration. It is helpful to drink fluids containing carbohydrates and salt to maintain the electrolyte balance in the body. Sometimes illness leads to nausea and an inability to keep any food or medications down. Don't stop taking oral medications in this case; it is important to take them to treat the high blood sugar levels that naturally occur when ill, and also to dose the insulin accordingly, even if illness prevents eating.
While fighting an illness, most people with Type 1 diabetes may require additional short-acting insulin, along with typical doses. Similarly, people with Type 2 diabetes who manage the disease entirely by diet and oral medications may require short-acting insulin during the course of an illness.
Is it safe to take Over-the-Counter Medications? Often when people are sick, they look for remedies to treat various symptoms, such as a cough or fever. While these nonprescription medications are typically fine for people with diabetes, it is important to remember that they can affect the blood and could potentially interact with diabetes medications. For example, cough syrup generally contains sugar. Some antibiotics can interact with oral diabetes medications and result in lower blood sugar levels.
It is very important to talk to your doctor or diabetic consultant before taking any additional prescription or nonprescription medication to determine what, if any, changes to your diabetes management may be needed. If you become ill it is important to let your diabetes care team know of any changes to your health. This includes symptoms -- such as nausea, vomiting, diarrhea, or fever - the amount of insulin given, your food and fluid intake, heart rate, breathing rate, and current body weight.
This information will help the team to advise patients on how to manage their blood sugar levels and other symptoms during the illness with a goal of preventing dehydration and the development of dangerous hyperglycemia.
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