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When you are ill
Why your glucose rises when you are ill
When you are ill, particularly if you have a fever, your body needs more energy, and therefore glucose, to fight the infection. Normally extra insulin is produced to cope with the rise in glucose, but when you have diabetes your body cannot meet the extra demand for insulin. This happens even when you have completely lost your appetite and cannot eat at all. Many people with diabetes make the mistake of thinking that, because they are eating very little, they should cut down or even stop their insulin. This is wrong. In fact you many need more insulin than normal.
Here are some suggestions for you to follow if you are unwell:
- Make a plan
Have a plan of what you will do when you are ill BEFORE it happens. Your GP, Practice Nurse, DNS or the staff at your diabetes clinic will be able to help you. Even with a great plan you may still need their help so keep the phone number of your clinic, DNS or Practice Nurse handy - Keep taking your diabetes treatment
It is ESSENTIAL that you keep taking your insulin. Missing an insulin injection means that your blood glucose will continue to rise but your body will not be able to use it as fuel. Instead, you will start to break down fat. Breaking down a lot of fat results in ketones in your blood. At high levels ketones are dangerous and can cause ketoacidosis leading to diabetic coma - Keep drinking
It is very important not to become dehydrated when you are ill, particularly if you are being sick or have diarrhoea. Take small quantities of fluids such as sugar-free drinks, tea or clear soup every 15-30 minutes
- Keep eating too
You must continue to eat when you are ill. Try taking normal meals if you can but if you don't feel it take small meals and eat more frequently. Soft foods and liquids are often the easiest to eat when you feel unwell. Foods you could try include:- A bowl of soup
- A glass of milk/mug of milky drink
- A glass of fruit juice
- A small carton of ordinary fruit yoghurt
- A small bowl of ice cream
- A small bowl of jelly
During the day, try to eat one portion of one of these foods each hour. If you are being sick and cannot keep anything down take regular sips of sugary drinks such as Lucozade® or ordinary lemonade.
Illness and blood testing
- Measure your blood glucose regularly
When you are ill you must measure your blood glucose regularly - at least four times a day. Record your results, as you may need to discuss them with your GP or healthcare team - If your sugars are rising
You may need to increase your testing to every two hours so you can spot in plenty of time if you need to adjust your insulin dose, you may need extra soluble insulin between your usual insulin injections. - Measure your ketone levels
If you have been given a meter with the option of checking ketone levels, then you should check them if your blood glucose is over 16.7 mmol/L or if you are vomiting. This will tell you if you are at risk of diabetic coma
If you are vomiting and have consistently high ketones or blood glucose levels you may need to go to hospital. Seek medical advice or go straight to Accident & Emergency.
