Taking care when you are ill

When you have diabetes it is always important to take extra care of yourself when you are ill, but when you are pregnant it is essential.

What happens when you are ill?

• Your body needs more energy to fight the illness, particularly if you have a fever, and so makes glucose from its stores
• So insulin is needed, even if you cannot eat at all
• Without insulin, your body uses fat for energy. This causes a rise in ketones in your blood
• If your glucose is rising, you must take action to avoid ketones forming, because ketones are dangerous for you and your baby

Monitoring your progress - blood glucose

• Even though you may already be monitoring very frequently, increase your testing to at least every two hours so you can get help straightaway if your levels are rising
• If your blood glucose goes above 16.7mmol/L you must monitor for ketones

Monitoring your progress - ketones

• Discuss ketone monitoring with your Diabetes Specialist Nurse or Diabetes Specialist Midwife at your regular clinic visit, before you become ill
• There are two ways to monitor your ketones - in your urine or your blood
• Blood ketone testing has an advantage over urine testing because it tells you your levels at the time you test
• It is normal to have a low level of ketones in your blood but if they begin to increase this is a medial emergency. Call your Diabetes Specialist Nurse or Diabetes Specialist Midwife for help or go straight to the Emergency Department at your hospital

Rules to follow when you are ill

Don't be frightenend of illness; instead accept that it may happen and plan what you will do when it does.

• Make a plan - have a plan of what to do if you become ill BEFORE it happens. Make sure you have the number of your Diabetes Specialist Nurse or Diabetes Specialist Midwife to hand
• Get help - as soon as your glucose levels begin to rise, or at the first sign of a fever, alert your Diabetes Specialist Nurse or Diabetes Specialist Midwife so he or she is ready to give you the help you need
• Keep taking your insulin - remember you need insulin to deal with rising glucose and to stop your body making ketones, even if you are not eating
  
  NEVER STOP TAKING YOUR INSULIN.
• Keep drinking - avoid dehydration, particularly if you are being sick or have diarrhoea, by taking small quantities of fluid, such as sugar-free drinks , tea or coffee every 15 to 30 minutes
• Keep eating too - try normal meals if you can. If not, take small meals more frequently - about once an hour.
  
  Foods you could try include:
  • A bowl of soup
  • A glass of fruit juice
  • A small bowl of ice cream
  • A glass of milk or mug of milky drink
  • A small carton of ordinary fruit yoghurt (not diet)
  • A small bowl of jelly
• If you are being sick - if you can't keep anything down get medical advice immediately, and take regular sips of sugary drinks such as Lucozade or non-diet lemonade

FreeStyle Optium β Ketone test strips You can you the FreeStyle Optium blood glucose meter to measure your blood ketone levels using a test strip called MediSense® FreeStyle Optium β-Ketone test strips, which your GP can prescribe.