1. Continue to take your usual dose of insulin.
2. Never omit or reduce your insulin dose when you are sick. More insulin is often needed rather than less at this time.
3. Contact your doctor or diabetes nurse for advice about increasing your dose of short acting (clear) insulin. You may also need extra doses of this insulin e.g. 2-4 units every 2 hours.
4. Eat according to how you feel and what food you can tolerate.
5. If you cannot eat your usual meals, have small low fat snacks at regular intervals throughout the day. e.g. toast, crackers, boiled rice, soup, low fat custard or ice-cream.
6. If you cannot eat food, have sips of fluid every few minutes. High blood sugar levels, vomiting and diarrhoea can all lead to dehydration.
7. If your blood sugar level is more than 12 mmol/l, have unsweetened fluids like water, clear soups, weak tea, or diet lemonade.
8. If your blood sugar level is less than 12 mmol/l, have sweetened fluids like ordinary lemonade, cordial or apple juice.
9. Test your blood sugar level more frequently e.g. every 2-4 hours and record all results.
10. Test your urine for ketones every time you pass urine.
11. Contact your doctor or go to hospital if:
    • your blood sugar level remains more than 17 mmol/l
    • moderate to large ketones are present in your urine
    • you cannot keep down any food or fluids
12. In type 1 diabetes, high blood sugar levels or illness can lead to a serious condition called ketoacidosis. There will be moderate to large ketones in the urine.

You may also notice:

• breathlessness
• abdominal pain
• nausea and vomiting
• sweet fruity smell on the breath
• drowsiness

This is a medical emergency. If you have these signs, contact your doctor or go to a hospital emergency department immediately.

See Ketoacidosis