Caring for yourself when you are unwell
- When you’re unwell, you need to take extra care
- As a person with diabetes when you are sick, your body’s increased production of stress hormones will cause your blood glucose levels to rise
Make sure you keep a list of contact numbers for your doctor, credentialled diabetes educator, hospital and ambulance by the phone. If possible, have a friend or relative come and regularly check on you.
Testing Blood Glucose Levels when Sick
When you are sick, you need to test your blood glucose levels more frequently, e.g. every 2-4 hours, and record all results. Illness or high blood glucose levels can lead to a serious condition called ketoacidosis.
Taking Insulin when Sick
When you’re sick continue to take your usual dose of insulin. Never stop taking or reduce your insulin dose. Sometimes when you are sick you may need more insulin or extra doses of insulin. Contact your doctor or credentialled diabetes educator if your illness lasts for more than one day, or if you vomit more than three times in a day, to discuss whether your insulin needs to be changed.
When to Seek Medical Assistance
If you have diabetes and are sick you should immediately contact your doctor or go to hospital if you have any of the following symptoms:
- Abdominal pain
- Nausea and vomiting
- Sweet fruity smell on the breath
- Your blood glucose level is higher than 15 mmol/L for two consecutive readings (in a 2-6 hour timeframe)
- A moderate to large ketones are present in your urine or your blood ketone level is ≥ 1.5 mmol/L
- You can’t keep down any food or fluids.
What to eat?
Eat according to how you feel and what food you can tolerate. If you can’t eat your usual meals, make sure you have small low-fat snacks at regular intervals throughout the day, e.g. toast, crackers, boiled rice, soup, low-fat custard or ice-cream.
If you can’t eat food, have sips of fluid every few minutes.
Include carbohydrate drinks (such as fruit juice or lemonade) if your blood glucose level is below 15 mmol/L or unsweetened fluids (such as soda water or diet lemonade) if your blood glucose level is above 15 mmol/L.
Drink lots of water
High blood glucose levels, vomiting and diarrhoea can all lead to dehydration. You will need to drink more, but it is important what you should drink, based on your blood glucose levels.
If your blood sugar level is more than 15 mmol/L then you should drink unsweetened fluids like water, clear soups, weak tea, or diet lemonade.
If your blood sugar level is less than 15 mmol/L then you should drink sweetened fluids like ordinary lemonade, cordial or apple juice.
No strenuous exercise
People with diabetes are generally discouraged from strenuous physical activity if they feel unwell or have ketones present in their blood or urine.
It is expected that people with diabetes will, at various times, have other health conditions that may require medication.
Most Australians take complementary medicines at least once a day and, as a nation, we spend more money on them than on conventional medicines. Before you do take them, you need to know:
- Is the preparation safe?
- Will it work?
- Will it affect my diabetes?
Complementary medicines are a group of diverse medical and health care systems, practices and products that are not presently considered part of conventional medicine but are often used in addition to conventional medicine.
You should never take a new medication without determining if it may affect your diabetes. Make sure doctor or pharmacist you consult knows that you have diabetes and is aware of all the medications you use.
You should always tell your doctor and credentialed diabetes educator about any medicines, vitamins or herbal products (even those you buy at the supermarket or pharmacy) you are taking as they may affect your blood glucose levels or inter-acting with insulin or other medications.
Regulation and side affects
Conventional and complementary/alternative/natural medications both have side effects and drug interactions but there is an important difference. Conventional medications are carefully controlled. The ingredients are known, in exact amounts, and the quality is controlled.
Complementary/alternative/natural medicines may not be regulated in the same way. There have been several occasions when a product has been found to contain an unexpected, and potentially dangerous, ingredient and the amounts of the active ingredient may not be consistent.
Some complementary/alternative/natural medications can have a negative side effect on diabetes. For example, glucosamine which is taken to treat/prevent arthritis may increase insulin resistance in animals (according to some studies) and might increase blood glucose levels in people.
Complementary medicines may be ‘natural’ but they are not necessarily safe. Just like conventional medicine, they can have side effects or interact with other medications, conventional, complementary or alternative.
Always check complementary medicines with your doctor prior to use.
Choosing Safe Complementary Medications
The Therapeutic Goods Administration (TGA) divides medicines into two categories:
- Registered medicines are those which treat serious medical conditions and/or which are considered higher risk. All prescription medicines are registered, along with some over the counter (sold in pharmacies and supermarkets) medicines, such as some pain killers and cough mixtures.
- Listed medicines are those which are designed to treat minor conditions and which are considered to be lower risk. Most natural and complementary medicines are listed medicines.
While registered and listed medicines may look the same on the pharmacy shelf, the testing process they undergo by the TGA is very different.
Registered products are thoroughly tested for safety, quality and efficacy. Efficacy means that the medicine has the effect that is claimed for it.
Listed products are only tested for quality and safety. TGA does not test listed medicines for efficacy, although the manufacturers of listed medicines are supposed to have data to support the claims they make for their product.
To check whether a medicine is listed or registered, look for a small number on the packaging which begins either AUSTR (registered medicines) or AUSTL (listed medicines).
For consumers, this means that you cannot be sure that a listed product has been tested to ensure that it has the effect that is claimed for it. If you are unsure about taking a listed medicine, it is a good idea to talk to your doctor or other health care provider and to find out if there is evidence available to support its use.