When you are unwell – type 2 diabetes sick day action plan

A minor illness can result in a major rise in blood glucose levels. At the earliest sign of any form of illness such as a cold or virus, it is important for you to take action. Start following a Sick Day Action Plan immediately if

  • You are unwell or have any signs of illness, even if your blood glucose levels are normal
  • Your blood glucose levels are greater than 15mmol/L for eight to 12 hours or more, even if you are feeling ok.

Sick Day Action Plan – What to do – Six steps

1.  Managing your blood glucose levels when you are feeling unwell can be difficult especially if this is the first time. Phone your doctor or diabetes team early so that they can help you manage your diabetes during this time. If you are not feeling well enough to be constantly testing your blood glucose levels, ask someone to stay with you to provide support.

2.  Check your blood glucose levels (BGL) more frequently – this is the only way to monitor the effect of illness on diabetes. If your BGL is above 15mmol/L  (for more than eight to 12 hours or earlier if advised by your diabetes team) test two hourly

3.  Keep drinking and eat if possible. Try to have one cup of fluid (125 – 250 mls) every hour to avoid dehydration.  Eating will help meet energy requirements and prevent low blood glucose levels (if you take certain diabetes medications or insulin). If you are too unwell to eat, and
-    your blood glucose level is less than 15mmol/L drink sweetened fluids (e.g. ordinary soft drink or tea/coffee with one tablespoon of sugar or honey)
-    if your blood glucose level is more than 15mmol/L drink sugar free fluids (e.g. water, diet drinks or tea/coffee with no added sugar)

4.  Continue taking your usual diabetes medication or insulin dose, even if you are eating little or are vomiting and have diarrhoea. Metformin (which has a number of different brand names) is the only medication that may need to be ceased if you are vomiting or have diarrhoea. Check with your doctor for further advice.

5.  Go to hospital or your medical clinic if

  • Vomiting persists
  • Your blood glucose level is greater than 15mmol/L for more than 24 hours
  • Hypoglycaemia (low blood glucose level) is severe and cannot be kept above 4mmol/L
  • You are too unwell and you or your support people are unable to carry out regular blood glucose monitoring

Women with diabetes who are pregnant may need to be more cautious and seek medical advice with any signs of illness

6.  Be prepared for the next time when you are unwell – have a sick day kit

Every six months, check that your kit is fully stocked and items are within their expiry date. Suggested items for your sick day kit

  • Copy of the six step sick day action plan
  • Telephone numbers to call for help e.g. support people, general practitioner, local hospital, diabetes educator
  • Food for sick days, eg. dry biscuits and sweetened and diet drinks
  • Carbohydrate containing food, eg. dry biscuits
  • Pain relief such as paracetamol or ibuprofen

Monitoring equipment including in date test strips, thermometer and spare record book/paper to record your BGL

More Information

Sick days & type 2 diabetes (PDF)