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Sick Day Guidelines When You Have Type 2 Diabetes (4307)

Sick Day Guidelines When You Have Type 2 Diabetes (4307) - Clinical Hub, Patient Education, Health and Nutrition Facts For You, Diabetes, Endocrine


Sick Day Guidelines When You Have Type 2 Diabetes

Any type of illness can raise blood sugar.
You may think that your blood sugar will be
low because you are not able to eat or drink.
When you’re sick, stress hormones are made
in the body which raise blood sugar. Blood
sugar levels may become hard to control.

Causes of High Blood Sugars
ξ Any illness, infection, surgery
ξ Missed or skipped insulin or diabetes
oral medicine
ξ Physical or emotional stress
ξ Some medicines

Warning Signs of High Blood Sugar
ξ Increased thirst – your body needs
extra fluids
ξ Increased urination – your body’s
way of getting rid of extra sugar
ξ Fatigue – your body’s cells are not
getting enough sugar or energy
because you lack insulin
ξ Weight loss – your body is burning
fat for energy
ξ Dehydration – due to increased
urination, vomiting, diarrhea, or

Checking Blood Sugars When Sick
Check your blood sugars every 3-4 hours.

Adjust Medicines
Adjust your medicines as follows or as your
health care team has advised.

Oral Medicines
ξ If you are able to eat, you may
keep taking your oral medicines
for diabetes.

ξ If you are not able to eat, you
o Continue taking Actos®
(pioglitazone), Avandia®
(rosiglitazone), Januvia®
(sitagliptin), Onglyza®
(saxagliptin), Tradjenta®
(linagliptin), and Nesina®
o Stop taking metformin,
glipizide, glimepiride, glyburide,
Invokana® (canagliflozin),
Farxiga® (dapagliflozin),
Jardiance® (empagliflozin) until
you are able to eat.

Injectable Medicine
ξ Stop taking Victoza®, Byetta® and
Bydureon® until you are able to eat.

ξ Always take your insulin, even if
you are not able to eat your usual
meal plan.
ξ Your doses may change when you
are sick. See the tables below to
learn more.

Insulin Plan When Eating
ξ Take your usual dose of basal insulin
(NPH, Levemir , Basaglar ,
Lantus , Toujeo , or Tresiba ).
ξ Keep taking your Regular,
Humalog , Apidra , or Novolog to
cover your meals. Use correction
insulin. Call your health care team to
decide if your correction scale doses
need to be changed while you are
ξ If you use an insulin pump, do not
change basal rates unless discussed
with your provider. Take your usual
correction per the pump bolus

Insulin Plan When Not Eating
It is always best to discuss insulin changes
with your health care team. The chart below
shows what changes are often made when
you are not able to eat your usual meals.

Types of Insulin
You Take
Doses To Take
When Sick and
Not Eating
NPH  Take ½ dose of NPH
Levemir (detemir)
 Take usual
Lantus , Basaglar
Regular Novolog ,
Apidra , Humalog
 Do not take
meal insulin.
Only use your
Pre-mixed Insulin
(70/30, 75/25,
 Take ½ of
usual dose and
call your health
care team for
insulin (U-500, U-
300, U-200)
 Call your
health care
team for

Prevent Dehydration
 Drink water and other liquids.
 Take small amounts of fluid every 10
minutes (8 ounces per hour is best).
 With vomiting and diarrhea, your
body loses electrolytes like
potassium and sodium. Replace these
losses with bouillon, soups, sports
drinks, and juices.
If you cannot eat your normal meals, replace
carbohydrates from the meal with foods that
have sugar. These foods must have sugar to
prevent the breakdown of fat into ketones. If
you use insulin with meals, take insulin for
the carbohydrates in the liquids or food that
you have.
Examples are:
 Soda
 Jell-O
 Pudding
 Juices
 Popsicles
 Sports drinks
 Cooked cereals
 Soups
 Crackers or toast
 Sherbet or ice cream

Remember, these choices should not be
diet or sugar-free. Also, soda that is warm
and flat are better tolerated than cold,
carbonated sodas.

When to Call Your Health Care Team
If you are not able to control your blood
sugar, call your health care team. When you
call, be ready to tell us:
ξ How long you have been sick
ξ Current symptoms
ξ Blood sugar levels
ξ What you have been able to eat and
ξ Your temperature (whether or not
you have a fever)
ξ Medicines taken

Your health care team may have given you this information as part of your care. If so, please use it and call if you have any
questions. If this information was not given to you as part of your care, please check with your doctor. This is not medical
advice. This is not to be used for diagnosis or treatment of any medical condition. Because each person’s health needs are
different, you should talk with your doctor or others on your health care team when using this information. If you have an
emergency, please call 911.Copyright 8/2017. University of Wisconsin Hospitals and Clinics Authority. All rights
reserved. Produced by the Department of Nursing. HF#4307.