When sugars are high due to illness the following actions will help you maintain some control;
Type 1 diabetes.
Test/scan blood sugars more often, ideally every 2 hours.
Be prepared to give up to an additional half your usual dose of basal insulin, in order to bring your fasting sugars down to target.
e.g if you normally take 16 units, add another 8 and give 24 units.
It is likely you will also need more NovoRapid for bolus doses and corrections, may up to twice as much.
Please resist the temptation to correct sugars in between meal as this can result in insulin stacking & hypos. Wait until your next meal time & then add the correction dose on to the bolus and give them both together.
Please remember to test for KETONES. Any sugar >14mmols test for ketones.
Ketone results; <0.6 = negative, no action.
>0.6 = positive. Take a correction dose of 6 units of NovoRapid (regardless of mealtimes)
Continue to monitor frequently & retest for Ketones 4 hours after the injection of NovoRapid. If ketones are still positive give a further dose of 6 units of NovoRapid. This can be repeated every 4 hours until the ketones are cleared.
If sugars & ketones remain high and you experience abdominal pain, nausea and or vomiting, please attend E.D immediately. These symptoms may indicate Diabetic Keto-Acidosis , DKA.
Try to maintain your normal dietary habits. If appetite is very poor, try to consume some fluids which contain calories, e.g soup, milky drinks without sugar, in order to give your body some energy.
If not able to eat anything and sugars are still high, give correction doses of NovoRapid at meal times. And maintain a good fluid intake, e.g glass of water/ cup of tea every 2 hours.
Be vigilant & observe for sugars falling when you start to feel better. You will then need to reduce your insulin doses again.
Type 2 diabetes.
Frequent monitoring of blood sugars if you are already testing, every 2 hours.
DO NOT stop taking your medication, even if appetite is poor and not eating much. Your sugars will be high due to the virus.
Continue to eat a healthy balanced diet and drink plenty of fluids. e.g glass of water, cup of tea every 2 hours.
If taking Empagliflozin (Jardiace) tablets, please test blood for ketones if sugar is >14mmol. If ketones are positive, see above, report to E.D.
Please check your supply of ketone testing strips. Make sure they are in date. Request more from your G.P if necessary.