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Unwell General Principles

General Principles of Sickness Management in Diabetes Patients

  1. Ensure appropriate fluid intake (greater than 3L/24h)

  2. Ensure patient is able to glucose monitor (if not a regular tester generally consider a one off prescription of ‘tru-one’ glucose strips (which have a very simple disposable meter embedded into the lid of the 50 strip carton) and knows an appropriate monitoring schedule during illness

  3. Ensure patient knows an appropriate target range for self-managed glucose control during illness

    1. ideal  range = 4-10mmol/L

    2. acceptable range = 4-14mmol

  4. Ensure patient knows how to adjust therapy if blodd glucose levels rise above targets (or when and how to contact their primary care-giver)

  5. Ensure resources are available to make adjustments (eg access to insulin)

Given that many of these plans will have been discussed some time before an illness, patients who are at risk of an illness (any who have had one in the last year) should have an individualised illness management planner – see attached link (MY ILLNESS PLAN) for a proforma.

Usual Insulin Requirements

Insulin Requirements during illness