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Unwell Managing high sugar levels when unwell

  1. You should try and maintain sugar levels between 5 and 10mmol/L as much of the time as possible when you are unwell

  2. Do not overdo sugar-containing drinks or ‘medicines’ which can worsen the situation

  3. Drink plenty of water (at least 3L per day)

  4. Never stop taking your usual medicines, consider the need for additional medications

  •  if you take less than 160mg gliclazide per day, increasing by 80mg (one tablet) can often help after a couple of days (and cut down again once feeling better)

  • generally increasing the dose of metformin / pioglitazone / gliptins does not make much difference over the timescale of most illnesses, and is therefore not encouraged

  • occasionally if your sugar levels run high and you are already on higher doses of treatment, then using insulin injections for a few days while ill will reduce the chances of the illness being prolonged and make you feel better quicker

    • this is generally given as 1 or 2 injections daily of an ‘NPH’ insulin (such as insulatard or humulin I) given first thing in the morning (and again at night if necessary) starting with 10unit doses
    • these insulins can be given from simple disposable ‘pen’ devices, which can be provided and taught for self-use within an hour or so (if you have experienced this problem in the past then planning a session with your diabetes nurse to understand how to do this makes sense while you do NOT have illness
         5.    If you already use insulin to control your sugar levels you should follow insulin ‘sick day rules’ as for     patients with type 1 diabetes.