When someone with diabetes talks about sick day rules, it’s referring to knowing what to do when you’re ill. Knowing the information, having it ingrained in your psyche, will stop any panics when a sick day happens and allow you to cope with it in the most efficient way.

The first thing to remember is always to take your insulin.

If your body is ill, its resistance to insulin will be increased (both the insulin you inject, or the insulin you manufacture yourself). And in turn, this causes raised levels of blood glucose.

It stands to reason that at such important points, you’ll need to monitor your a) ketone levels and b) blood glucose in order to gauge if you need more insulin (which is quite likely).

Do this, even though you may not feel up to it. This is very important, otherwise diabetic ketoacidosis may develop – Symptoms of which are:


Early symptoms

  • Dry mouth or thirst
  • Urinating frequently
  • High urine or blood ketone levels
  • High blood glucose levels

Later symptoms

  • Nausea, vomiting or stomach pain
  • Breathing difficulties
  • Constant tiredness
  • Flushed or dry skin
  • Breath gives off a ‘fruity’ smell
  • Confusion or lack of concentration.


The second piece of advice is to keep hydrated. If you are losing fluids through vomiting or diarrhoea, then replace lost fluids with a cup of liquid every hour. Water is recommended (as sugary drinks can affect glucose levels adversely). However, if you are sick to the stomach, a sugary drink may be required every few hours in this particular case. Alternate the drink with water. Other alternatives include tea with a small amount of sugar, or the occasional fruit juice.

If vomiting continues and you can’t keep fluids down (and/or blood/ketone levels won’t reduce), then contact the hospital as an emergency.


Thirdly – Check Any Over-The-Counter Medication

Medication for colds and flu is generally safe for diabetics. However, if there are kidney issues, there may be contraindications. Always ask the pharmacist or your GP if in doubt.


General advice

If you’ve lost your appetite for the food you normally eat, try easy to digest foods like soup, milk puddings or ice cream.

In the case of a lingering infection, see your GP. If it’s not clearing up after a couple of days, you may need further treatment.