Lightning Learning: Diabetic Sick Day Rules
““Diabetic patients who are unwell often have a higher BM than normal. The liver releases glucose to enable the body to fight illness.””
What?
Diabetic patients who are unwell often have a higher BM than normal. The liver releases glucose to enable the body to fight illness.
In unwell diabetic patients:
DON’T STOP INSULIN!
Encourage sugar free fluids (>3 litres/day for adults)
Keep eating, if they cannot tolerate normal diet give appropriate dose of carbohydrate.
Patients should check their blood glucose and ketones every 2-4 hours.
BG >11 but no ketones = increase normal insulin doses
Ketones present = extra bolus doses insulin required
Why?
Most diabetic patients with hyperglycaemia do not need IV insulin.
Patients should be provided with Sick Day Rules by their Diabetic Team and be reminded to follow them to help manage their own illness.
Familiarise yourself with our local Diabetic Sick Day Rules for patients within your local area.
Further Reading
- NICE: Clinical Knowledge Summary
- Sick Day Rules: Type 1 (local)
- Sick Day Rules: Type 2 (local)
