Do You Have a Diabetes Sick Day Plan?

Meagan Esler

| Sep 22, 2011

It's that time of year again: flu season. I never thought much about getting a flu shot until fourteen years ago, when I ended up in the emergency room with the flu and a staggering blood sugar of over 800 mg/dL. I had been diagnosed with type 1 diabetes a few years before and had never discussed a sick day plan with my doctor. But during this experience, I discovered that diabetes and the flu get along about as well as a house cat and a junkyard dog.

I hadn't eaten in three days, although I occasionally sipped juice and ate popsicles to try to keep my blood sugar from dropping too low. I had been home for three days throwing up and had stopped taking my insulin completely. Because I couldn't keep food down, I thought that if I took the insulin, I'd go low.

I ended up dealing with the extreme opposite. I lay in bed on the third day and couldn't sleep because of the terrible pain. Late at night, I picked up the phone and dialed 911 for the first time in my life. On the ride to the hospital, the paramedics tried repeatedly to find a vein to start my IV. I still have scars from that night. They said that my blood sugar was so high that they were unable to start one.

Finally, at the hospital, they started the IV and began working on lowering my blood sugar. The nurse told my family that my blood sugar was the second highest the ER had seen. With an elevated blood sugar for such a long period of time, I was lucky to be alive.

It took a while for my blood sugars to come back into the normal range. The next afternoon I still couldn't eat because my blood sugars remained elevated. At the time, I was a stay-at-home mom and was uninsured. I cried and stressed about being in the hospital because of the impending bill. Worried, I asked to be released, but the doctor insisted I stay.

Nearly 24 hours later, I was sent home. One of the first things I did was schedule a visit with my diabetes educator. I found out that regardless of whether I eat, my body requires some insulin when I'm sick. I made lots of mistakes during my illness, but I learned a great deal. I now have a plan of insulin dosages to follow in case of illness and safe amounts of carbohydrates to eat or drink. I also get a yearly flu shot to lessen the chance of contracting the flu or at least minimize its severity.

I did get the flu again years later, even with the flu shot, but its duration was much shorter and with my insulin dosages and carbohydrate plan, I made it through safely. I had slightly elevated blood sugars, but no scary lows, and I recovered quickly.

If I could give all people with diabetes a word of advice upon diagnosis, it would be to have a sick day plan. Even if you cannot get a flu shot, make sure you have a plan with your doctor. Keep it written down somewhere to fall back on in case of unexpected illness. My sick day plan is my security blanket, and I feel much safer knowing it's there.

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Categories: 911, Blood Sugar, Carbohydrate/Carbs,, Diabetes, Diabetes, Diabetes Nurse Educator/CDE, Diagnosis, ER/Emergency, Flu Season, Food, Insulin, Low Blood Sugar, Sick Day, Type 1 Issues

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Posted by amysmercer on 27 September 2011

Meagan, What a terrible experience, so sorry you had to go through that! And what a good reminder that the flu shot needs to be a priority for people with diabetes. I get a flu shot when I take my three boys for theirs, the nurse gives the nasal spray to each of us, and as a working mom with type 1, it's one less thing to worry about.

Posted by Anonymous on 27 September 2011

Thanks for the article. I never had a plan until recently. But now the first step in my sick day plan is to NEVER skip my basal shots no matter how often I throw up. I also only give my pre-meal shot/s once I am able to hold something down. So far this has worked for me. Like the author says, my readings are a little higher than normal (about 10mmol for me)following this regime but I cope.

Posted by Anonymous on 27 September 2011

As a registered nurse and a Type 1 diabetic, all I can add is that blood sugars MUST be checked every few hours while sick and typically just basal insulin is NOT enough to cover an illness even when you are not eating! I have more than tripled my typical insulin when sick to keep my sugars normal even when NOT eating because I can't keep food down. Check those sugars every few hours and give insulin if needed!! Doug Munda

Posted by Anonymous on 27 September 2011

My kids' doctor recommended taking about half your usual dose of insulin, and about every 30 minutes to an hour, sip about a teaspoon of real soda pop (not diet, no caffeine), so you won't drop low. That will also give you some energy till you recover. It has worked for us.

Posted by Anonymous on 29 September 2011

Your sick day experience reminds all of us to check our blood sugars frequently, even when not sick. It's better to be proactive and avoid the complications of high glucose.

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