Managing diabetes during seasonal infections or sick days can be difficult. Having a cold, flu, viral or bacterial infections can cause fluctuations in sugar levels and hence, it is especially important for people with diabetes to be prepared and know the measures to take to manage sugar levels while feeling under the weather.
What should diabetics do when they are sick?
Dr Johann Varghese, consultant, endocrinology, SRV Hospitals, Goregaon, Mumbai, says the dose of medications for sugar control for people with diabetes is usually changed when they fall sick. “We advise them to cut down the dose of medicines that they are taking by around 20%. But it varies from person to person. So usually, they require a good follow up with the doctor to understand the dose of medications and frequent monitoring of sugar levels,” he says.
Also, if one does not have diabetes under control, they are more prone to developing infections, which again affects the sugar levels, adds Dr Farah Ingale, director, Internal Medicine, Fortis Hiranandani Hospital, Vashi, Mumbai. “When one is sick, they may not eat well, vomit and have loose stools, affecting the absorption of food by the gut, causing sugar levels to fluctuate. Stress can cause sugar levels to go up and inability to eat food can cause it to drop. So, it is important to keep monitoring sugar levels more frequently and adjust the medication accordingly,” she says.
What to do when a diabetic is vomiting?
Dr Varghese says, depending on the severity of the infection, the dose of medications is adjusted. “If they have vomiting, everything including food and oral medicines are thrown out. If it only lasts an hour or two, we tell them to skip their morning dose of medicine to see how they’re feeling by afternoon. If the infection or illness is improving, they can continue the rest of the medications. If they are not feeling better and the vomiting continues for more than a day, we tell them to go to the doctor and get it evaluated,” he says.
If the cause of vomiting is gastrointestinal issues, antacids or antiemetics can help. Hence, always have these emergency medications, especially while traveling. Dr Ingale says, “If outside food cannot be avoided, look for diabetic meal options. They are available in plenty now. Also, eat fresh cooked food.”
If one is unable to have their normal diet, they can have something liquid, say experts. Dr Varghese adds, “Something like ORS which has some amount of sugar would also work better in such cases as their blood glucose levels drop.”
When to visit a doctor?
Here are some of the emergency signs to look out for when you are sick. If these symptoms persist, it is important to consult a nearby physician.
- Persistent vomiting
- Rapid breathing
- Giddiness
- Dehydration
- Fever and shivering
- Fatigue
- Weight loss despite eating well
- Abdominal pain
Dr Ingale says, “If you’re on insulin and if your sugars are under control, you’re not affected more than those who have sugar under control with oral hypoglycemics. When there is an infection and the person’s sugar is not under control, we put them on insulin. Insulin is the best treatment then because it acts faster than oral anti-diabetics or hypoglycemics and brings sugars under control quickly.”
When one is admitted in a hospital due to an illness with high glucose levels, she says, they are given continuous insulin drip, and their sugar levels are monitored every hour, while also providing treatment for their infection. Also, if other organs like kidneys are involved, many medications are not prescribed. So, the treatment is tailored as per the condition of the person, say experts.
Takeaways
- Managing diabetes can be difficult when sick or down with an infection as they fluctuate due to stress and the inability of a person to eat well.
- On such days, it is important to stay well hydrated and avoid spicy, oily and outside food.
- Dose of medications are usually reduced to 20 percent on sick days.
- One should monitor their sugar levels frequently and adjust the dose of medications or insulin accordingly.
- If the symptoms or the infection persist for more than a day, consult a doctor immediately.
