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Sick day protocol


Sick Day Protocol is SO IMPORTANT for people with diabetes (PWD). Illness causes our body’s stress hormones to elevate. This often leads to high BGs and sometimes even diabetic ketoacidosis. Because Illness can be unavoidable, it is essential that PWD are prepared!


Let’s fist talk type 1. People with type 1 diabetes often need MORE insulin during illness. This seems counterintuitive at times because illness can lead to loss of appetite. I often see patients who are sick withholding insulin because of this. DO NOT decrease or hold insulin due to illness. In fact, an increase in long acting insulin may be beneficial. Pumpers can use a temporary basal rate in these situations.


Hydration is also a MUST and diet sports drinks can help keep electrolytes up. Dehydration can quickly lead to DKA.


If sans CGM, frequent testing is a MUST. Be sure to check ketones if BG is >250mg/dl two tests in a row. Make sure to seek help (ER) if ketones are high, especially if nausea or vomiting is also present.


Type 2 DM is a little bit different. Because people with type 2 diabetes still make some of their own insulin, it is often necessary to withhold exogenous insulin or oral medications when there is appetite loss to prevent hypoglycemia.


It is flu season! Please please please don’t let a minor illness become a major problem. Proactively speak with your clinician regarding sick day protocol.




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