The following is some information on how to manage sick days for brief illness (24 hours or less). When you are sick your blood sugar usually goes up.

Taking Medication

• If you take insulin, never omit your insulin. Consult your doctor for guidelines on insulin dose if you have a question about how much to take.

• If you take diabetes pills, take the same number of diabetes pills you always do. Consult your doctor for guidelines if you have a question about how much to take.

• If you vomit, do not take your diabetes pills until you can eat without vomiting.

Testing

• Test your blood sugar four times a day.

• If you have Type 1 diabetes mellitus check urine ketones four times a day. (Ask the nurse to show you how to check urine ketones. Always have ketone testing strips available.)

Eating

• Eat your usual meals and snacks if possible.

• If you cannot eat solid foods, some foods that you can eat or drink to help maintain your blood sugar are listed in the following table. Eat one of the food items each hour from breakfast to bedtime. Contact your doctor if you have any questions about this type of carbohydrate or food replacement.

  Food Item	How Much
  Regular soda pop	= 1/2 to 3/4 cup
  Juice	= 1/2 cup
  Ice cream	= 1/2 cup
  Sherbet	= 1/4 cup
  Soup	= 1 cup
  Soda crackers	= 6

• When you feel you can eat again, eat a small snack. Then eat your usual meals and snacks at their normal times.

Fluids

In addition to the above foods and fluids, it is important to drink plenty of fluids every hour to prevent dehydration. These extra fluids should be calorie free fluids such as diet pop, broth, tea, etc. If you are on a fluid restricted diet, please consult your doctor about the amount of fluid to drink.

Call Your Doctor:

• if you are unable to take in fluids
• if vomiting occurs more than once
• if you have diarrhea more than 5 times or longer than 24 hours
• if your blood sugars are higher than 300 mg/dL two times in a row
• if you have moderate or large ketones in your urine
• if you have stomach pain or rapid, hard breathing
• if you have increasing weakness or drowsiness