Care at NUH

Living with Diabetes

What to do when you are ill
What to do when you are ill

Illnesses such as flu or gastroenteritis can cause fluctuations in blood glucose levels due to the stress of being sick and potential changes in appetite. It's crucial for individuals living with diabetes, to know how to manage their diabetes during illness to avoid both hyperglycaemia and hypoglycaemia. 
If you have Type 1 Diabetes, the following guide does not apply to you. Please consult your healthcare team for an individualized sick day plan.

As the following is a general guide, please consult your healthcare team for specific instructions tailored to your condition.

1.  Check Blood Glucose 

Monitor your blood glucose every four hours. 

Set a reminder to ensure timely checks.

2. Stay Hydrated 

Drink plenty of water, unless you are on fluid restriction 

Sip at least half a cup of water or sugar-free fluid every hour  

3. Take Regular Meals 

Continue your regular meal plan as much as possible. Consider easy-to-digest meals, such as: 

  • 1 bowl of rice porridge 
  • 1 bowl of oatmeal porridge 
  • 1 bowl of macaroni soup 
  • 6 plain crackers with a beverage 
  • 2 slices of bread with soup 
  • Diabetes-specific oral nutritional supplements  

If you are unable to eat and your blood glucose is between 4 and 10 mmol/L, consume the following every one to two hours: 

  • Half a cup of fruit juice 
  • Half of cup of cordial 

If your blood glucose falls below 4 mmol/L, follow the 15/15 rule to treat hypoglycaemia. 

4. Advice for Diabetes Medication 

Continue with insulin injections 

Keep taking your diabetes tablets except in certain situations below. 

If experiencing vomiting, having diarrhoea or poor eating/drinking, stop SGLT 2 inhibitors (e.g., dapagliflozin, empagliflozin) 

If you have a significantly reduced appetite, consult your healthcare provider about adjusting your diabetes medication. 

Seek medical attention if you are experiencing any of the following symptoms 

Fever over 37.5⁰C for more than two days 

Recurrent low blood glucose (less than 4 mmol/L) 

Recurrent high blood glucose (more than 20 mmol/L) 

Severe or persistent vomiting or inability to consume food 

Severe or persistent abdominal pain 

Feeling of breathlessness 

Persistent diarrhoea 

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