Care at NUH

Sick Day Management (for people with Type 1 Diabetes)

2024/06/25

Click to return to Resources for People with Type 1 Diabetes Main Page

"Sick days" are short periods of illness such as infections that last a few days, including flu, viral fever and diarrhoea. When unwell, your body releases stress hormones, potentially elevating blood glucose levels, even with minimal food intake. Additionally, ketone levels might increase. A sick day plan is essential for managing glucose levels during these periods, aiding in the prevention of diabetic ketoacidosis (DKA) and low blood glucose. 
Signs and Symptoms of DKA

Thirst
Increased frequency of urination
Nausea, vomitting and/or stomach pain
Difficulty breathing
Extreme fatigue
Drowsiness

What to do on sick days?

Prepare for sick days by collaborating with your healthcare team when you are healthy. This preparation ensures effective management when unwell. 

The initial step involves frequent monitoring of your blood glucose and blood ketones, ideally every two hours, during periods of illness. 

Should checking your blood ketones be unfeasible, and you feel unwell, it is crucial to seek medical attention promptly. In cases where your blood ketones exceed 3.0 mmol/L, it is imperative to visit the emergency department immediately. 

Steps to do on sick days

Examples of food and liquids containing 15g of carbohydrate

Flowchart of how much quick-acting correction insulin to give based on ketone levels

Flowchart of how much quick-acting correction insulin to give based on ketone levels

How to calculate your Total Daily Dose and amount of quick-acting correction insulin

When to go to the emergency department urgently

When to go to the emergency department

Last updated on
Best viewed with Chrome 79.0, Edge 112.0, Firefox 61.0, Safari 11
National University Health System
  • National University Hospital
  • Ng Teng Fong General Hospital
  • Alexandra Hospital
  • Jurong Community Hospital
  • National University Polyclinics
  • Jurong Medical Centre
  • National University Cancer Institute, Singapore
  • National University Heart Centre, Singapore
  • National University Centre for Oral Health, Singapore
  • NUHS Diagnostics
  • NUHS Pharmacy
  • Yong Loo Lin School of Medicine
  • Faculty of Dentistry
  • Saw Swee Hock School of Public Health
Back to Top