ILLNESS & INJURY RAISES BLOOD SUGAR (BS).

GOAL: KEEP BS LESS THAN 250 mg/dl WITHOUT KETONES.

Ketones occur when your body is short on insulin or calories.  They are acids that may build-up in the blood and cause diabetic ketoacidosis. 

BE PREPARED by making a sick day box with:

Ø      INSTRUCTIONS and PHONE NUMBERS

Ø      SUGAR and NON-SUGAR LIQUIDS such as regular and diet clear pop, glucose tablets or gel, apple juice or sports drink, regular Jell-O, instant broth or canned soup and crackers

Ø      KETOSTIX Bottles of ketostix expire 6 mo. after opening. Foil wrapped strips will be accurate until expiration date. People with Type 2 DM will rarely have ketones unless they are ill.

What to do:

Ø      CHECK BS every 2-4 hrs.

Ø      CHECK KETONES if BS is greater than 250 mg/dl.  

Ø      ALWAYS TAKE DIABETES MEDICATION Take oral medications or basal insulin (Lantus or Levemir). Take meal insulin after eating. If you have eaten only 50 % of normal calories, take 1/2 dose of meal insulin. If vomiting & diarrhea causes hypoglycemia (low BS), do not take your meal insulin.

Ø      DRINK EXTRA FLUIDS. If unable to eat, drink 8 oz non-sugar and 4 oz sugar liquid every hour while awake.  Non-sugar liquids include water, diet Sprite or weak decaf tea.  Sugar liquids are regular Sprite, apple juice or sports drinks. If eating normally, drink extra water to prevent dehydration from high BS.  Ketones can come back if you don't drink enough fluid.

When to call:

Ø      BLOOD SUGAR greater than 250 mg/dl for 2 checks or ketones in urine. Ketostix will turn pink or purple.

Ø      VOMITING that lasts more than 4-6 hours.

Ø      DOSE ADJUSTMENT on diabetes medication or insulin needed.

Ø      FEELING DEHYDRATED.  Lips and mouth are dry and muscles are weak.

Ø      EXTENDED ILLNESS that lasts longer than 2 days or unable to eat for more than 1 day.

When to go to ER or call 911:

Ø      Dehydration, being overly sleepy, confused, having trouble breathing, repeated vomiting, persistent high BS, or ketones that will not clear.

What happens when you feel better?

Ø      Eat soft bland foods like chicken soup, tea, toast or crackers, rice, applesauce or pudding.

Ø      Resume usual insulin or medication doses when blood sugars come down.

Ø      Check your blood sugar at least 4 times daily for several days.  Call if you need help managing blood sugars.

PHONE Numbers:

Ø      MADA office 316-687-3100 or 1-888-878-5101

Ø      Physician Exchange 316-262-6262