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b Adapting Day-By-Day:
When you're always "on", plan ahead for off days.

bodypic2Ever feel like a circus theme would be the appropriate soundtrack for your life? In ring number one, there's work. Ring number two, family. Rings three through twenty-six, everything else you've got going, including managing your diabetes. Give yourself a big round of applause — every day that you eat well, get some exercise, and keep your blood sugar within the target zone, you're doing a terrific job.

Naturally, some days aren't going to fit under "terrific." You're bound to come down with a cold or flu from time to time, or experience blood sugar highs or lows that won't leave you feeling so great. The best defence? A strong offence. Plan now for those days, and they'll be easier to manage.

Make a sick day plan. Having a plan on paper will make it easier to carry out when you're fogged in by congestion or fever. Remember, when you're sick, your body is stressed. Your system will automatically start releasing illness-fighting hormones, which also have the side effect of raising your blood sugar. So even when you're feeling your worst, careful blood sugar control is essential.


Here are a few tips for your sick day plan:
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jellyKeep sick day foods on hand:
Low-sodium canned soups, jelly, and even regular (not sugar-free) drink or sweetened tea can deliver the carbohydrates you need without upsetting your stomach.
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Take your insulin or medication as prescribed.
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Drink lots of caffeine-free liquids to keep hydrated (and flush sugar and ketones from your blood). If you're nauseated, take small sips that will stay down.
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Check and record your blood sugar levels regularly.
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Test for urine ketones every two to four hours if you have type 1 diabetes, if your blood sugar is over 15mmol/L, or if you're vomiting.
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Know when to call the doctor. A good rule of thumb is to call if you've been sick for more than 24 hours, if you can't keep down your medication or food, or if your urine ketone test reads moderate to high. List your doctor's numbers on your plan, so you don't have to try to remember them or go hunting them down.

 

b Plan for Blood Sugar Drops
Hypoglycemia, or low blood sugar, is the most common short-term complication of diabetes. You probably know the feeling — weakness, dizziness, shaking, or just not feeling "right."


Here's how to be prepared:
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Know your own safe blood sugar ranges (after all, what's too low for you might be just fine for someone else) and trust your body.

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bloodtestIf you think your  blood sugar level is low, do a blood test. The preferential place to test is from your fingertip. Studies suggest that changes in blood sugar become apparent at the fingertips as much as 15 or 20 minutes before a forearm site — that's a long time in a potentially critical situation.

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Follow the 15-15 rule. Eat 15 grams of carbohydrates and wait 15 minutes to re-test. If you're still low, have another 15 grams of carbohydrate — but be careful not to overdo it. Opt for simple sugar sweets or fast-acting glucose, which will give you results sooner than chocolate or fruit juice.

 

b Expect Occasional Blood Sugar Spikes
Hyperglycemia, or high blood sugar levels, can occur whenever you miss medications, don't get enough exercise, eat more than usual, or feel sick. You may recognize the same symptoms that you experienced before being diagnosed — excessive thirst, blurred vision or fatigue.


If your blood sugar level is high :
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Test your blood sugar levels more frequently to assess changes promptly.
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Check your urine for ketones. Call the doctor if they're moderate or high.

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Avoid exercising whenever ketones are present.

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Drink lots of water to help flush extra blood sugar and ketones out of your system.

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Adjust medications with the advice of  your health care professional.

 

Everyone can expect to have an off day now and then. After all, no one's perfect — and no one expects you to be. Taking an hour now to plan for those days will make them much easier to cope with when they arrive.

b When You're Ill

It's inevitable. Everyone comes down with a cold or the flu from time to time. Knowing that, it's important to plan ahead for these days—when you may not feel like eating much and you're unlikely to want to run out to the supermarket.

b A Sick Day Plan

bodypic1The stress of illness causes your body to release hormones that can raise your blood sugar and interfere with the effectiveness of insulin. Some medications, such as decongestants, can raise it even further.

As a result, it can be harder to keep your blood sugar in range. For people with type 1 diabetes, this can also lead to ketoacidosis, the presence of harmful ketones in the system. That's why your doctor will want you to take special precautions to keep your blood sugar under control whenever you're under the weather.

Talk with your doctor about how to handle sick days.

In general, you'll want to :
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Know when to call your doctor and keep phone numbers nearby.
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Continue to take your insulin or diabetes tablets as you normally would, unless your doctor instructs otherwise. In some cases, additional medication may be needed.
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Test blood sugar regularly, and if you have type 1 diabetes, test ketones as well.

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Write down self-monitoring results, medications taken, your temperature, food you've eaten, and anything else that may affect your blood sugar, so you can update your healthcare team if needed.

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Drink plenty of liquids to avoid dehydration and help get rid of the extra sugar and ketones in your blood. Try to drink at least one glass of fluid every hour you're awake.
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Keep sick-day foods on hand that let you get the carbohydrates you need, even if your stomach is upset.
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Get a flu shot each autumn to reduce your chances of getting sick in the first place, and have the people you live with get one, too.

b Sick Day Foods

Stick to your regular meal plan if you can. But if your stomach is upset, other foods can provide the carbohydrates your body needs. Many sick-day foods have a long shelf life, so you can purchase them well in advance and keep them on hand.



Sick day foods can include :
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Broth

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Regular (not diet) soda
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Apple sauce

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Mashed Potatoes
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Gelatin

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Popsicles
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Milk

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Fruit Juice
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Hard sweets

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Dry Toast
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Ice Cream

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Crackers

 

If necessary, try taking small sips every 15 minutes to help keep liquids down.

b When to Call the Doctor

There are certain times your doctor will want to hear from you. Talk to your doctor about specifics.


It's a good idea to call whenever...

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You've been sick for a couple of days and aren't getting better.

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You've been vomiting or have had diarrhea for more than six hours.

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Your blood sugar is higher than 15mmol/L even though you've taken any extra insulin or medication recommended by your sick-day plan.

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You have any serious symptoms of ketoacidosis, dehydration, chest problems, or other issues.

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You aren't sure what to do.


   

 

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