Past Feature Article

Do You Have a Sick Day Plan?

Written by: Kristin Prosenjak, 6th year PharmD candidate
Duquesne University Mylan School of Pharmacy, Pittsburgh, PA

When you’re sick with a cold or the flu, nothing feels right. You may be achy, tired, lethargic, sneezing, coughing… just downright miserable. But did you know that sickness will affect your glucose levels too? The body makes extra hormones to help combat illness, and these hormones affect your glucose levels. This glucose aids in healing, but can lead to dangerous complications in people with diabetes.

Prevention is an important first step

People with diabetes have a more vulnerable immune system, and are three times more likely to die from the flu or pneumonia. Vaccination is key. A flu shot is recommended once a year for people with diabetes, and also for their family and friends. The pneumococcal vaccine only needs to be received once and can prevent pneumonia, blood infection, and meningitis from the same organism. Washing your hands often, getting enough Vitamin C, and avoiding crowds during cold and flu season can also help you stay healthy.

A well-organized plan can help you prevent complications if you do get sick.

Talk to your doctor, pharmacist, and other members of your health care team to come up with a sick-day plan that is right for you. An example of a plan can be found at the Centers for Disease Control website. Not only will your plan provide helpful reminders of what to do when you are sick, but the information can also be helpful to your doctor in case you get worse. Be sure to attach phone numbers of your doctor and pharmacy so that if needed, family and friends who may be taking care of you can call with questions.

Take your medicine and test often.

Keep taking your medicine as usual (even if you are nauseous or vomiting), and test your glucose and ketones more often than normal. If you have Type 1 diabetes, testing is recommended every 4 hours; for Type 2, test 4 times a day. This can help you identify high blood glucose early, and prevent the serious conditions of ketoacidosis or hyperosmolar nonketotic coma.

Eat and drink.

Try and maintain your normal meal plan. Also, drink lots of water and non-caloric fluids to prevent dehydration and flush out extra glucose, especially if you have vomiting or diarrhea. Even if you do have stomach upset, it is important to get some carbs in your system. Aim for 50 grams of carbohydrates every 3-4 hours. Some foods that contain 10-15 grams of carbs that are easy on the stomach include:

1/2 cup fruit juice, fruit-flavored drink, regular (non-diet) soda
6 saltines
1 cup milk
1/2 cup vanilla ice cream, sugar-free pudding, regular Jell-O (not sugar-free)
1/2 cup cooked macaroni, noodles, rice, mashed potatoes

Ask before you self-treat.

Consult your doctor or pharmacist before taking any over-the-counter medicines. Many cough and cold medicines contain sweeteners. Be aware that large doses of aspirin could lower glucose levels, while decongestants may raise them. Even prescription antibiotics may affect glucose levels. There are sugar-free medicines available and your pharmacist can assist in selecting the best product for you.

When needed, contact your doctor.

If you are very sick, your cold or flu can progress very quickly into serious complications. Be familiar with these signs of when to contact your doctor:

Blood glucose under 60mg/dL or over 300 mg/dL; or over 240 mg/dL for 24 hours
Urine ketone level moderate-large
Vomiting or diarrhea for more than 6 hours
Too sick to eat and unable to keep food down for more than 6 hours
Feeling confused, very tired, or can’t think clearly
Signs of dehydration or ketoacidosis (dry mouth and lips, chest pain, trouble breathing, rapid breathing, fruity-smelling breath)
Fever of 101ºF or higher, or a fever for more than 24 hours
Losing 5 pounds or more

Taking the proper steps for prevention and having a good sick day plan to back you up will help you get back on your feet in no time! Be sure to work with your healthcare team to ensure you develop the best sick day plan for you. When you do get hit with illness, be sure to talk to your Rite Aid Pharmacist for help in finding the right relief for you.

References:

Anonymous. Diabetes management: Creating your sick-day plan (www.mayoclinic.com/health/diabetes-
management/DA00110) Accessed on 7 February 2007.
Anonymous. When You're Sick (www.diabetes.org/type-1-
diabetes/sick.jsp) Accessed on 7 February 2007.
Anonymous. Flu & Pneumonia Shots.
(www.diabetes. org/type-2-diabetes/flu-
pneumonia-shots.jsp) Accessed 7 February 2007.
Anonymous. Frequently Asked Questions: Diabetes-Related Health Concerns (www.cdc.gov/diabetes/faq/
concerns.htm) Accessed on 7 February 2007.
Anonymous. Taking Care of Yourself When You're Sick. (www.cdc.gov/diabetes/pubs/tcyd/
ktrack.htm) Accessed on 7 February 2007.