Managing Diabetes During Intercurrent Illness
- Blood glucose levels can rise during illness even if the person is not eating.
- Advise to increase blood glucose monitoring if the person has access to it.
- Diabetes medications (sulfonylureas and insulin doses) may need to be increased temporarily during illness to manage these raised glucose levels
- NEVER stop insulin or oral diabetes medications*(see qualifier below).
- Insulin doses may need to be increased during illness, especially if ketones are present.
- Ensure the person maintains hydration and carbohydrate intake.
- If the person is not able to eat or is vomiting, advise to replace meals with sugary fluids.
- If blood glucose levels are high, maintain fluid intake with sugar-free fluids.
- If blood glucose levels are low, encourage regular intake of sugary fluids.
- In type 1 diabetes, advise to check for ketones every 2–4 hours.
- Give extra rapid-acting insulin doses (in addition to regular doses) based on total daily insulin dose if ketones are present.
- Advise to drink plenty of water to maintain hydration and flush through ketones
*Metformin and SGLT2 inhibitors may need to be temporarily stopped if at risk of dehydration.
For more information click glance-factsheet-covid-19-and-diabetes-dpc