Endocrinology Book

Information Resources

http://www.fpnotebook.com/

Diabetes Sick Day Management

Aka: Diabetes Sick Day Management, Sick Day Management in Diabetes
  1. See Also
    1. Diabetes Mellitus
    2. Type I Diabetes Mellitus
    3. Type II Diabetes Mellitus
    4. Insulin Resistance Syndrome
    5. Glucose Metabolism
    6. Diabetes Mellitus Education
    7. Diabetic Ketoacidosis
    8. Hyperosmolar Hyperglycemic State
    9. Diabetes Mellitus Control in Hospital
    10. Diabetes Mellitus Glucose Management
    11. Diabetes Sick Day Management
    12. Hypertension in Diabetes Mellitus
    13. Hyperlipidemia in Diabetes Mellitus
    14. Diabetic Retinopathy
    15. Diabetic Nephropathy
    16. Diabetic Neuropathy
    17. Coronary Artery Disease Prevention in Diabetes
    18. Tobacco Cessation
    19. Obesity Management
  2. Management: General
    1. Diabetic action plan based on Blood Glucose Monitoring
    2. Early contact with medical provider when Glucose control acutely changes (see red flags listed below)
  3. Management: Medications
    1. Metformin
      1. Stop when dehydrated (e.g. Vomiting, Diarrhea) and restart when resolves
    2. Insulin Secretagogues (Sulfonylureas, Repaglinide, Nateglinide)
      1. Hold for decreased intake and risk of Hypoglycemia
    3. Bolus Insulin (e.g. Regular, Lispro)
      1. Increase Bolus Insulin by 5-20% for consistent Blood Glucose >250 mg/dl
      2. Hold or decrease Bolus Insulin for inability to take carbohydrates and risk of Hypoglycemia
    4. Basal Insulin (e.g. Lantus, Detemir)
      1. Continue basal dosing despite illness
      2. Consider decreased basal Insulin Dosing if inability to eat carbohydrates
    5. Insulin Pump
      1. Make a back-up plan for Insulin Pump failure
  4. Management: Labs
    1. Glucose
      1. Seek medical attention (or call) for Blood Glucose consistently >300 mg/dl on at least 2 consecutive checks
      2. Increase monitor while ill
        1. No Insulin: 2-4 times daily
        2. Insulin: every 2-4 hours
    2. Ketones or Beta Hydroxybutyrate (in Type I Diabetes Mellitus)
      1. Home ketone monitoring while ill (especially with Blood Glucose >240 mg/dl)
  5. Precuations: Red flags warranting repeat examination
    1. Prolonged Vomiting
    2. Inability to hold down fluids
    3. Presistent or Recurrent Hypoglcemia or Hyperglycemia
  6. References
    1. (2012) Presc Lett 20(3): 13-14
    2. Westerberg (2013) Am Fam Physician 87(5): 337-46 [PubMed]

You are currently viewing the original 'fpnotebook.com\legacy' version of this website. Internet Explorer 8.0 and older will automatically be redirected to this legacy version.

If you are using a modern web browser, you may instead navigate to the newer desktop version of fpnotebook. Another, mobile version is also available which should function on both newer and older web browsers.

Please Contact Me as you run across problems with any of these versions on the website.

Navigation Tree