For affected patients, diabetes is not just a disease but a part of life. Knowing how to care for the patient during illness and special times—such as when away from home, during an emergency or natural disaster, when trying to conceive, or during pregnancy—is very important for a diabetic patient and his family.
In a sick condition:
Being sick puts pressure on the body. The body releases various hormones to deal with this illness and stress. If the level of secretion of these hormones increases, it can increase the level of sugar in the blood. In addition, colds, flu, or any other infection can increase blood sugar levels.
It is important to make a plan in advance for managing diabetes while sick. In this case, the first step is to discuss with the doctor and write down the following points:
- Blood sugar levels should be measured several times a day.
- Whether a blood or urine ‘ketone’ test should be done or not
- Whether to change the dose of diabetes medicine or not
- How to properly eat and drink
- Knowing when to contact a doctor
What to do if you are an insulin user
- Continue taking insulin when sick—even if vomiting.
- Ask your doctor how to adjust insulin dosage based on blood sugar levels.
What to do if you are taking diabetes medication
Diabetes medication should be continued when sick, even if vomiting.
Many people cannot eat properly when they are sick. Many people may feel that eating will make them vomit, so they do not eat properly. This can cause blood sugar levels to drop. Consuming sugary foods and drinks can prevent hypoglycemia.
When a diabetic patient falls ill due to any reason, the doctor usually gives the following suggestions:
- Blood sugar should be measured at least four times a day, and the results should be recorded in a diary. This diary should be kept close at hand so that it can be easily shown to the doctor.
- Even if you cannot eat properly, you should continue to take diabetes medicine.
- The patient should drink at least one cup of water every hour while awake every day.
- If you can’t eat normal food, you can try any of the following drinks or foods to prevent low blood sugar:
- Fruit juice
- Crackers Biscuits
- Dry toast
- Thin soup of chicken or vegetables
- Lollipop ice cream
- Milk and curd
- Soft drink Ex: Coke, Pepsi, Fanta, and Seven Up (not Diet or Zero Sugar)
Also, ask your doctor if you have any health-related questions.
In the following 7 cases, a doctor should be contacted without delay:
- If the blood sugar level is higher than 11 points (mmol/l) even after taking diabetes medicine,
- Ketone levels in the urine or blood are higher than normal.
- Repeated vomiting
- Diarrhea lasts more than 6 hours.
- Shortness of breath
- Fever or high body temperature
- Have trouble thinking straight or have more tremors than usual?
At school or at work:
Ways to keep diabetes under control while at school or at work
- Follow a healthy diet.
- Take diabetes medicine regularly. Take insulin as needed and measure blood sugar.
- Tell teachers, friends, and close colleagues that you have diabetes. Explain to them the signs of low blood sugar. They can help quickly if your blood sugar levels drop too low.
- Always carry sugary dry snacks with you to treat low blood sugar.
- You can write about diabetes on your ID card. It will make it easier for others to decide if there is a problem.
If away from home
If you are away from home, the following will help you:
- If any vaccinations are required before traveling, consult a doctor and get them. For example, the coronavirus vaccine and the flu vaccine
- Try to choose healthy foods as much as possible when eating out. Always keep some sugary, dry snacks with you so that you can grab them if you are late for dinner.
- Before driving for long periods of time, measure blood sugar levels. Measure blood sugar every 2 hours thereafter.
- Always keep diabetes medicine close at hand.
- Many times, it may be too late to return home. In that case, a double amount of medicine, a sugar measuring machine, and other necessary items should be taken along.
- Take comfortable and well-fitting shoes with you when going on vacation. This can prevent foot injuries if you need to walk more than usual.
- While traveling, keep photocopies of prescriptions, diabetes books, and phone numbers of close relatives in a clear file. Also, you can write the word ‘Diabetes patient’ in large size on paper and keep it in the file.
- A small first-aid kit is always good to keep close at hand.
- Get a prescription from a doctor if you are going anywhere for a long time. You can also consult a diabetes specialist where you are going.
- Buying diabetes medicine while traveling is a no-brainer. It is crucial to take your diabetes medication with you while traveling. This becomes very important, especially if you go to another country.
- Avoid drinking alcoholic beverages (i.e., wine).
Diabetes treatment varies across different countries. Patients cannot purchase medicines from pharmacies in that country without a doctor’s prescription. Not purchasing the medication beforehand can make the entire process cumbersome and expensive. As a result, there is a risk of disrupting your health.
If you are planning to conceive
Keeping blood sugar levels close to normal before conception and during pregnancy is very important for the health of the mother and the unborn child. Blood sugar levels should be close to normal even before conception.
Consult a doctor to control blood sugar levels before conception. If a woman with diabetes is already pregnant, she should immediately contact the doctor and get the necessary advice.
Insulin use may be required during pregnancy, or dose changes may occur if insulin is used before. During this time, it is necessary to measure blood sugar more frequently than usual. Consult a doctor on these matters.
If you are planning to conceive-
- Try to keep blood sugar as close to normal as possible with the doctor’s advice.
- Seek guidance from a doctor with expertise in managing diabetes in pregnant women.
- Avoid smoking and drinking alcohol, and use any medicine without a doctor’s prescription.
- Follow a healthy diet and exercise regularly.
Pregnancy can aggravate various health problems. So the eyes, heart, blood vessels, blood pressure, and kidneys should be checked regularly. It is also important to check the nerves of the hands and feet (sense and other things).
If you go somewhere by plane:
When traveling by plane, keep the following points in mind:
- If you plan to travel abroad, check with your doctor in advance about medications—especially insulin dosage.
- Get a letter from your doctor stating that you have diabetes. This letter should also include a list of medications you will need on the flight. Insulin users must carry special items for taking insulin and measuring blood sugar.
This letter should mention if the blood sugar meter or insulin injection is not suitable for passing through the x-ray machine. Avoiding these problems at the airport is possible as a result.
- Keep diabetes medications and blood tests with you on the plane. Never put them in checked luggage.
- Take dry snacks with you on the plane.
- If you are using an insulin pump, ask security personnel at the airport to hand-check it. An insulin pump can be damaged if it passes through an X-ray machine, regardless of its location on your body or in your luggage.
- While on the plane, if possible, get out of your seat and take a short walk around. It can reduce the risk of various blood vessel complications.
If you are using insulin
Keep your insulin in a special type of ‘insulated bag’, so that it doesn’t get spoiled by being too cold or too hot. Such bags are available for purchase at various major drug stores, including BMA Market in Dhaka.
Carry extra equipment for taking insulin and measuring blood sugar levels. If something is lost or broken, you can use the extra items.
In case of an emergency or natural calamity:
Everyone with diabetes should be especially prepared for any emergency or natural disaster. It could be load shedding, rainstorms, floods, cyclones, or lockdowns. Always have a bag ready for such situations. Keep all the necessary things for diabetes in one set in the bag.
Below is a list of some essentials for diabetes:
- Blood sugar meter, lancet, and testing strip
- Diabetes medication
- For insulin users, a proper insulin syringe and a special insulating bag are needed to keep insulin cool.
- Glucose or dextrose tablets, glucose gels, and sugary dry foods or drinks to treat low blood sugar
- Antibiotic cream or ointment
- A set of photocopies of medical information. It should contain details of the disease, medication, and recent test reports.
- Photocopy of the prescription. It will contain information about the name and dosage of the medicine.
Note that if the doctor recommends the use of a glucagon kit in the treatment of hypoglycemia and if you know how to use it, you can also carry it. Also, keep some dry food and a bottle of water that won’t go to waste.
Written by: Dr.Umme Fatima Fareen
Medical review is done by Dr. Ima Islam
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