Sick day rules & wellbeing (summary)

This advice is for:

1. People with Type 2 diabetes who take tablets and/or non-insulin injectable medicine.
2. People with Type 2 diabetes who take tablets, insulin, and other injectable medicine.

Some illnesses and infections can raise your blood glucose levels. For example, if you have:

• A common cold or flu.
• A sore throat.
• A urine (water) infection.
• Bronchitis or other chest infection.
• A stomach upset or diarrhoea.
• A skin infection or abscess.

This is because when you are ill, more glucose is released into the blood as part of the body’s defence system for fighting illness and infection - particularly if you have a high temperature.

It can be harder to keep your diabetes under control if you are ill. You will need to know how to manage this. These are known as ‘sick day rules’.

If you become ill:

• Do not panic.

• Keep taking your medications.

• Check your blood sugar levels.

• Have plenty to drink.

• Keep eating and drinking.

• If you are taking a SGLT2 inhibitor and become unwell, stop taking this medication.

Your blood glucose may rise even if you are unable to eat your normal food or drink.

You should contact your GP or clinic:

• If you are not sure what to do.
• If you keep being sick and are not able to hold down any food or drink for more than six hours. You can quickly become very dehydrated.
• If your blood glucose stays high.

Sometimes you may feel overwhelmed, frustrated, in denial, or even guilty if you don’t achieve the daily requirements to manage your diabetes well. 

If all of this feels like too much to deal with, you may have something called diabetes distress. 

This is when you find it hard to take care of yourself due to the worry, frustration, and sometimes anger of having to keep up with the daily demands of managing your diabetes. In other words, you may feel burnout from having to deal with your diabetes.