Question

1. Since blood sugar goes up with infection, we need to teach "Sick Day Rules"

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2. "You should call the MD if:

(give 5 reasons)

Answer 1

Sick day rules means when infection occurs, naturally body activates inflammatory mediators to fight against infection. These inflammatory mediators are tense to rise the blood sugar level and resistence to insulin. because of this the patient with diabetes have risen blood sugar level during any infection. To manage this sick days - a sick day plan to be explained to them.

Sick day rules for diabetes

Encourage them to take their regular antidiabetic medicine as regularly.

Tell to them to follow their regular diet

Encourage them to drink more fluids ( non sugary) to maintain hydration

Check blood sugar level every 4 hours

Check their urine ketones. observe for fruit breath smell (sign of ketoacidosis)

Do not take any medication without prescription that may rise up their blood glucose level.

You should call MD for the following reason

If you have vomiting and you can not take your regular oral antidiabetic drugs or regular diet and to ask about diet and exchange of regular medicines.

If blood sugar level rise up than normal limit prescribed by doctor (> 240 mgs/ dl) more than 2 readings

If have felt the symptoms of diabetic keto acidosis such as fruit breath smell, severe vomiting, breathing difficulty

If presence of dehydration symptoms such as dry mouth, coated tongue, dark urine

Persistence of fever or any other abnormal symptoms