S

(Sugar)

• 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.

I

(Insulin)

• NEVER stop insulin or oral diabetes medications*
• Insulin doses may need to be increased during illness, especially if ketones are present
• Specific advice for people on insulin therapy is available

C

(Carbohydrate)

• 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

K

(Ketones)

• In type 1 diabetes, advise to check for ketones every 4-6 hours.  If present, check every 2 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