Doctor or a trip to the ER for sick Diabetic?

Call your doctor immediately! You can go to the ER or the Urgent Care but best to call the doctor. They may not want you in their waiting rooms and tell you where to go and what to do for best care.

temperature is most concerning!! And will cause glucose levels to rise horridly. But you already know that.

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Call your doctor. This is better handled at home. The ER is at least a six hour ordeal and they may not have a clue.

One thing I always forget is to take Tylenol and the two hours later take advil for the fever.

Check your sugars hourly and try to keep hydrated.I usually sip on a regular soda during the day.

If you cannot get a good handle on this or feel too weak to care for yourself, call ambulance.

A fever of 104 will start to literally cook your brain. I would Go to the walk-in or ER. If you cant afford it Take some fever reducing medicine like tylenol or ibuprofen. Take a cool shower. Don't take sleep medicine and try to take short naps while checking your temperature between them. Be careful with yourself.

Ahh, the same thing is happening to me right now! I've called my endocrinologist, and he changed my basal and bolus rates, which helped a lot. You should probably do that. Also, be sure and drink lots of water to flush the ketones out, and go by the diabetes sick day rules:

During an illness, blood sugar levels tend to rise. As a result of this increase, your body may require more insulin. Illness causes a greater than normal demand for insulin due to the release of stress hormones. These hormones are triggered by such things as fever, loss of body fluid (dehydration), and infection.

Monitoring Your Blood Glucose During Illness

Frequent blood glucose monitoring is especially important during an illness. Blood glucose should be monitored (preferably with a meter) every four hours. If your blood sugar level exceeds 240mg/ml, it is important to test the urine for ketones. Testing for ketones should also be done every twelve hours.

Eating Meals

Loss of appetite is common during illness. Nausea and vomiting may prevent you from eating your usual meals. However, you need food and fluids to help you get better. Sip or eat slowly, especially if you feel nauseous and if you are vomiting, do not eat for two hours.

Fluids

Fluids are also important during an illness, especially if you are experiencing nausea and vomiting. Repeated vomited can lead to dehydration (loss of body fluid) and loss of important electrolytes such as sodium and potassium. Try to consume four to eight ounces of fluid every one to two hours. Fluids such as broth, teas, Gatorade, water, cola or soda, orange juice, and soup will not only help with fluid replacement, but also with sodium and potassium losses. You should not eat for two hours after vomiting. If you take your routine dose of insulin and you are not eating or taking fluids, there is a danger of hypoglycemia (low blood sugar).

Sick Day Rules:

1. Always take your usual daily dose of insulin or diabetes medication. Never omit your medicines, even if you are unable to eat. Illness may even be a time when you need additional insulin or to change to a different schedule.

2. Test your blood sugar every four hours or as directed by your physician. If your blood sugar is 240mg/ml or greater, you should also check your urine for ketones and notify your physician if ketones are present in your urine. Keep a record of your results to report to your physician.

3. Weigh yourself frequently during an illness. This can help your physician estimate any fluid loss you may be experiencing.

4. Drink four to eight ounces of fluid (e.g., beverages containing sugar, water, broth, teas) every two hours. Keep a record of total fluid intake that you can report to your physician.

5. If you are unable to eat regular meals, try to consume liquid or soft foods that equal 15 grams of carbohydrate every hour or 50 grams every three to four hours. See sample diet at bottom of page.

6. Rest and stay warm. Do not exercise. Have someone available to help you take care of yourself.

7. If you should be alone during an illness, contact a neighbor, friend, or relative who will check on you several times a day.

8. Check with your doctor to determine at what blood sugar level he/she wants to be notified. Usually a blood sugar greater than 320 or 2+ ketones. KEEP NAME AND TELEPHONE NUMBER OF PHYSICIAN HANDY.

9. In any illness preventing you from eating anything at all (Nausea/Vomiting) for more than six hours, you should check your blood sugar every four to six hours and adjust with sliding scale of regular insulin and cut down long-acting insulin to half the daily insulin dose, per physician recommendation.

10. Call your doctor if:

a) Fever persists

b) Vomiting and/or diarrhea is severe

c) Illness persists beyond one to two days

11. Once the illness has passed, gradually return to your regular diabetic meal plan.

Sick Day Foods and Drinks

If you are unable to eat regular meals, try to consume liquid or soft foods that equal 15 grams of carbohydrate every hour or 50 grams every three to four hours. The following is a list of sample foods suitable for a sick day.

Fluids containing 10-27 grams of carbohydrate:

1 cup soup (1 cup Chunky Chicken Noodle ready-to-serve has 27 grams CHO

OR 1 cup Tomato with milk=22 grams CHO

OR 1 cup Tomato with water=17 grams CHO

OR 1 cup Potato with water=17 grams CHO

OR 1 cup Chicken Rice with water=7 grams CHO

1 cup Gatorade

1 cup Milk

half cup Fruit Juice

half cup Soft Drink (not sugar free)

Foods containing 10-15 grams of carbohydrate:

half cup Gelatin (not sugar free

5 to 7 Saltine Crackers

10 to 11 Wheat Thins or 5 Ritz Crackers

half cup Cooked Cereal (Oatmeal) or half Single-Serve Packet of Instant Oatmeal

3 Graham Crackers

6 Vanilla Wafers

half cup Custard

1 Popsicle

quarter cup Sherbet

half cup Applesauce

half cup Ice Cream

half cup Sugar-Free Pudding

half cup Mashed Potatoes