Endocrine Question #23
The nurse is instructing a Type 1 diabetic on “sick day rules” and stresses which key sick day advice?
- “You should perform more vigorous exercises to get well sooner.”
- “Sick day means not to take insulin on days that you are ill.”
- “The number one rule of thumb is to continue taking your insulin.”
- “Limit fluids when ill because fluids will be hypotonic and more harmful.”
Sick day advice includes taking insulin. When ill, stress hormones are increased and activate glucose production in the liver which leads to increase in blood glucose and desensitization of blood glucose lowering effects of insulin. Additionally, fat will be used for energy if there are not enough carbohydrates and ketones will develop. It is important to take blood sugar freqnently and log results during illness. Excess exercise will create further demand on the already stressed body. Activity in moderation may continue. Sick day does not mean to take the day off from diabetic medication. Never withhold fluids since dehydration can occur and fluids will help flush ketones from the system.