Your Sick-Day Rules

Illness is the commonest trigger for ketoacidosis, and it is manageable if you know the rules in advance. Work them out while you are well.

The first rule overrides instinct: keep taking your insulin, even if you are not eating. Illness releases hormones that push your blood sugar up, so your need for insulin goes up too, not down. You may in fact need extra.

While you are unwell

• Continue insulin as directed — never stop it because you are not eating.
• Check blood sugar every four hours and write down the results.
• Check ketones every four to six hours, and any time your reading is 250 mg/dL or above.
• Drink plenty of fluids. If you cannot keep them down, take small sips or ice chips every 15 minutes.
• If you cannot eat meals, aim for around 50 grams of carbohydrate every four hours — juice, thin khichdi, or something similarly easy.

Get your own written plan from your doctor, covering how much extra insulin to give for ketones and who to call. Then keep it somewhere your family can find it — on the fridge is the traditional answer and still the best one.

For a child, tell the school if they have been unwell, and do not send them in while ketones are present.