Getting sick or unwell is a normal part of life whether you have diabetes or not. With diabetes, however, it is best not to get sick (remember to protect yourself and be up to date with your vaccinations), and if it happens – be prepared for what can happen. Any illness may increase your glucose levels, but if you vomit and cannot eat, you should also be mindful of hypoglycaemia. If you vomit and have high glucose levels – this is a sign that you might have ketones in your body and are at risk of Diabetes Ketoacidosis.
Read the particular sick day guidelines appropriate for your diabetes type below:
Managing Type 1 Diabetes During Illness
HSE Sick Day Guidelines for Adults with Type 1 Diabetes
If you have Type 1 diabetes and become unwell, your blood glucose and ketone levels can fluctuate, making it harder for your body to fight illness. During times of illness, your body often needs more insulin—even if you’re eating less or unable to eat. This makes regular monitoring and careful management even more important.
Always continue taking your insulin, even if you’re feeling sick or not eating. Missing doses can lead to serious complications such as diabetic ketoacidosis (DKA). Be sure to monitor your blood glucose and ketone levels more frequently and know how to interpret the results.
It’s also important to ensure you have an adequate supply of ketone test strips and hypo treatment on hand. Check that your supplies are in date and stored properly.
We recommend that you follow the HSE Sick Day Guidelines below for detailed advice on managing Type 1 diabetes during illness. This information serves as a general guide only. Each person should have a personalised Sick Day Plan, developed and reviewed regularly with their diabetes care team.
Consider discussing with your Diabetes Team how to manage Sick Day if you use diabetes technologies such as CGM, pump or Hybrid Closed Loop system.
Managing Type 2 Diabetes During Illness
Sick Day Advice for adults Managing your Type 2 Diabetes Mellitus
If you have Type 2 diabetes and are feeling unwell, your blood glucose levels may become more difficult to manage, which can make it harder for your body to recover. It’s important to understand how illness can affect your diabetes and how to adjust your medication—especially if you’re not eating as usual.
We strongly recommend speaking with your pharmacist or healthcare team if you’re unsure how to manage your condition during illness.
The HSE Sick Day Guidelines provide essential advice for adults with Type 2 diabetes on how to stay safe and in control when unwell. Please refer to the document below for practical guidance. This resource is intended as a general guide only. Be sure to have a personal sick day plan in place and review it regularly with your healthcare team.
Sick Day Guidelines for Children with Type 1 Diabetes
Illness can significantly impact blood glucose and increase the risk of diabetic ketoacidosis (DKA). It is important to seek advice from your diabetes team and also to treat the underlying illness.
Continue Insulin
Maintain insulin therapy, even if your child is eating less. Stopping insulin can lead to serious complications, including DKA.
Monitor Frequently
- Blood glucose every 2–4 hours (including overnight).
- Ketone testing (blood or urine) if blood glucose is >13.9 mmol/l, your child is vomiting, or you’re concerned.
Prevent Dehydration
Offer small, regular sips of fluids. If glucose is low, use glucose-containing drinks or fast-acting carbohydrates such as 7up.
Adjust Insulin per Plan
Use your personalised sick day plan, which may include extra rapid-acting insulin for high glucose or ketones. If you do not have a personalised sick day plan, speak with your healthcare professional team.
Know When to Seek Help
Contact your diabetes care team or attend the emergency department if any of the following occur:
- Persistent vomiting
- Moderate to high ketones not improving
- Blood glucose stays elevated despite correction
- You feel unsure or worried
Prepare in Advance
Keep the following easily accessible:
- Your child’s sick day plan and emergency contacts
- Supplies: glucose & ketone test kits, rapid-acting insulin, syringes/pens
- Suitable fluids: both sugar-free and glucose-containing
HSE Paediatric Type 1 Diabetes Resource Pack
For further guidance see the HSE HSE Paediatric Diabetes Resource pack:
Early Action is Key
Prompt monitoring, insulin adjustment, hydration, and support from your diabetes care team help ensure your child’s safe recovery during time of illness.
