Emergency / Urgent Advice

This part of the site is designed to give you basic emergency information about diabetes or endocrine problems. It is not a substitute for medical advice from a health care professional.

Sick Day Rules - looking after yourself if you are ill and have diabetes

We all get ill occasionally with the flu or a tummy bug or a chest infection. If you are concerned about Swine Flu please see the information above.

Having diabetes does not make you more likely to get ill. However, while you are ill, it can be harder to control your diabetes. In turn, having high blood sugar will make you feel worse and may slow your recovery.

What you need to do depends on what type of diabetes you have and what sort of treatment you are on.

The advice below can help you keep your diabetes under control until you are better. Make sure you look at the advice that is appropriate for you.

In the table below, identify your type of diabetes and your current treatment.  If you click on the wrong leaflet the advice will be inappropriate.

If you are feeling unwell and have diabetes treated with tablets alone click here

If you are feeling unwell and have Type 2 diabetes treated with insulin (Type 2 diabetes usually starts in later life and is often controlled by tablets initially) click here

If you are feeling unwell and have Type 1 diabetes and are on 2 injections of insulin a day click here

If you are feeling unwell and have Type 1 diabetes and are on 4 or 5 injections of insulin a day click here

Emergency Advice for People with Addison's Disease or on Replacement Pituitary Steroids

Steroids (usually hydrocortisone) as replacement for either pituitary or adrenal problems are extremely important. If you are ill, injured or stressed physically in any other way the body normally produces extra steroids. You need to do the same and increase the dose of steroid tablets that you take.

IMPORTANT - If you are not sure what to do or feel very unwell you must ask your GP for urgent advice.

Below is a rough guide to when and how to increase the dose:

*Addison's Society suggests different alteration of hydrocortisone dose for different severity of fever.

For information on Addison's Disease Crisis Management please click here.

Fludrocortisone

If you are also taking fludrocortisone you should not need to increase the dose.

Hydrocortisone by injection

If you are unable to take your hydrocortisone by mouth it must be given by injection and within a few hours. The more unwell you are the sooner you will need to have your hydrocortisone.

You or a member of your family may have been taught how to give an injection. If not you should seek emergency medical help.

Reducing your steroid dose once you are better

The longer you have been on an increased dose the more slowly you will need to reduce it. In general, if you have only been on an increased dose for 48hrs it is OK to go straight back to your usual dose.

For more detailed information on managing steroid hormone replacement see the Addison's Society website, which has an excellent emergency section.

If you are travelling abroad the Addison's Society have emergency instructions for medical staff in several different languages that you can print out.

Another useful link is the American Addison's website.