Sick-Day Rules for Type 2 Diabetes

Assess and manage the intercurrent illness
Check diabetic control
Consider need for self-monitoring of blood glucose levels
Consider need to exclude hypoglycaemia, hyperglycaemia, ketosis (blood and urine testing)
Arrange immediate hospital admission if suspected diabetic ketoacidosis (DKA).
Warn some illnesses (such as gastroenteritis, diarrhoea, vomiting) can cause hypoglycaemia (blood glucose <3.5 mmol/L) and dehydration
Provide clear individualise oral and written advice (sick-day rules) on managing type 2 diabetes during intercurrent illness or episodes of hyperglycaemia or hypoglycaemia.
If on insulin treatment: do not stop insulin but may need to adjust dose according to self-monitored blood glucose (every 3-4 hours, including through the night) and consider ketone monitoring (thresholds are urine 2+ or blood ketone>3 mmol/L)