🚨 URGENT: When to Seek Emergency Help

• Blood ketones ≥3.0 mmol/L or urine ketones +++/++++
• Cannot keep fluids down (repeated vomiting)
• Very high glucose despite extra insulin
Call 999 or go to A&E immediately

Sick Day Rules for Diabetes

Essential management guidelines for people with diabetes during flu, COVID, food poisoning, and other illnesses. Learn how to maintain stable blood sugar levels when you're feeling unwell.

Key Takeaways - Pin This to Your Fridge

✅ Always Do These

Never stop basal insulin - even if you're not eating
Check glucose every 2 hours whilst ill
Test ketones if glucose >13-14 mmol/L or feeling sick
Keep fluids going - sip small amounts often

⚠️ Critical Numbers

Glucose >13-14 mmol/L → Check ketones + consider extra insulin
Ketones 0.6-2.9 mmol/L → Extra insulin + fluids, recheck 2hrs
Ketones ≥3.0 mmol/L → A&E/999 immediately
Glucose <4.0 mmol/L → Treat hypo with 15-20g fast carbs

Person with diabetes managing illness at home with medical supplies and thermometer

Medication Rules

Which medicines to pause and which to continue

Ketone Testing

When to test and how to interpret results

Illness Types

Flu, COVID vs food poisoning differences

Why Does Being Ill Mess With Your Blood Sugar?

Man with fever lying sick in bed with thermometer showing effects of illness on diabetes

Fever & Infection

Your body releases stress hormones like cortisol when fighting infection. These hormones tell your liver to dump glucose into your bloodstream - it's trying to give you energy to fight the illness, but it makes blood sugar spike.

Dehydration

When you're dehydrated, your blood becomes more concentrated - like adding less water to orange squash. Same amount of glucose, but in a smaller volume of fluid equals higher readings.

When you're sick, your body enters "fight mode" - releasing stress hormones like cortisol and adrenaline that naturally raise blood sugar. This happens even if you're not eating much. Understanding this biological response is crucial for proper diabetes management during illness.

I've been managing diabetes for over 15 years now, and I'll be honest with you - the first time I got proper flu after my diagnosis, I was completely unprepared. My blood sugar went from its usual well-behaved 6-8 mmol/L range to consistently hitting 15+ mmol/L, despite me barely eating anything. It didn't make sense at the time.

The Exception That Proves the Rule

There's one major exception to the "illness = high blood sugar" rule. If you're vomiting loads or can't keep anything down, especially if you're on insulin or sulfonylureas (like gliclazide), you might actually go low. Your body's still pumping out stress hormones, but you're not getting any carbs in. It's like having the accelerator and brake pressed at the same time.

The Science Bit (Without the Boring Parts)

When you get ill - whether it's flu, COVID, a chest infection, or even food poisoning - your body releases what we call "stress hormones." The main culprits are cortisol, adrenaline, and growth hormone. These aren't trying to make your life difficult; they're actually trying to help.

Your body thinks "Right, we're under attack, we need energy to fight this off." So it tells your liver to convert stored glycogen into glucose and dump it into your bloodstream. Problem is, when you have diabetes, you either can't make enough insulin to deal with this extra glucose (Type 1), or your body can't use the insulin properly (Type 2).

Why Blood Sugar Goes UP During Illness

• Stress hormones increase glucose production
• Dehydration concentrates existing glucose
• Reduced physical activity
• Some medications (like steroids) raise glucose
• Sleep disruption affects hormones

Why Blood Sugar Might Go LOW

• Vomiting prevents carb absorption
• Poor appetite = reduced food intake
• Still taking same insulin/medication dose
• Diarrhoea can affect absorption
• Fever increases metabolic rate

Real Talk: What This Actually Feels Like

Last winter, I caught what I thought was just a minor cold. Within 24 hours, my continuous glucose monitor was basically having a nervous breakdown - alarms going off left, right and centre. My blood sugar hit 18 mmol/L at one point, and I genuinely felt worse from the high blood sugar than I did from the actual cold symptoms.

The frustrating thing is that you feel rubbish from being ill, then you feel even more rubbish from the high blood sugar - thirsty, tired, headachy. It's like a double whammy. Plus, high blood sugar can actually make it harder for your immune system to fight off the infection, so you end up being ill for longer.

Expert Tip: The Two-Hour Rule

As someone who's been through this more times than I'd like to count, here's what I wish someone had told me early on: check your blood sugar every 2 hours when you're unwell, even if you normally only check once or twice a day. Set phone alarms if you need to. Being ill makes everything unpredictable, and those 2-hourly checks give you the information you need to stay safe.

The Golden Rules - Never Break These

These apply to everyone with diabetes, whether you're Type 1, Type 2, or managing any other form. Think of them as your safety net when everything else feels chaotic.

Rule #1: Never, Ever Stop Your Basal/Background Insulin

I don't care if you haven't eaten for 24 hours. I don't care if you're vomiting everything up. Your basal insulin keeps ticking away in the background, and stopping it is like removing the foundation from under a house.

Why this matters: Even when you're not eating, your liver is still producing glucose. Without basal insulin, people with Type 1 diabetes can develop diabetic ketoacidosis (DKA) within hours. For Type 2s on insulin, the risk is lower but still real.

Rule #2: Check Your Numbers Like Your Life Depends on It

Type 1 Diabetes

• Glucose every 2 hours
• Ketones every 2-4 hours if glucose high
• Ketones if you feel sick (even with normal glucose)

Type 2 Diabetes

• Glucose every 2-4 hours (if you have a meter)
• More frequent if levels rising
• Consider ketone testing if very high

Yes, it's a pain. Yes, your fingers will get sore. But here's the thing - when you're ill, diabetes becomes unpredictable. Those regular checks are your early warning system.

Rule #3: Fluids + Some Carbs (The Balancing Act)

This one's trickier than it sounds. You need to stay hydrated, but you also need to think about what you're drinking and eating based on your blood sugar levels.

If Blood Sugar is HIGH (>10 mmol/L)

• Water, sugar-free squash, diet drinks
• Avoid fruit juice, regular fizzy drinks
• Small sips every 10-15 minutes
• If you must have carbs, account for them

If Blood Sugar is LOW/NORMAL or You Can't Eat

• Add some glucose-containing fluids
• Milky tea, sports drinks (diluted), yoghurt drinks
• Toast, crackers, rice pudding
• Whatever you can keep down

Medical research showing diabetes management during illness with testing supplies and medications

Rule #4: Test Ketones When Unwell

Ketones are like the canary in the coal mine for people with diabetes. They tell you when your body is starting to burn fat for energy instead of glucose - which sounds healthy, but isn't when you have diabetes.

When to test: If your blood sugar is above 13-14 mmol/L, or if you feel sick/nauseous even with normal blood sugar. Don't wait until you feel awful.

Personal tip: I keep my blood ketone meter in the same place as my thermometer and paracetamol. When I reach for the "feeling rubbish" supplies, I'm reminded to check ketones too. Has saved me from a couple of hospital trips over the years.

Rule #5: Keep Hypo Treatments Within Arm's Reach

When you're feeling rough and potentially not thinking straight, the last thing you want is to be stumbling around looking for glucose tablets because your blood sugar has dropped to 3.2 mmol/L.

Glucose Tablets

4-5 tablets = 20g

Lucozade

150-200ml original

Jelly Babies

4-5 sweets

The drill: If below 4.0 mmol/L, take 15-20g fast carbs, wait 10-15 minutes, recheck. Once you're 4.0+ mmol/L, have something starchy like toast or biscuits. Don't skip the starchy bit - illness can make hypos more likely to bounce back.

Rule #1: Check Blood Sugar Every 2-4 Hours

This is non-negotiable. Even if you're not eating, illness can send your blood sugar soaring. Use our blood sugar testing guide for proper technique.

Set alarms every 2-4 hours, even overnight
Record all readings with time and symptoms
Check more frequently if blood sugar is unstable
Know your target blood sugar ranges

Ketone Action Table - Your Safety Guide

Print this out and stick it on your fridge. When you're feeling rough and your brain's a bit fuzzy, you don't want to be trying to remember what different ketone levels mean.

Ketone Levels & Actions

Use blood ketones where possible - they're more accurate than urine

Blood Ketones	Urine Ketones	Risk Level	What to Do
0.0-0.5 mmol/L	Negative/trace	Normal	Keep fluids up; monitor more often than usual
0.6-1.5 mmol/L	+ or ++	At Risk	Fluids + extra rapid-acting insulin per your plan; recheck in 2 hours
1.6-2.9 mmol/L	++	High Risk	Fluids + extra insulin; recheck in 2 hours; contact diabetes team/call 111
≥3.0 mmol/L	+++/++++	Emergency	A&E/999 immediately - probable DKA

Blood vs Urine Ketones - Which Should You Use?

If you can afford it, get a blood ketone meter. Urine ketone strips are better than nothing, but they're a bit like looking in the rear-view mirror - they tell you what was happening a few hours ago, not what's happening right now.

Cost tip: Blood ketone strips are expensive (about £1 each), but many diabetes teams will provide them free if you're at higher risk. Worth asking!

What "Recheck in 2 Hours" Actually Means

Set a proper alarm. I don't mean "I'll remember to check in a bit." When you're ill and potentially not thinking clearly, 2 hours can easily become 4 or 6 hours. That's how people end up in A&E.

Personal trick: I name my phone alarms "CHECK KETONES NOW" in capital letters. Sounds dramatic, but it works.

Diabetes management supplies including ketone testing strips and blood glucose meter for sick day monitoring

Emergency Action Steps for High Ketones (1.6+ mmol/L)

Immediate Actions:

Take extra rapid-acting insulin (as per your sick day plan)
Drink sugar-free fluids every 15-30 minutes
Don't exercise (it can make ketones worse)
Set alarm to recheck in exactly 2 hours

Contact Numbers Ready:

• Your diabetes team/specialist nurse
• NHS 111 for advice
• Local A&E department
• Someone who can drive you if needed

Why This Table Exists - A Personal Story

About 8 years ago, I had what I thought was a mild stomach bug. My blood sugar was running high (around 15 mmol/L), but I thought "well, I'm ill, that's normal." I didn't test ketones until I started feeling really sick - nauseous, breathing felt weird, just generally awful.

When I finally tested, my ketones were 2.1 mmol/L. Not quite emergency territory, but definitely in the "you need to sort this out right now" zone. Six hours of extra insulin, constant sipping of sugar-free drinks, and obsessive monitoring later, I was back to normal. But it was scary.

The thing that struck me afterwards was how quickly it escalated. From "bit under the weather" to "potentially serious problem" in about 12 hours. That's why having this table and following it religiously matters so much.

Ketone testing is essential when you're sick, especially with Type 1 diabetes. High ketones combined with dangerously high blood sugar levels can lead to diabetic ketoacidosis (DKA), a life-threatening emergency.

Medicines: Stop, Pause, or Keep Going?

This is where it gets proper confusing. Some tablets need stopping when you're ill, others you keep taking, and getting it wrong can land you in hospital. Here's the simple version - no medical degree required.

Remember: SADMAN(S) - The Medicines to Pause

UK healthcare teams use this memory trick. These medicines increase the risk of dehydration, kidney problems, or DKA when you're unwell.

S

SGLT2 inhibitors

A

ACE inhibitors

D

Diuretics

M

Metformin

A

ARBs

N

NSAIDs

S

Sulfonylureas

Complete Medicine Guide for Sick Days

Medicine Type	Examples	Sick Day Action	Why
SGLT2 inhibitors	dapagliflozin, empagliflozin, canagliflozin	PAUSE when unwell	Reduces DKA risk during illness
Metformin	metformin	PAUSE if vomiting/dehydrated	Prevents kidney injury & lactic acidosis
Sulfonylureas	gliclazide, glipizide	PAUSE if not eating properly	Prevents hypos when intake is poor
ACE inhibitors / ARBs	ramipril, lisinopril, losartan	PAUSE during dehydration	Kidney injury risk when dehydrated
Diuretics	furosemide, bendroflumethiazide	PAUSE during dehydration	Can worsen dehydration
NSAIDs	ibuprofen, naproxen	AVOID - use paracetamol	Kidney injury risk with dehydration
All Insulins	basal, bolus, mixed	NEVER STOP	Illness usually increases insulin need
GLP-1 RAs	semaglutide, liraglutide	CONSIDER pausing if severe vomiting	To reduce nausea & dehydration

When to Restart Paused Medicines

• Been eating and drinking normally for 24-48 hours
• No vomiting or diarrhoea for at least 24 hours
• Temperature back to normal
• Feeling generally better
• Blood sugar levels more stable

Don't rush it: Better to wait an extra day than restart too early and end up back at square one.

Special Case: If You're Prescribed Steroids

Sometimes doctors give you prednisolone or other steroids for chest infections or COVID complications. These will send your blood sugar through the roof, often later in the day.

Action needed: Contact your diabetes team immediately for a temporary management plan. Don't try to wing it - steroids can be brutal on blood sugar control.

Real Example: My Last Bout of Food Poisoning

Last summer, I got proper food poisoning - the kind where you're best friends with the bathroom for 48 hours. Here's exactly what I did with my medicines, and why:

What I STOPPED:

• Metformin (vomiting = dehydration risk)
• Ramipril (my ACE inhibitor)
• Ibuprofen for the headache (used paracetamol instead)

What I KEPT:

• Basal insulin (obviously)
• Rapid-acting for corrections
• Blood pressure medicine (different type)

The tricky bit was restarting everything. I waited until I'd been eating properly for 2 full days before I restarted the metformin and ramipril. Felt a bit paranoid, but my GP said I'd done exactly the right thing.

The lesson: When in doubt, err on the side of caution. It's better to be off a tablet for a few extra days than to end up in hospital with kidney problems.

Managing medications during illness requires careful attention. Some medications may need adjustment, while others should be continued. If you're looking for natural support alongside your prescribed medications, consider reviewing our best blood sugar supplements guide.

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Type 1 vs Type 2 - What's Different?

While the golden rules apply to everyone, there are some important differences between managing Type 1 and Type 2 diabetes when you're ill. Here's what you need to know for your specific situation. For comprehensive information by age group, see our diabetes by age groups guide.

Type 1 Diabetes

Higher risk, more intensive monitoring needed

Key Differences for Type 1

Much higher DKA risk - can develop within hours
Check glucose & ketones every 2 hours minimum
Almost always need extra rapid-acting insulin
Never, ever stop basal insulin - even if not eating

Pump Users - Extra Vigilance Needed

If you're on an insulin pump and your glucose stays high despite corrections, or ketones appear, change your infusion set and reservoir immediately. Sometimes the set gets blocked or kinked when you're lying in bed feeling rough.

Never go to sleep with unresolved high glucose or ketones if you're on a pump!

Your Sick Day Insulin Plan

Every person with Type 1 should have a written sick day plan from their diabetes team. If you don't have one, ask for it at your next appointment. It should tell you exactly how much extra rapid-acting insulin to give for different glucose and ketone levels.

As a rough guide, many people need 10-20% more rapid-acting insulin during illness, but this varies massively between individuals. Learn more about natural approaches to blood sugar management that can complement your medical treatment.

Type 2 Diabetes

Different approaches depending on your treatment

If You Take Tablets Only

• Use the SADMAN(S) pause/continue rules
• Check glucose every 2-4 hours if you have a meter
• Lower DKA risk, but still possible (especially with SGLT2 inhibitors)
• Focus on staying hydrated
• Consider ketone testing if glucose very high (>20 mmol/L)

If You Use Insulin (± Tablets)

• Never stop insulin (same rule as Type 1)
• May need extra short-acting insulin while ill
• Higher DKA risk than tablets-only
• Check ketones if glucose >15 mmol/L
• Ask your team for a personalised sick day plan

The Tricky Middle Ground

Type 2 diabetes management during illness can be more complex than Type 1 in some ways, because there's more variation in treatment approaches. Someone on just metformin has very different needs to someone on insulin plus multiple tablets. The key is understanding your specific medication regime and how it interacts with being unwell.

CGM and Finger-Prick Testing During Illness

CGM Adjustments

• Set tighter alert ranges (lower high alert, higher low alert)
• Increase scan frequency if using Libre
• Set overnight alerts - don't silence them when ill
• Be aware CGM may be less accurate during dehydration

When CGM and Finger-Prick Don't Match

• Trust your symptoms first
• Do a finger-prick test to confirm
• Treat based on symptoms while you recheck
• Dehydration can affect both readings

Personal experience: When I had COVID in 2022, my Libre readings were consistently 2-3 mmol/L lower than finger-prick tests. I suspect it was related to being dehydrated and my circulation being a bit off. Always worth double-checking with finger-pricks when you're unwell.

What Most People Don't Realise

Here's something I've learned from nearly two decades of managing Type 1 diabetes: the difference between Type 1 and Type 2 sick day management isn't just about insulin vs tablets. It's about how quickly things can go wrong.

With Type 1, you can go from "feeling a bit rough" to "needs hospital attention" in 6-12 hours if you make the wrong choices. With Type 2 (especially if you're not on insulin), you usually have more time to correct mistakes. But that doesn't mean you should be complacent.

The other thing that surprises people is that some Type 2s who've had diabetes for many years can actually develop DKA just like Type 1s, especially if they're very unwell or have lost a lot of weight recently.

Bottom line: Whatever type of diabetes you have, take illness seriously, follow the monitoring guidelines for your type, and don't hesitate to seek help if you're unsure. Better safe than sorry doesn't just apply to crossing the road.

Different Bugs, Different Rules

Not all illnesses are created equal when you have diabetes. Flu and COVID behave differently to food poisoning or stomach bugs. Here's how to tailor your approach based on what's actually wrong with you.

Flu, COVID & Viral Infections

Fever-focused illnesses that love to mess with your blood sugar

What to Expect

Blood sugar usually goes HIGH (stress hormone response to fever)
Fever, aches, fatigue - classic viral symptoms
May not want to eat much, but usually can keep fluids down
Symptoms develop gradually over 1-3 days

COVID Specifics

COVID can be particularly brutal on blood sugar control, sometimes for weeks after the initial infection. Some people report persistent high readings even after other symptoms clear up.

Long COVID note: If your diabetes control remains poor weeks after COVID, mention this to your diabetes team - it's a recognised issue.

Management Approach for Viral Illnesses

Do:

• Follow standard sick day rules
• Check glucose every 2 hours
• Test ketones if glucose >13 mmol/L
• Take paracetamol for fever (not ibuprofen)
• Rest and stay hydrated

Watch for:

• Persistent high readings despite extra insulin
• Ketones developing
• Difficulty breathing
• Chest pain or pressure
• Severe dehydration

Vaccination Reminder

People with diabetes are eligible for free NHS flu vaccinations every autumn/winter, and should be prioritised for COVID boosters. Book early for best protection - it's much easier to prevent these illnesses than manage diabetes through them!

Food Poisoning & Stomach Bugs

High dehydration risk - different management needed

What's Different

Massive dehydration risk from vomiting & diarrhoea
Can't keep food OR fluids down initially
Blood sugar can go UP (dehydration) or DOWN (no carbs)
Symptoms often hit suddenly and severely

Higher Risk Situations

Taking SGLT2 inhibitors (higher DKA risk)

On insulin (hypo risk if can't eat)

Heart/kidney problems (dehydration more dangerous)

Critical SADMAN(S) Application

This is where the medicine pausing rules become absolutely crucial. When you're vomiting and losing fluids rapidly, continuing certain medicines can be dangerous:

STOP immediately:

• SGLT2 inhibitors (DKA risk)
• Metformin (kidney protection)
• ACE inhibitors/ARBs
• Diuretics
• NSAIDs for pain

KEEP going:

• All insulin (never stop)
• Paracetamol for fever
• Essential heart medicines (check with GP)
• Thyroid medications

Rehydration Strategy

Small sips every 10-15 minutes. If you drink too much too quickly, it often comes straight back up. Oral rehydration salts (like Dioralyte) are brilliant if you can keep them down.

Emergency signs: If you can't keep ANY fluids down for 6+ hours, or you're showing signs of severe dehydration (dizziness, confusion, very dry mouth), get urgent medical help.

Quick Comparison Guide

Aspect	Flu/COVID/Viral	Food Poisoning/D&V
Blood Sugar Pattern	Usually HIGH (stress response)	Variable - can go high OR low
Main Risk	High glucose, possible DKA	Severe dehydration, hypos
Medicine Changes	Standard sick day rules	Aggressive SADMAN(S) pausing
Fluid Intake	Usually manageable	Major challenge - tiny sips only
Onset	Gradual (1-3 days)	Sudden (hours)

Flu, COVID & Viral Infections

The marathon illness - lasting several days

What to Expect

Blood sugar typically elevated for 3-7 days
Fever increases insulin resistance significantly
Dehydration compounds the problem
Appetite usually reduced but stress hormones still high
Risk of secondary bacterial infections
Be alert for high blood sugar symptoms

Management Strategy

Monitor blood sugar every 2-4 hours religiously
Check ketones if Type 1 or blood sugar >15mmol/L
Maintain medication schedule (use SADMAN(S) rules)
Prioritise hydration - aim for pale yellow urine
Rest is crucial - your body needs energy to fight infection
Consider anti-viral treatment if eligible and within window

Your Sick Day Survival Kit

Being prepared is half the battle. When you're feeling rubbish at 2am, the last thing you want is to be rummaging around looking for test strips or glucose tablets. Here's what every person with diabetes should have ready.

Essential Sick Day Kit

Keep this stuff together in one place - drawer, cupboard, or dedicated box

Blood Sugar Testing

• Blood glucose meter + spare batteries
• Test strips (1-month supply minimum)
• Lancets + lancing device
• CGM sensors (if you use them)
• Phone charger for CGM apps

Pro tip: Check expiry dates every 3 months. Expired strips give dodgy readings.

Ketone Testing

• Blood ketone meter (if possible)
• Blood ketone strips (expensive but accurate)
• Urine ketone strips (cheaper backup option)
• Instructions for interpreting results

Money saver: Ask your diabetes team if they provide ketone strips free for high-risk patients.

Hypo Treatment

• Glucose tablets (check expiry dates)
• Glucose gels/liquid glucose
• Jelly babies or similar sweets
• Lucozade or similar sugary drinks
• Longer-acting carbs (crackers, biscuits)

Stock check: Replace items before they expire. Stale glucose tablets taste awful and work slower.

Insulin & Medications

• Spare insulin pens (in-date)
• Extra pen needles
• Pump supplies (sets, reservoirs, batteries)
• All your regular medications
• Copy of your sick day plan

Insulin storage: Keep spares in the fridge. When ill, you might use more than usual.

General Illness Supplies

• Digital thermometer
• Paracetamol (avoid ibuprofen)
• Oral rehydration salts (Dioralyte type)
• Sugar-free drinks, squash
• Tissues, throat lozenges

Pain relief: Stick to paracetamol when dehydrated. NSAIDs can damage kidneys.

Emergency Contacts

• GP surgery number
• Diabetes specialist nurse
• NHS 111
• Local A&E department
• Someone who can drive you

Smart move: Program these into your phone AND write them down (in case phone battery dies).

Storage & Organisation

Don't scatter this stuff around the house. When you're feeling rough, you won't want to be hunting through different cupboards for supplies. I use a clear plastic storage box that lives in my bedroom - everything in one place.

Label everything: Include expiry dates and what each item is for. When your brain's foggy from illness, clear labels are a godsend.

Maintenance Schedule

Set a phone reminder every 3 months to check your kit. Replace expired items, test that your meter still works, make sure you've got enough of everything. It's boring, but essential.

Seasonal check: I do mine when the clocks change - easy to remember and happens twice a year.

Travel Version of Your Sick Day Kit

Getting ill away from home is even more stressful when you have diabetes. Pack a mini version of your sick day kit whenever you travel - even for day trips.

Travel Essentials

• Blood glucose meter + strips
• Ketone testing strips
• Fast-acting glucose treatment
• Extra insulin + needles
• Paracetamol
• Written contact numbers
• Travel insurance documents

Smart Packing Tips

• Split supplies between carry-on and checked luggage
• Carry doctor's letter for insulin/needles
• Know how to say "I have diabetes" in local language
• Research local emergency numbers
• Pack 50% more supplies than you think you'll need

Why This Kit Saved My Sanity (and Possibly My Life)

About 5 years ago, I got hit with a nasty stomach bug at about 11pm on a Sunday night. Before I had my sick day kit sorted, this would have meant stumbling around the house in the dark, trying to remember where I'd left my meter, realising I was out of ketone strips, and generally panicking.

Instead, I grabbed my kit, tested glucose (16 mmol/L), tested ketones (1.2 mmol/L - concerning but not emergency), gave myself extra insulin, and started sipping sugar-free fluids. All sorted within 10 minutes, even though I felt absolutely dreadful.

By morning, my levels were back to normal and I was on the mend. Without the kit, I reckon I would have ended up in A&E purely because I wouldn't have been able to manage things properly when I felt so rough.

The investment: Setting up a proper sick day kit costs maybe £50-100 if you buy everything from scratch. Compare that to a potentially avoidable hospital visit, and it's the best money you'll ever spend.

Essential Testing

Blood glucose meter + strips (use our testing guide)
Ketone testing strips/meter
Thermometer
Backup batteries

Medication Backup

Extra diabetes medications (7-day supply)
Glucagon emergency kit
Natural support options from our supplement guide
Basic pain relief/fever reducers

Emergency Foods

Glucose tablets/gels (hypo treatment)
Clear soups/broths
Electrolyte solutions
Easy-to-digest carbs (crackers, toast)

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Frequently Asked Questions

These are the questions that come up time and time again. If you're wondering about something specific, chances are the answer's here.

Should I change my basal insulin dose when I'm ill?

I'm on an insulin pump and my glucose is stuck high - what should I do first?

I take an SGLT2 inhibitor - what's different when I'm ill?

Can I take ibuprofen for fever and aches when I have diabetes?

My CGM and finger-prick readings don't match when I'm ill - which should I trust?

What vaccines should I get as someone with diabetes?

How long should I wait before restarting my paused medications?

What if I can't afford blood ketone strips?

Should I exercise when I'm ill to help lower my blood sugar?

My child has diabetes and keeps getting sick at school - what should I tell the teachers?

Should I stop my diabetes medications when I'm sick?

When should I go to hospital?

Still Have Questions?

Every person with diabetes should have a personalised sick day management plan from their healthcare team. If you don't have one, or if these guidelines don't match what you've been told, it's time for a conversation with your diabetes specialist nurse or consultant.

NHS 111

For urgent advice

A&E / 999

If ketones ≥3.0 or very unwell

Your diabetes team

For personalised advice