Which patient education point is essential for sick day management in diabetes?

• A. Continue taking prescribed medications, monitor glucose and ketones, stay hydrated, and seek medical care if hyperglycemia or ketonuria persists.
• B. Stop taking all medications during illness
• C. Only monitor glucose if symptoms worsen
• D. Avoid fluids to limit electrolyte shifts

Answer: (A)

When you’re sick, your body releases stress hormones that raise blood glucose and can lead to dehydration. The essential point for sick day management is to continue prescribed diabetes medications, monitor glucose and ketones, stay hydrated, and seek medical care if hyperglycemia or ketonuria persists.

Keeping medications going, especially insulin or other diabetes meds, helps prevent dangerous high glucose and ketone buildup. Checking glucose regularly (and checking ketones when glucose is high or you’re ill) lets you know if you need to adjust doses as advised by your clinician. Staying hydrated supports your kidneys and makes glucose management easier, while dehydration can worsen high readings and ketone production. If readings stay high or ketones remain present despite fluids and medications, or if you can’t keep fluids down, seek medical care promptly.

This approach contrasts with stopping all meds, which can trigger severe high glucose or DKA, relying only on symptoms to monitor glucose, which can miss non-obvious high readings, or avoiding fluids, which worsens dehydration and glucose control.